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和形态特征。鉴于 PET 能够在相同肿瘤没有 CT 相关性的情况下定位恶性肿瘤，PET/CT 引导活检有助于提高肝脏病变活检的诊断率。然而，在当前实践中，即使来自混合 PET/CT 机器的 PET 图像的诊断效果也受到呼吸运动伪影的严重影响。 CT 数据采集速度快，代表呼吸周期中相对瞬时的快照。相比之下，PET 数据采集通常需要至少一分钟的时间 最新的扫描仪，但每个龙门台位置通常需要长达五分钟的时间。这些长时间的采集会导致 PET 图像中出现呼吸运动伪影，这在下肺野和肝脏中尤其明显。这些伪影导致 CT 和 PET 数据之间的空间对应差异，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 引导肝脏病变活检方法需要强大的呼吸运动校正技术。该项目的总体目标是通过将呼吸补偿 PET/CT 与介入 CT 套件中的 CT 图像融合，提高肝脏病灶活检的临床效果。在第一阶段，我们开发了一种运动补偿技术，该技术使用相位匹配的呼吸门控 PET 和 CT 数据来生成无运动的高质量 PET 和 CT 图像。该方法被证明可以生成高质量、无运动的 PET 图像。使用模拟 PET 和 CT 模型数据对其进行了验证。该方法已集成到我们的开源图像引导手术软件工具包（IGSTK）中。此外，我们还扩展了该工具包处理 PET 图像数据并生成临床有效的融合 PET/CT 可视化的能力。然后，我们通过将这些方法集成到应用原型中，并使用它来靶向植入拟人模型中的 18 氟脱氧葡萄糖 (FDG) 填充的球形小瓶，证明了这些方法的可行性。在第二阶段的工作中，我们建议通过以下方式展示这些技术的临床实用性：1）使用患者数据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 成像在可疑病变的早期检测、分期和评估中发挥着关键作用。 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和形态特征。通过融合这两种成像技术并结合先进的图像配准和呼吸运动补偿技术，临床医生可以更有效地对肝脏病变进行活检，从而改善癌症筛查和诊断。