A PET/CT scanner for guiding treatment of head and neck cancer

用于指导头颈癌治疗的 PET/CT 扫描仪

• 批准号: 10161756
• 负责人: RAYMOND ROBERT RAYLMAN
• 金额: $ 48.65万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-08 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10161756
• 关键词: Address; Algorithm Design; Algorithms; Anatomy; Area; Blinded; Carotid Arteries; Characteristics; Clinic; Clinical; Clinical Trials; Compton radiation; Computed Tomography Scanners; Computer software; Data; Detection; Development; Devices; Discipline of Nuclear Medicine; Dose; Effectiveness; Elements; Emission-Computed Tomography; Epidemic; Esophagus; Evaluation; Excision; Feedback; Formulation; Geometry; Goals; Head; Head and Neck Cancer; Head and Neck Squamous Cell Carcinoma; Head and Neck Surgery; Head and neck structure; Heterogeneity; High Resolution Computed Tomography; Histologic; Human; Human Papillomavirus; Image; Immersion; Infiltration; Intensity-Modulated Radiotherapy; Investigation; Location; Malignant Neoplasms; Maps; Metabolic; Methods; Microscopic; Modality; Morbidity - disease rate; Multimodal Imaging; Nature; Neoplasm Metastasis; Operative Surgical Procedures; Parotid Gland; Patient Schedules; Patients; Performance; Physiologic pulse; Planning Techniques; Positron-Emission Tomography; Primary Neoplasm; Privatization; Process; Production; Protocols documentation; ROC Curve; Radiation; Radiation Dose Unit; Radiation Oncology; Radiation therapy; Radiology Specialty; Radiology, Head, Neck; Recurrence; Resolution; Roentgen Rays; Role; Rotation; Salivary Glands; Scanning; Selection for Treatments; Slide; Source; Spinal Cord; Staging; Structure; Survival Rate; System; Technology; Test Result; Testing; Thyroid Gland; Tissues; Treatment Effectiveness; Underserved Population; Universities; Vendor; West Virginia; X-Ray Computed Tomography; anatomic imaging; base; bone; cone-beam computed tomography; cost; data acquisition; design; detection sensitivity; detector; draining lymph node; electron density; flexibility; head and neck cancer patient; high resolution imaging; image guided; image reconstruction; imaging Segmentation; imaging modality; imaging system; improved; industry partner; instrumentation; lymph nodes; multidisciplinary; novel; personalized medicine; pre-clinical; radiation detector; reconstruction; research clinical testing; treatment planning; treatment strategy; tumor; uptake

ABSTRACT/SUMMARY Head and neck carcinomas (HNC) are some of the most challenging cancers to effectively treat (five-year survival rates for some HNCs are as low as 25%); recurrence rates range from 8% to 43%. The number of new cases is rising due to the current, near epidemic of HPV-associated HNCs. Unfortunately, most treatments are associated with significant morbidity due to damage of sensitive structures in the region (spinal cord, salivary glands, parotid gland, esophagus, carotid arteries and thyroid gland). HNCs are treated with surgical excision, radiation therapy, or a combination of methods. Selection of therapy is based upon assessment of tumor location, size, proximity to bone, amount of infiltration into surrounding tissues and spread to regional lymph nodes performed with advanced imaging methods. Perhaps the most promising of these methods is metabolic-based imaging, specifically PET, often utilizing FDG. The non-optimal spatial resolution and fixed geometry of whole body scanners, however, limits PET in fulfilling its promise in this role by inhibiting the ability to accurately detect small tumor masses in lymph nodes, and in quantifying the size and nature of the primary tumor. Thus, there is an unmet need for improved PET/CT scanner technology to enhance treatment planning of HNCs. To address this opportunity, we propose the creation and testing of a lower-cost, flexible geometry, high-resolution PET/CT system (approaching the spatial resolution of pre-clinical PET scanners), called HNPET/CT, designed specifically for the imaging of the head and neck region. It will consist of a novel pair of large area, immersion-cooled, PET detectors and a cone beam CT (CBCT) scanner mounted on a rotating gantry whose geometry can be tailored to patient size and anatomy to be scanned. To capitalize on HNPET/CT’s high-resolution images, an image segmentation method that utilizes both CBCT and PET images will be developed and tested. We plan to explore the potential utility of HNPET/CT for enhancing therapy planning (surgical and radiation). This assessment will first be performed with anthropomorphic phantoms and then in a limited human trial. In addition to the novel detector design and adjustable geometry, HNPET/CT will introduce a new capability to the treatment planning of HNCs not yet broadly employed by end users in the clinical. It could enhance current planning techniques (reduce treatment margin size, for example), enable the effective application of advanced methods (dose painting, for example), and perhaps inspire development of new, more effective personalized treatment strategies that require high resolution, multi-modality imaging. The lower cost of the system promises the introduction of cutting-edge, image-guided treatments to under-served populations in areas treated by small or private clinics that often cannot afford such technology. This project will be performed by a multi-disciplinary academic industrial partnership joining the Departments of Radiology, Head and Neck Surgery and Radiation Oncology at West Virginia University, and Xoran Technologies, LLC.

摘要/摘要 头颈癌（HNC）是有效治疗的最挑战的癌症（五年） 某些HNC的存活率高达25％）；复发率在8％至43％之间。数量 由于当前的HPV相关HNC流行，新病例正在增加。不幸的是，大多数治疗方法 由于该地区敏感结构的损害，与明显的发病率有关（脊髓， 唾液腺，腮腺，食管，颈动脉和甲状腺）。 HNC通过手术治疗 切除，放射疗法或方法组合。治疗的选择是基于评估 肿瘤的位置，大小，靠近骨头，浸润到周围组织中并扩散到区域 使用高级成像方法进行的淋巴结。这些方法中最有希望的是 通常使用FDG的基于代谢的成像，特别是PET。非最佳空间分辨率和固定 但是，整个身体扫描仪的几何形状通过抑制能力来限制宠物在这一角色中实现其承诺 准确检测淋巴结中的小肿瘤质量，并在量化主要的大小和性质时 瘤。这是没有满足的需要改进的PET/CT扫描仪技术来增强治疗计划的需求 HNCS。为了解决这个机会，我们提出了低成本，灵活的几何形状的创建和测试， 高分辨率宠物/CT系统（接近临床前宠物扫描仪的空间分辨率），称为 HNPET/CT，专为头颈区域的成像设计。它将由一对新颖 大面积，沉浸冷却，宠物探测器和圆锥形束CT（CBCT）扫描仪安装在旋转 可以根据患者的大小和解剖结构来量身定制其几何形状的龙门。大写 HNPET/CT的高分辨率图像，一种使用CBCT和PET图像的图像分割方法 将开发和测试。我们计划探索HNPET/CT对增强治疗的潜在效用 计划（手术和辐射）。该评估将首先通过拟人化幻影和 然后在有限的人类审判中。除了新颖的检测器设计和可调节的几何形状外，HNPET/CT还将 引入新的功能，以针对HNC的治疗计划，尚未由最终用户广泛雇用 临床。它可以增强当前的计划技术（例如，减少治疗余量的规模），使 有效应用高级方法（例如剂量绘画），并可能激发发展的发展 需要高分辨率，多模式成像的新的，更有效的个性化治疗策略。 系统的较低成本承诺将尖端的图像引导处理引入服务不足 小型或私人诊所治疗的地区通常无法负担此类技术。这个项目 将由多学科的学术工业伙伴关系来执行，加入放射学部门， 西弗吉尼亚大学的头部和颈部手术和辐射肿瘤学和Xoran Technologies，LLC。