NA-MIC virtual colonoscopy

描述（由申请人提供）：本提案是根据通知编号（NOT-OD-09-058）和通知标题：NIH宣布恢复法案资金可用于竞争性修订申请而提交的。 结肠癌是美国男性和女性癌症死亡的第二大原因，如果发现并切除结肠前病变，结肠癌是可以预防的。虚拟结肠镜检查（VC），也被称为计算机断层结肠成像（CTC），最近在新的指南中被认可为结直肠癌筛查的可行选择。非泻药CTC（ncCTC）是一种新兴的技术，用于从当前CTC中使用的肠道准备中消除严格的泻药清洁。电子清洁（EC）是一种用于去除CTC图像中对比度增强的粪便物质的技术，在图像采集后有效地清洁结肠以可视化整个结肠粘膜。 计算机辅助检测（CAD）可以自动检测CTC图像中的息肉，具有高灵敏度和特异性检测息肉的潜力，并提高放射科医生的息肉检测性能。 母项目的目标是为ncCTC开发和验证新的EC和CAD方案，并将其作为计算模块集成到国家医学成像计算联盟（NA-MIC）工具包中，从而开发NA-MIC VC系统。自提交和审查母提案以来，在反恐领域取得了两项重要进展。一个是双能量和高清晰度（高分辨率）CT扫描仪在临床实践中的广泛应用。二是认识到非息肉样病变的频繁发生及其在结肠癌筛查中的临床意义。 因此，本提案的短期目标是开发和评价（1）用于非泻药双能量CTC的无伪影EC方案，该方案将有效清除接受非泻药肠道准备检查并使用双能量CT扫描仪成像的患者的CTC图像中结肠中的残留粪便物质，以及（2）用于检测CTC中平坦病变的新型高分辨率CAD方案。与母赠款类似，它们将被纳入NA-MIC工具包，以开发一个先进的NA-MIC VC解释系统。我们假设先进的NA-MIC VC系统将允许结肠粘膜表面的无伪影可视化，并提高放射科医生在ncCTC中检测非息肉样病变的性能。为了探索这些假设，我们提出了以下具体目标： 具体目标一：发展双能源电子商务方案。具体目标2：开发用于检测非息肉样病变的高分辨率CAD方案。具体目标3：评估双能源EC和CAD方案的性能和效益。先进的NA-MIC VC系统的成功开发将提供一个复杂的平台，包括VC研究的工具，以及VC解释系统，可以有效地用于临床试验。这样的风险投资平台将鼓励新的研究工作，并为研究合作提供动力。该系统还具有提供基于CT的息肉样和非息肉样病变的结肠直肠筛查方案的潜力，该方案对患者来说是高度可接受的并且是高度准确的。这样的VC系统将显著推进基于CT的结肠癌筛查的临床实施，促进结肠癌的早期诊断，最终降低结肠癌的死亡率 癌 公共卫生相关性：高分辨率CAD的成功开发将大大扩展NA-MIC VC系统，提供一个由VC研究工具组成的复杂平台，以及一个可有效用于临床试验的VC系统。这样的风险投资平台将鼓励新的研究工作，并为研究合作提供动力。该系统还具有提供基于CT的非息肉样病变检测方案的潜力，该方案对患者来说是高度可接受的并且高度准确。该VC系统将大大推进基于CT的结肠癌筛查的临床实施，促进结肠癌的早期诊断，最终降低结肠癌的死亡率。

DESCRIPTION (provided by applicant): This proposal is being submitted in response to Notice Number (NOT-OD-09-058) and Notice Title: NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications. Colon cancer, the second leading cause of cancer deaths for men and women in the United States, can be prevented if precursor colonic lesions are detected and removed. Virtual colonoscopy (VC), also known as computed tomographic colonography (CTC), Uhas been recently endorsed as a viable option for colorectal cancer screening in the new guideline. Non-cathartic CTC (ncCTC) is an emerging technique for eliminating rigorous cathartic cleansing from the bowel preparation used in current CTC. Electronic cleansing (EC) is a technique for removal of contrast-enhanced fecal materials in CTC images, effectively cleansing the colon after image acquisition to visualize the entire colonic mucosa. Computer-aided detection (CAD), which automatically detects polyps in CTC images, has the potential to detect polyps with high sensitivity and specificity, and to improve radiologists' polyp detection performance. The goals of the parent project was to develop and validate novel EC and CAD schemes for ncCTC, and to integrate them into the National Alliance of Medical Imaging Computing (NA-MIC) toolkit as computational modules, thereby developing a NA-MIC VC system. Since the time when the parent proposal was submitted and reviewed, two important advancements happened in the field of CTC. One is a wider availability of dual-energy and high-definition (high-resolution) CT scanners in clinical practice. The other is the recognition of the frequent occurrence of non-polypoid lesions and their clinical significance in colon cancer screening. Thus, the short-term goals of this proposal are to develop evaluate (1) an artifact-free EC scheme for non-cathartic dual energy CTC, which will effectively cleanse the residual fecal materials in the colon in CTC images of patients examined with non-cathartic bowel preparation and imaged with dual-energy CT scanner, and (2) a novel high-resolution CAD scheme for the detection of flat lesions in CTC. In a manner similar to the parent grant, they will be integrated into the NA-MIC toolkit to develop an advanced NA-MIC VC interpretation system. We hypothesize that the advanced NA-MIC VC system will allow artifact-free visualization of the mucosal surface of the colon, and improve radiologists' performance in the detection of non-polypoid lesions in ncCTC. To explore these hypotheses, we propose the following specific aims: Specific Aim 1: Develop dual-energy EC scheme. Specific Aim 2: Develop a high-resolution CAD scheme for the detection of non-polypoid lesions. Specific Aim 3: Validate the performance and benefit of the dual energy EC and CAD schemes. Successful development of the advanced NA-MIC VC system will provide a sophisticated platform consisting of tools for VC research as well as a VC interpretation system that can effectively be used for clinical trials. Such a VC platform will encourage new research efforts and provide impetus for research collaboration. The system also has the potential to provide a CT-based colorectal screening scheme of polypoid and non-polypoid lesions that will be highly acceptable to patients and highly accurate. Such a VC system will significantly advance the clinical implementation of CT-based colon cancer screening, promote the early diagnosis of colon cancer, and ultimately reduce the mortality due to colon cancer. PUBLIC HEALTH RELEVANCE: Successful development of the high-resolution CAD will substantially extend the NA-MIC VC system for providing a sophisticated platform consisting of tools for VC research as well as a VC system that can effectively be used for clinical trials. Such a VC platform will encourage new research efforts and provide impetus for research collaboration. The system also has the potential to provide a CT-based detection scheme of non-polypoid lesions that is highly acceptable to patients and highly accurate. Such a VC system will significantly advance the clinical implementation of CT-based colon cancer screening, promote the early diagnosis of colon cancer, and ultimately reduce the mortality due to colon cancer.