Digital Specimen Tomosynthesis for Volumetric Imaging of Lumpectomy Specimens

描述(由申请人提供)：该项目的目标是开发一种基于临床标本放射成像(SR)系统的数字标本断层合成(DST)系统，用于对手术室内或附近的乳腺肿块切除标本进行快速、体积成像。尽管目前SR被用于外科阳性切缘评估、病理检查指导和其他临床/临床前应用，但由于缺乏关于SR图像中标本的体积信息，其应用受到限制。建议的DST可以产生关于标本的有用的体积信息，通过这些信息可以识别重叠的解剖结构，但只涉及对临床SR的最小修改。它可以在1-2分钟内完成成像任务，这是一个可以接受的临床时间，用于快速评估标本以确定手术室内和附近的阳性边缘，从而减少手术后确定阳性边缘和随后再次切除的频率。它还可以用于提高病理检查的准确性，方法是指导病理学家将重点放在标本中阳性概率最高的区域，从而通过减少 因次优抽样而漏掉阳性区域的发生率。由于在DST成像中收集了多个SR图像，包括当前临床评估中使用的图像，因此DST保留了当前SR的全部功能，并且不会改变手术室的工作流程，而只是提高从成像获得的信息的质量，从而改进决策。由于DST是基于广泛用于乳房手术的廉价SR系统而设计的，因此它提供了一种经济、实用且易于传播的解决方案。在该项目中获得的知识可用于设计和开发先进的、特定用途的新兴X射线断层成像系统，用于图像引导手术和放射治疗，以及肢体成像。该项目的具体目标是(1)开发用于肿块切除标本的快速、体积成像的DST；(2)开发实现肿块切除标本的DST成像的算法；以及(3)评估DST扫描配置/算法的性能。

DESCRIPTION (provided by applicant): The objective of the project is to develop a digital specimen tomosynthesis (DST) system, based upon the clinical specimen radiography (SR) system for performing rapid, volumetric imaging of breast lumpectomy specimen in or near a surgical suite. Even though SR is used currently for surgical positive-margin evaluation, pathological examination guidance, and other clinical/preclinical applications, its utility is limied by the lack of volumetric information about specimens in SR images. The proposed DST can yield useful volumetric information about the specimen by virtue of which overlapping anatomic structures can be discerned, yet involving only minimal modifications to clinical SR. It can accomplish the imaging task within 1-2 minutes, an acceptable clinical time for a rapid evaluation of the specimen in identifying positive margins in and near an operating suite, thus reducing the frequency of positive margins being identified, and of consequent re- excisions, post surgically. It can also be used for improving accuracy in pathologic examinations by providing guidance to the pathologist to focus on regions in the specimen with the highest probability of positivity, thus increasing the sensitivity of the pathology process by reducing the incidence of missed positive regions due to suboptimal sampling. Because multiple SR images, including the ones used in current clinic evaluation, are collected in DST imaging, the DST thus retains the full functionality of current SR, and would not alter the workflow in the operating room, but only enhance the quality of information obtained from imaging, leading to improved decision making. Because the DST is designed based upon an inexpensive SR system that is used widely in breast-surgery suites, it provides an economical, practical solution which can readily be disseminated. Knowledge gained in the project can be exploited for the design and development of advanced, application- specific emerging X-ray-based tomographic imaging systems in image-guided surgery and radiation therapy, and in extremity imaging. The specific aims of the project are (1) to develop DST for rapid, volumetric imaging of lumpectomy specimen; (2) to develop algorithms for enabling DST imaging of lumpectomy specimen; and (3) to evaluate the performance of DST-scan configurations/algorithms.