Cardiac SPECT w/Rotating Slant Hole Collimator

描述（由申请人提供）：这项竞争性更新资助申请旨在将一种比传统SPECT具有实质性优势的新型3D SPECT成像技术引入全面的临床实施和评估，以改进心肌灌注（MP） SPECT中心肌缺陷的检测和门控MP SPECT中局部壁运动异常的检测。新的三维SPECT成像技术是基于一种独特的旋转多段斜孔（RMSSH）准直器，与传统的平行孔准直器相比，具有更高的检测效率，具有相同的分辨率（例如，4段3次）。它需要简单的数据采集配置来实现无伪影的全三维图像重建，并且与传统的SPECT成像技术相比，可以提供更好的图像质量。在过去的2个资助期间，我们已经(1)开发了RMSSH SPECT的全3D分析和迭代图像重建方法，(2)开发了补偿方法，以提高RMSSH SPECT图像的质量和定量准确性，(3)使用逼真的模拟数据评估其在MP和乳房成像中的实用性，(4)设计并构建了通用的4段R4SSH准直器，(5)使用物理幻象评估其在MP和乳房成像中的应用。(6)在IRB批准的患者研究中对其在MP中的应用进行初步临床评估。特别值得一提的是，我们得到了一家大型医疗成像公司飞利浦医疗系统的大力支持，在我们的核医学诊所的最先进的优先级(R) SPECT/CT系统上实施了新颖的RMSSH SPECT成像技术。在项目的最后阶段，我们建议将项目重点放在MP和门控MP SPECT上，加快3年的研究计划。我们将与临床研究人员和行业合作伙伴密切合作，将创新的SPECT成像技术全面应用于临床。具体而言，我们将专注于旋转多段可变斜孔（RMSVSH）准直器设计，该设计提供更大的公共视野（CVOV），用于成像更大的心脏，并更容易定位患者。为了实现这一目标，我们提出(1)开发RMSVSH SPECT的全三维定量图像重建方法，(2)设计和制造针对MP SPECT成像优化的RMSVSH准直器，(3)开发最佳实现方法并使用真实模拟数据和基于任务的图像评估方法评估RMSVSH MP SPECT的性能，(4)使用实验幻影研究评估RMSVSH MP SPECT的性能。(6)评价RMSSH和RMSVSH SPECT在临床MP和门控SPECT中的应用。基于我们在前两轮所取得的实质性进展和进展，以及可行性研究和初步临床研究的令人信服的结果，建议项目具有很大的成功潜力。与公共卫生相关：我们建议将一种新型的三维SPECT成像技术引入临床，该技术比传统的SPECT有很大的优势，可以改善心肌灌注SPECT （MP）心肌缺损的检测和门控MP SPECT局部壁运动异常的检测。新的3D SPECT成像技术是基于一种独特的旋转多段斜孔（RMSSH）准直器，与传统的平行孔准直器相比，具有更高的检测效率，具有相同的分辨率（例如，4段3次）。鉴于该项目取得的实质性进展，以及可行性研究和初步临床研究的令人信服的结果，该项目具有很大的成功潜力。

DESCRIPTION (provided by applicant): This competitive renewal grant application aims to bring a novel 3D SPECT imaging technique that has substantial advantage over conventional SPECT to a full clinical implementation and evaluation for improved detection of myocardial defect in myocardial perfusion (MP) SPECT and regional wall motion abnormalities in gated MP SPECT. The novel 3D SPECT imaging technique is based on a unique rotating multi-segment slant- hole (RMSSH) collimator, which has much higher detection efficiency as compared to a conventional parallel- hole collimator with the same resolution (e.g., 3 times for 4-segments). It requires simple data acquisition configuration for artifact-free fully 3D image reconstruction and can provide substantially better image quality compared with conventional SPECT imaging techniques. During the last 2 grant funding periods, we have (1) developed fully 3D analytical and iterative image reconstruction methods for RMSSH SPECT, (2) developed compensation methods to improve the quality and quantitative accuracy of RMSSH SPECT images, (3) evaluated its utility in MP and breast imaging using realistic simulation data, (4) designed and constructed a general purpose 4-segment R4SSH collimator, (5) evaluated its application to MP and breast imaging using physical phantoms, and (6) conducted preliminary clinical evaluation of its application to MP in IRB approved patient studies. In particular, we have obtained strong support from a major medical imaging company, Philips Medical Systems, to implement the novel RMSSH SPECT imaging technique on a state-of-the-art Precedence(R) SPECT/CT system in our nuclear medicine clinic. In this final phase of the project, we propose to focus the project on MP and gated MP SPECT in an accelerated 3-year research program. We will work closely with our clinical investigators and industrial partner to bring the innovative SPECT imaging technique to a full clinical implementation. Specifically, we will concentrate our development on the rotating multi-segment variable slant-hole (RMSVSH) collimator design that provides a larger common-volume-of-view (CVOV) for imaging larger hearts and easier patient positioning. To achieve this goal, we propose (1) to develop fully 3D quantitative image reconstruction methods for RMSVSH SPECT, (2) to design and fabricate RMSVSH collimators that are optimized for MP SPECT imaging, (3) to develop optimum implementation methods and evaluate the performance of RMSVSH MP SPECT using realistic simulated data and task-based image evaluation methods, (4) to evaluate the performance of RMSVSH MP SPECT using experimental phantom studies, and (6) to evaluate the application of RMSSH and RMSVSH SPECT to clinical MP and gated SPECT. Based on the substantial progress and advances we have achieved in the previous 2 rounds, and the convincing results from feasibility studies and preliminary clinical studies, the proposed project has a great potential for success. PUBLIC HEALTH RELEVANCE: We propose to bring a novel three-dimensional SPECT imaging technique that has substantial advantage over conventional SPECT to a full clinical implementation and evaluation for improved detection of myocardial defect in myocardial perfusion (MP) SPECT and regional wall motion abnormalities in gated MP SPECT. The novel 3D SPECT imaging technique is based on a unique rotating multi-segment slant-hole (RMSSH) collimator, which has much higher detection efficiency as compared to a conventional parallel-hole collimator with the same resolution (e.g., 3 times for 4-segments). Based on substantial progress and advances, and convincing results from feasibility study and preliminary clinical study, the project has great potential for success.