High Performance, Quantitative Breast PET Scanner Integrated With Tomosynthesis

该项目的长期目标是测试和完善使用BPET-DBT作为联合注册的工具 分子和解剖成像，指导活检和提供个性化的乳腺癌治疗 病人。集成的BPET-DBT系统采集相同(轻度)压缩位置的PET数据 在DBT数据采集后立即，从而提供共同注册的分子和解剖学 图像，同时还允许轻松的患者工作流程。BPET扫描仪是一种专用的高空间 分辨率、飞行时间(TOF)乳腺PET扫描仪产生定量图像。DBT图像，在中 除了提供卓越的诊断解剖信息外，还提供了准确的结构 正电子发射计算机断层扫描图像的背景(对于根据正电子发射计算机断层扫描引导活检和/或手术入路是必要的 图像)和对PET数据执行精确衰减校正(AC)的手段。在这个项目中，我们 将使用设计用于测试的选定患者队列来评估这种新设备的临床应用 手术指导、监测治疗反应、组织取样、 从硬件和软件两个方面进一步增强了该装置的定量成像能力。 我们的目标是：(1)展示这一独特设备的成像能力和实用性，包括两个具体的 作为示范的临床情况(肿瘤的特征和边缘定义，以及残留的肿瘤 新辅助治疗后的测量)，(2)开发新的定量图像生成技术 并在临床研究中进行回顾和前瞻性评估，以及(3)DBT引导的试验 使用与DBT图像共同配准的图像集的PET部分进行活检以指导立体定向 活组织检查。AIMS 1和AIMS 3中的临床研究将：(I)表征肿瘤表型并确定肿瘤 18F-氟雌二醇(18F-FES)作为生物标志物的切缘与手术病理对照 和WB PET-CT测量SUV，(Ii)测量18F-脱氧葡萄糖(18F-FDG)摄取 接受新辅助化疗的患者术前小残留肿瘤的比较 BPET-DBT和全身PET-CT SUV检查术后的组织病理学结果，以及(Iii) 使用联合配准的18F-FeS BPET-DBT图像进行靶向乳腺活检。在目标2中，我们将：(I)评估 现有TOF重建算法在消除有限角度伪影方面的性能 在BPET图像中，(Ii)开发和评估新的BPET重建和AC方法，使用图像- 基于分辨率建模(IRM)和深度学习(DL)的直接PET图像处理方法 用于PET AC的稳健DBT图像的重建和生成，以及(Iii)开发和测试新高 高性能PET探测器作为现有BPET探测器的扩展，以改善图像。在最后 我们期望的研究已经证明了高分辨率的BPET-DBT扫描仪可以在 个性化乳腺癌治疗的未来。

The long-term objective of this project is to test and refine the use BPET-DBT as a tool for co-registered molecular and anatomic imaging to direct biopsy and deliver personalized breast cancer treatment to patients. The integrated BPET-DBT system acquires PET data in the same (mildly) compressed position immediately after the DBT data acquisition, thereby providing co-registered molecular and anatomical images while also allowing easy patient workflow. The BPET scanner is a dedicated, high spatial resolution, time-of-flight (TOF) breast PET scanner producing quantitative images. The DBT image, in addition to providing superior diagnostic anatomical information, also provides an accurate structural context to the PET image (necessary for guiding biopsy and/or surgical approach based on the PET image) and the means to perform accurate attenuation correction (AC) of the PET data. In this project we will evaluate clinical applications of this novel device using selected cohorts of patients designed to test efficacy of the combined device for surgical guidance, monitoring response to therapy, tissue sampling, and further enhancing the quantitative imaging capability of the device both in hardware and software. Our aims are to: (1) demonstrate imaging capability and utility of this unique device, with two specific clinical situations as demonstration (tumor characterization and margin definition, and residual tumor measurement after neo-adjuvant therapy), (2) develop new quantitative image generation techniques and to evaluate them both retroactively and prospectively in clinical studies, and (3) test DBT-guided biopsy using the PET portion of the image set co-registered to the DBT image to direct stereotactic biopsy. The clinical studies in Aims 1 and 3 will: (i) characterize tumor phenotype and determine tumor margins using 18F-fluoroestradiol (18F-FES) as the biomarker and compare to surgical pathology results and SUV measurements with WB PET-CT, (ii) measure 18F-fluorodeoxyglucose (18F-FDG) uptake in small residual tumor prior to surgery in patients undergoing neoadjuvant chemotherapy and compare BPET-DBT and whole-body PET-CT SUV to histopathology findings post-surgery, and (iii) perform targeted breast biopsy using co-registered 18F-FES BPET-DBT images. In Aim 2 we will: (i) evaluate the performance of the existing TOF reconstruction algorithm in mitigating the limited angle artifacts present in the BPET images, (ii) develop and evaluate new BPET reconstruction and AC methods using image- based resolution modeling (IRM) methods as well as Deep-Learning (DL) methods for direct PET image reconstruction and generation of robust DBT images for PET AC, and (iii) develop and test a new high performance PET detector as an extension to existing BPET detectors for improved images. At the end of the study we expect to have demonstrated the role a high resolution, BPET-DBT scanner can play in the future for personalized breast cancer treatment.