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

项目摘要/摘要 FDG全身PET/CT成像是一种检测原发癌和转移癌的成熟技术。它 对于许多类型的癌症分期、再分期和监测治疗反应，具有很高的准确性和价值 癌症。尽管它的成功和广泛的临床应用，仍然是一个尚未满足的临床挑战 检测远小于1厘米的微小转移癌。FDG PET/CT已被证明具有 检测这种小病变的灵敏度有限，在某些情况下不到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，它可以 改善临床PET/CT扫描仪的图像分辨率，以提高其图像分辨率，并提供变焦 在不影响其身体成像能力的情况下，在图像中使用。虽然这是一种独特的能力，但它并不是 用于临床全身癌症成像，因为远处转移的位置往往是未知的。 因此，在全身成像过程中，人们不会事先知道在哪里进行放大。如果 另一方面，人们需要首先扫描整个身体，然后选择一个高度不确定的区域进行放大- 这项技术将需要一个两步方案，这将显著减慢临床工作流程。 在这个项目中，我们形成了华盛顿大学医学院之间的双向合作伙伴关系 (WUSM)和西门子分子成像(西门子MI，诺克斯维尔，田纳西州)，以克服这一特定限制和 翻译一种原本新颖的成像技术，使其适合临床应用。我们将共同发展和发展 通过放大PET(AWSM-PET)技术验证增强的全身扫描将增强 PET扫描仪的本机图像分辨率，与临床全身癌症成像完全兼容 申请。添加的设备不会减慢临床工作流程，因为放大的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……里面 除了标准的(原生)PET/CT图像外，AWSM-PET还将提供第二套PET图像 更高的分辨率和计数统计，无需额外的扫描时间。这个信息丰富的第二个数据集是 以期进一步提高PET/CT全身显像对脑出血的诊断准确率 转移性癌。 在这个项目完成后，我们将开发和验证一种新的能力，可以改善 临床全身PET/CT扫描仪的图像分辨率和计数统计。如果初选的结果 人体成像试验显示，使用完整的- 配备了AWSM-PET技术的身体PET/CT，我们将寻求额外的资金来进行多 中心临床试验，充分量化AWSM-PET技术在诊断准确性方面的改进 检测转移性癌症。这项新的活体成像技术的成功将解决一个尚未满足的问题 标准护理全身PET/CT在检测小转移癌中的挑战。WUSM 与西门子MI的合作将加快AWSM-PET技术在核能领域向最终用户的交付 世界各地的医学和放射诊所。因此，拟议的技术开发将具有非常重要的意义 以及对依赖全身PET/CT成像进行准确诊断和优化的患者的广泛影响 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.