Cardiac SPECT w/Rotating Slant Hole Collimator

描述（由申请人提供）：该竞争性更新资助申请旨在将一种新型3D SPECT成像技术引入全面临床实施和评价，该技术与传统SPECT相比具有显著优势，可改善心肌灌注（MP）SPECT中心肌缺损的检测和门控MP SPECT中局部室壁运动异常的检测。新颖的3D SPECT成像技术基于独特的旋转多段斜孔（RMSSH）准直器，其与具有相同分辨率的常规平行孔准直器相比具有高得多的检测效率（例如，3次为4段）。它需要简单的数据采集配置，用于无伪影的完全3D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个资助期内，我们（1）开发了用于RMSSH SPECT的完全三维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）使用真实模拟数据评估其在MP和乳腺成像中的实用性，（4）设计并构建了通用4段R4 SSH准直器，（5）使用物理体模评价其在MP和乳腺成像中的应用，以及（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价。特别是，我们得到了一家主要的医学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Precedence（R）SPECT/CT系统上实施新的RMSSH SPECT成像技术。在该项目的最后阶段，我们建议在加速的3年研究计划中将项目重点放在MP和门控MP SPECT上。我们将与临床研究人员和工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。具体来说，我们将集中我们的发展旋转多段可变斜孔（RMSVSH）准直器的设计，提供了一个更大的共同体积的视图（CVOV）成像更大的心脏和更容易的病人定位。为了实现这一目标，我们建议（1）开发RMSVSH SPECT的全3D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）开发最佳实施方法并评估RMSVSH MP SPECT的性能使用真实的模拟数据和基于任务的图像评估方法，（4）使用实验体模研究评价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。基于我们在前两轮中取得的实质性进展和进步，以及可行性研究和初步临床研究的令人信服的结果，拟议项目具有巨大的成功潜力。公共卫生相关性：我们提出了一种新的三维SPECT成像技术，具有实质性的优势，比传统的SPECT的全面的临床实施和评价，以改善心肌灌注（MP）SPECT和局部室壁运动异常的心肌缺损的检测门控MP SPECT。新颖的3D SPECT成像技术基于独特的旋转多段斜孔（RMSSH）准直器，其与具有相同分辨率的常规平行孔准直器（例如，3次为4段）。基于实质性的进展和进步，以及可行性研究和初步临床研究的令人信服的结果，该项目具有巨大的成功潜力。

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.