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Research Grants Awarded
Molecular Imaging of Breast Cancer with breast PET/CT
The standard method for diagnosis and local staging in breast cancer is mammography, which is credited with a significant reduction in breast cancer mortality, but its diagnostic accuracy is not ideal and it does not give functional information on disease state. Whole-body PET/CT addresses these issues and is a very effective tool in the management of metastatic breast cancer, but for local disease it is limited by poor spatial resolution and geometric sensitivity. To address this, we are close to completing a dedicated PET/CT scanner that rotates around the pendant breast. Our high-resolution detectors are close to the breast, increasing geometric sensitivity. Key applications for this technology are: staging of women who are known or are suspected to have breast cancer, follow-up for patients undergoing breast-conserving therapy, monitoring of neoadjuvant therapy and facilitating the study of new biomarkers for breast cancer. We hypothesize that: (1) upgrading the PET system electronics will quadruple count-rate capability, which will improve achievable accuracy, precision and spatial resolution; (2) further gains may be achieved by incorporating CT image-based priors in a Bayesian reconstruction framework for the PET data, and (3) this optimized device will significantly out-perform whole-body PET/CT in human response-to-therapy studies. We will: (1) implement custom PET electronics developed by our collaborators from commercial designs; (2) optimize energy window width, randoms treatment and implement scatter correction; (3) modify our Bayesian reconstruction to incorporate CT priors; (4) optimize reconstruction parameters using phantoms and (5) compare performance with a whole-body device using phantoms and human studies. This device offers a chance to study breast cancer and the effects of therapy in a way that currently does not exist. Advanced cancer imaging is a high priority for the NCI and we believe that this system will prove to be an important tool in future breast cancer research and care.
The standard method for diagnosis and initial staging in breast cancer is mammography, which has significantly reduced breast cancer mortality. However, it can have problems with dense tissue and does not directly measure cancerous tissue activity. PET/CT scanning does not suffer from these limitations and has proved very effective in the management of metastatic breast cancer. However, in local disease it is limited because the detectors are far away from the breast tissue and are not optimized for imaging objects as small as the breast. We are close to completing a dedicated high-resolution breast PET/CT scanner that solves these problems while avoiding breast compression. Key applications for this technology are: staging of women who are known or are suspected to have breast cancer, follow-up for patients undergoing breast-conserving therapy, monitoring of neoadjuvant therapy and facilitating the study of new biomarkers for breast cancer. We believe we can improve the performance of the PET part of this system by more than a factor of four by upgrading the electronics, by optimizing the data acquisition and by letting the CT images mathematically guide the formation of the PET images. We believe that the resulting system will significantly out-perform conventional whole-body PET/CT in human imaging. Our collaborators have built fast electronics for PET scanners that they will help us implement. We have good experience in optimizing scanner performance using test objects. We will use known mathematical techniques to combine the PET and CT data in the PET reconstruction. When this work is finished we will compare the performance of our scanner with a whole body scanner by imaging patients undergoing neoadjuvant chemotherapy before surgery. This device offers a chance to study breast cancer and the effects of therapy in a way that currently does not exist. We believe that this system will prove to be an important tool in future breast cancer research and care. We will make our system available to other Susan G. Komen-funded investigators on a recharge basis.