DUAL-ENERGY CONTRAST-ENHANCED DIGITAL SUBSTRACTION M

描述（由申请人提供）：早期发现乳腺癌对患者预后至关重要。该项目的具体目的是演示使用SRL目前正在开发的专有准单色x射线源（QMS）技术的双能对比度增强数字减影乳房x光检查（DE-CEDSM）。使用宽带光源，DE-CEDSM已经被证明可以增强乳腺肿瘤，否则乳房x光检查是隐匿的。我们的合作者科罗拉多大学健康科学中心的John Lewin博士最近进行了一项很有希望的DE-CEDSM临床演示。使用优化的准单色辐射将显著提高灵敏度，使DE-CEDSM能够检测到较小的肿瘤，否则这些肿瘤会被乳腺组织和脂肪的变化所掩盖。SRL的QMS技术目前正在开发中，用于改善血管造影图像。在这个第一阶段的项目中，我们将量化与Lewin博士演示的宽带光源相比，使用QMS进行乳房x光检查所能达到的图像质量改善和剂量减少。初步计算表明，随着辐射剂量要求降低一半，组织特征的抑制（该技术的一个关键特征）也得到改善，改进应该是显著的。在第一阶段项目成功之后，第二阶段的工作将集中在构建和测试一个集成了QMS和全领域数字乳房x光检查系统的原型。这项技术将允许使用工业标准碘造影剂进行连续的实时减影增强乳房x光检查。对比剂可以在乳房压缩之前施用，允许乳房组织充分灌注。双能量方法将允许从多个角度观察可疑病变，以及测量造影剂吸收和分散随时间的变化。对比密度的测量可以绝对校准，为放射科医生提供额外的诊断信息。

DESCRIPTION (provided by applicant): Early detection of breast cancer is critical to patient outcome. The specific aim of this program is to demonstrate dual-energy contrast-enhanced digital subtraction mammography (DE-CEDSM) using a proprietary quasi-monochromatic x-ray source (QMS) technology currently under development at SRL. Using a broadband source, DE-CEDSM has already been demonstrated to enhance breast tumors that are otherwise mammographically occult. A promising clinical demonstration of DE-CEDSM has been recently performed by our collaborator Dr. John Lewin of the University of Colorado Health Sciences Center. The use of optimized quasi-monochromatic radiation will significantly improve the sensitivity such that DE-CEDSM will be able to detect smaller tumors that would otherwise be masked by tissue and fat variations in the breast. SRL's QMS technology is currently under development for improving angiographic images. In this Phase I project, we will quantify the improvements in image quality and reduction of dose that can be achieved by using a QMS for mammography as compared to using a broadband source as has been demonstrated by Dr. Lewin. Preliminary calculations show that the improvements should be significant with the radiation dose requirement dropping by half and suppression of tissue features, a critical feature of the technique, improving as well. Following a successful Phase I program, the Phase II effort will concentrate on building and testing a prototype that integrates a QMS with a full-field digital mammography system. This technology will allow for successive real-time subtracted contrast-enhanced mammograms using industry standard iodinated contrast agents. Contrast agent can be administered prior to breast compression, allowing for adequate perfusion of breast tissue. The dual-energy method will allow for viewing suspected lesions from multiple angles as well as for measuring contrast uptake and dispersion over time. Measurements of contrast density can be absolutely calibrated, giving additional diagnostic information to the radiologist.