Translation of virtual-pinhole magnifying PET technology to clinical whole-body cancer imaging

项目总结/摘要 FDG全身PET/CT成像是检测原发性和转移性癌症的成熟技术。它 对于癌症分期、再分期和监测对多种类型治疗反应是高度准确和有价值的 癌症。尽管它的成功和广泛的临床效用，仍然存在未满足的临床挑战， 检测远小于1 cm的小转移癌。FDG PET/CT已被证明具有 检测这种小病变的灵敏度有限，在某些情况下小于50%的时间。 我们开发了一种新的成像技术，称为虚拟针孔放大PET技术， 提高临床PET/CT扫描仪的图像分辨率，以提高其图像分辨率并提供缩放- 而不影响其身体成像能力。虽然这是一种独特的能力，但它并没有被 因为远处转移的位置通常是未知的，所以被用于临床全身癌症成像。 因此，人们将不具有关于在全身成像协议期间在哪里放大的先验知识。如果 另一方面，需要首先扫描整个身体，然后选择高度不确定性的区域进行缩放， 该技术将需要两步协议，这将显著减慢临床工作流程。 在这个项目中，我们与华盛顿大学医学院建立了双向合作关系， （WUSM）和Siemens Molecular Imaging（Siemens MI，诺克斯维尔，TN）来克服这种特定的限制， 将其他新颖的成像技术转化为适用于临床应用。我们将共同开发和 验证通过放大PET（AWSM-PET）增强全身扫描技术， PET扫描仪的原始成像分辨率，并与临床全身癌症成像完全兼容 应用.增加的设备不会减慢临床工作流程，因为放大PET数据将 当患者接受全身PET/CT扫描时，与标准PET数据同时采集。在 除了标准（原生）PET/CT图像外，AWSM-PET还将提供第二组PET图像， 更高的分辨率和计数统计，而无需额外的扫描时间。这个信息丰富的第二个数据集是 预计将进一步提高全身PET/CT成像的诊断准确性，用于检测 转移性癌症 在这个项目完成后，我们将开发和验证一个新的能力，可以提高 临床全身PET/CT扫描仪的图像分辨率和计数统计。如果最初的结果 人体成像试验显示使用全- 身体PET/CT配备AWSM-PET技术，我们将寻求额外的资金进行多， 中心临床试验，以充分量化AWSM-PET技术对诊断准确性的改善， 转移性癌症的检测。这种新的体内成像技术的成功将解决一个未满足的问题。 标准治疗全身PET/CT在检测小转移性癌症方面的挑战。WUSM 与西门子MI的合作将加速AWSM-PET技术向核电终端用户的交付。 全世界的医学和放射学诊所。因此，提出的技术发展将具有非常重要的意义 对依赖全身PET/CT成像进行准确诊断和优化的患者产生广泛影响 管理他们的疾病。

Project Summary / Abstract FDG whole-body PET/CT imaging is a proven technique for the detection of primary and metastatic cancers. It is highly accurate and valuate for cancer staging, re-staging, and monitoring response to therapy for many types of cancers. Despite its success and broad clinical utility, there remains an unmet clinical challenge for the detection of small metastatic cancers that are much smaller than 1 cm. FDG PET/CT has been shown to have limited sensitivity for the detection of such small lesions, in some cases less than 50% of the time. We have developed a novel imaging technology called virtual-pinhole magnifying PET technology that can improve the image resolution of clinical PET/CT scanner to enhance its image resolution and to provide zoom- in images without compromising its body imaging capability. While this is a unique capability, it has not been adopted for clinical whole-body cancer imaging because the location of distant metastasis is often unknown. Therefore, one would not have prior knowledge on where to zoom-in during a whole-body imaging protocol. If on the other hand, one needs to scan the entire body first and then chooses a region of high uncertainty to zoom- in; this technology will require a two-step protocol which will significantly slow down clinical workflow. In this project, we formed a bi-directional partnership between the Washington University School of Medicine (WUSM) and Siemens Molecular Imaging (Siemens MI, Knoxville, TN) to overcome this specific limitation and translate an otherwise novel imaging technology to be suitable for clinical utility. We will jointly develop and validate the Augmented Whole-body Scanning via Magnifying PET (AWSM-PET) technology that will enhance the native image resolution of a PET scanner and is fully compatible with clinical whole-body cancer imaging applications. The added device will not slowdown clinical workflow because the magnifying PET data will be acquired simultaneously with the standard PET data when a patient undergoes a whole-body PET/CT scan. In addition to the standard (native) PET/CT images, AWSM-PET will provide a second set of PET images with higher resolution and counting statistics without additional scan time. This information-rich second data set is expected to further improve the diagnostic accuracy of whole-body PET/CT imaging for the detection of metastatic cancer. Upon completion of this project, we will have developed and validated a new capability that can improve the image resolution and counting statistics of a clinical whole-body PET/CT scanner. If the results of the initial human imaging trial show improvement in diagnostic sensitivity for metastatic cancer detection using a whole- body PET/CT equipped with the AWSM-PET technology, we will seek additional funding to conduct a multi- center clinical trial to fully quantify the improvement in diagnostic accuracy by AWSM-PET technology for the detection of metastatic cancers. The success of this novel in vivo imaging technology will address an unmet challenge of the standard-of-care whole-body PET/CT in detecting small metastatic cancers. The WUSM and Siemens MI partnership will accelerate the delivery of the AWSM-PET technology to end users in nuclear medicine and radiology clinics worldwide. Thus the proposed technology development will have highly significant and broad impact on patients who rely on whole-body PET/CT imaging for accurate diagnosis and optimal management of their diseases.