Improving liver lesion biopsy in the CT suite through fusion with PET images

通过与 PET 图像融合改进 CT 套件中的肝脏病变活检

• 批准号: 8390856
• 负责人: Kevin R. Cleary
• 金额: $ 39.37万
• 依托单位: KITWARE, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-21 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8390856
• 关键词: Academic Medical Centers; Accounting; Affect; Algorithms; Anatomy; Biopsy; Breathing; Characteristics; Child; Clinical; Clinical Trials; Clinical effectiveness; Computer software; Data; Data Set; Development; Diagnosis; Diagnostic; Diagnostic Neoplasm Staging; Diffusion; Early Diagnosis; Electromagnetics; Evaluation; Feasibility Studies; Financial compensation; Goals; Human; Hybrids; Image; Image-Guided Surgery; Imagery; Imaging Techniques; Implant; Interventional radiology; Lead; Lesion; Liver; Liver parenchyma; Localized Malignant Neoplasm; Lung; Medical Imaging; Medical center; Metabolic; Methodology; Methods; Monitor; Morphologic artifacts; Motion; Needle biopsy procedure; Needles; Organ; PET/CT scan; Participant; Patients; Phase; Physicians; Play; Positioning Attribute; Positron-Emission Tomography; Procedures; Relative (related person); Research Personnel; Screening for cancer; Simulate; Slide; Small Business Technology Transfer Research; Staging; System; Techniques; Tumor stage; Universities; Vial device; Washington; Work; base; cancer diagnosis; data acquisition; experience; fluorodeoxyglucose; graphical user interface; image registration; imaging Segmentation; improved; liver biopsy; novel; open source; professor; prototype; radiologist; respiratory; tool; tumor; virtual

DESCRIPTION (provided by applicant): PET imaging provides information on functional or metabolic characteristics of tumors, whereas CT predominately assesses tumor's anatomical and morphological features. Given the ability of PET to localize malignancies in situations where the same tumors do not have a CT correlate, PET/CT guided biopsy helps to improve the diagnostic yield of liver lesion biopsies. However, the diagnostic benefit of PET images, even from hybrid PET/CT machines, is gravely affected by respiratory motion artifacts in current practice. CT data acquisition is rapid and represents a relatively instantaneous snapshot during the breathing cycle. In contrast, PET data acquisition typically requires at least one minute using the newest scanners, but often requires as long as five minutes per gantry table position. These prolonged acquisitions lead to respiratory motion artifacts in the PET images, which are particularly pronounced in the lower lung fields and in the liver. These artifacts cause discrepancies in the spatial correspondence between the CT and PET data, potentially leading to inaccurate tumor localization and incorrect tumor staging. Hence, the development of an effective PET-CT guided biopsy methodology for liver lesions requires a robust respiratory motion correction technique. The overall goal of this project is to improve the clinical effectiveness of liver lesion biopsy by fusing respiratory- compensated PET/CT with CT images in the interventional CT suite. During Phase I, we developed a motion compensation technique that uses phase-matched respiratory-gated PET and CT data to generate motion-free high quality PET and CT images. The method was shown to generate high-quality, motion-free PET images. It was validated using simulated PET and CT phantom data. The method was integrated into our open source image-guided surgery software toolkit (IGSTK). In addition, we extended the toolkit's ability to handle PET image data and generate clinically effective fused PET/CT visualization. We then demonstrated the feasibility of these methods by integrating them into an application prototype and using it to target 18Fluordeoxyglucose (FDG) filled spherical vials implanted in an anthropomorphic phantom. In this Phase II effort, we propose to demonstrate the clinical utility of these techniques by 1) refining and evaluating our respiratory motion-compensation technique using patient data; and 2) conducting a clinical trial feasibility study. PUBLIC HEALTH RELEVANCE: PET/CT imaging plays a key role in early detection, staging, and evaluation of suspicious lesions. PET imaging provides information on functional or metabolic characteristics of tumors, whereas CT predominately assesses the tumor's anatomical and morphological features. By fusing these two imaging techniques and incorporating advanced image registration and respiratory motion compensation techniques, clinicians can more effectively biopsy liver lesions, which would improve cancer screening and diagnosis.

描述（由申请人提供）：PET成像提供有关肿瘤功能或代谢特征的信息，而CT主要评估肿瘤的解剖学和形态学特征。鉴于PET在相同肿瘤没有CT相关的情况下将恶性肿瘤定位的能力，PET/CT引导的活检有助于提高肝脏病变活检的诊断产量。但是，在当前实践中，即使是从混合宠物/CT机器中，宠物图像的诊断益处也受到呼吸运动伪像的严重影响。 CT数据采集很快，代表了呼吸周期中相对瞬时的快照。相反，宠物数据采集通常需要至少一分钟 最新的扫描仪，但通常需要每个龙门桌的位置五分​​钟。这些延长的采集导致PET图像中的呼吸道运动伪影，在下肺场和肝脏中特别明显。这些伪像在CT和PET数据之间的空间对应关系中导致差异，这可能导致肿瘤定位不准确和肿瘤分期不正确。因此，开发有效的PET-CT指导性活检方法论，需要使用强大的呼吸运动校正技术。该项目的总体目标是通过在介入的CT套件中与CT图像融合呼吸道补偿PET/CT来提高肝病变活检的临床有效性。在第一阶段，我们开发了一种使用相匹配的呼吸门控PET和CT数据来生成无运动高质量PET和CT图像的运动补偿技术。该方法显示出产生高质量的无运动PET图像。使用模拟PET和CT幻影数据对其进行了验证。该方法已集成到我们的开源图像指导手术软件工具包（IGSTK）中。此外，我们扩展了工具包处理PET图像数据并生成临床有效的PET/CT可视化的能力。然后，我们通过将这些方法集成到应用程序原型中，并将其用于靶向植入拟人化幻影的填充的球形小瓶来证明这些方法的可行性。在这一第二阶段的工作中，我们建议通过1）使用患者数据来完善和评估我们的呼吸运动补偿技术； 2）进行临床试验可行性研究。 公共卫生相关性：PET/CT成像在对可疑病变的早期发现，分期和评估中起关键作用。 PET成像提供有关肿瘤功能或代谢特征的信息，而CT主要评估肿瘤的解剖学和形态学特征。通过融合这两种成像技术，并结合了高级图像登记和呼吸运动补偿技术，临床医生可以更有效地有效地进行活检肝病变，从而改善癌症筛查和诊断。