Dedicated breast PET and MRI for characterization of breast cancer and its response to therapy

项目摘要/摘要 这个学术-产业合作(AIP)项目的目标是展示专门的 乳腺正电子发射断层扫描(DBPET)对原发乳腺癌及其疗效的评价 新辅助化疗(NAC)。动态增强磁共振成像(DCE-MRI) 描述了肿瘤形态和血管对NAC的反应变化，DBPET提供了补充 有关肿瘤代谢的信息可以有力地预测早期的治疗反应 心理治疗。我们将这个项目集中在OncoVision的Mammi DBPET上，因为它提供了关键的组合 具有高空间分辨率和敏感度，能够准确绘制肿瘤内代谢变化的图谱 病灶较小，放射性示踪剂量仅为全身PET的一半。重要的是，这一新系统对PET进行了缩放 这项技术在早期(转移前)乳腺癌的治疗中在经济上和临床上都是可行的。AS I-SPY 2试验的成像先导(PI：Nola Hylton)，这是一项旨在确定新疗法的临床试验 对于乳腺癌，我们处于一个独特的位置来集成和测试FDG-DBPET的早期性能 治疗反应的标志物。作为学术和产业合作伙伴，加州大学旧金山分校和OncoVision将共同努力 开发一种用户友好且经济实惠的DBPET技术，可以轻松地应用于临床 大多数乳腺癌中心的工作流程。在具体目标1中，我们将开发软件功能以标准化 DBPET图像配准和量化，以准确量化治疗过程中的纵向变化。在……里面 具体目标2，我们将获取I-SPY 2患者子集治疗前后的FDG-DBPET图像 并临床评估肿瘤代谢指标(即优化的标准化摄取值，SUV)是否来自 DBPET可以作为病理完全应答的早期预测指标--与之比较，或者结合使用 使用DCE-MRI的功能性肿瘤体积(FTV)指标。我们将测试生物标记物的性能 使用Logistic回归预测模型对DBPET、SUV和组合SUV+FTV进行预测。我们还将探索 DBPET和DCE-MRI放射学特征与乳腺癌生物标志物的相关性研究 有预后价值的影像表现。此外，我们的前瞻性研究的DBPET数据将用于 评估在特定目标1中开发的软件能力。我们期望成功完成此目标 AIP项目，使Mammi DBPET能够在常规乳腺癌治疗中使用，并生产一套 与肿瘤生物学相关的成像生物标志物及其对治疗的反应变化。

PROJECT SUMMARY/ABSTRACT The objective of this academic-industrial partnership (AIP) project is to demonstrate the utility of dedicated breast positron emission tomography (dbPET) for characterizing primary breast cancers and their response to neoadjuvant chemotherapy (NAC). While dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) depicts changes in tumor morphology and vascularity in response to NAC, dbPET provides complementary information about tumor metabolism that can powerfully predict treatment response earlier in the course of therapy. We focus this project on MAMMI dbPET by OncoVision because it provides the crucial combination of high spatial resolution and sensitivity that can enable accurate intratumoral mapping of metabolic changes in small lesions with only half the radiotracer dose of whole-body PET. Importantly, this new system scales PET technology to be both economically and clinically feasible in the early (pre-metastatic) breast cancer setting. As the imaging lead (PI: Nola Hylton) of the I-SPY 2 TRIAL, a clinical trial designed to identify novel therapeutics for breast cancer, we are in a unique position to integrate and test the performance of FDG-dbPET as an early marker for treatment response. As academic-industrial partners, UCSF and OncoVision will work together to develop a user-friendly and cost-effective dbPET technology that can be easily adopted into the clinical workflow of most breast cancer centers. In Specific Aim 1, we will develop software capabilities to standardize dbPET image registration and quantification to accurately quantify longitudinal changes with treatment. In Specific Aim 2, we will acquire pre- and post-treatment FDG-dbPET images of a subset of I-SPY 2 patients and clinically evaluate whether tumor metabolic metrics (i.e., optimized standardized uptake values, SUV) from dbPET can act as early predictors of pathologic complete response — in comparison to, and in combination with, the functional tumor volume (FTV) metric from DCE-MRI. We will test the biomarker performance of dbPET SUV and combined SUV+FTV using logistic regression predictive models. We will also explore the association of dbPET and DCE-MRI radiomic features with breast cancer biomarkers in order to identify imaging features with prognostic value. In addition, our prospective study’s dbPET data will be used to evaluate the software capabilities developed in Specific Aim 1. We expect the successful completion of this AIP project to enable the use of MAMMI dbPET in routine breast cancer management and to produce a set of imaging biomarkers relevant to tumor biology and its change in response to treatment.