This revised application is responsive to PAR-08-147 (reissue of PAR-06-293), """"""""Quick-Trials for Imaging and Image-Guided Interventions: Exploratory Grants (R21)"""""""". The proposed research is a feasibility study that is organ specific and is aimed at determining the ability of a dedicated breast computed tomography system (herein referred to as breast CT system) to visualize lesions. Superposition of breast structures in mammography may result in missed cancers due to 'masking'effect, or may mimic the presence of a lesion resulting in additional imaging or biopsy. Computed Tomographic (CT) Imaging of the breast can overcome this superposition problem, and provide much improved contrast, thus improving detectability. Further, CT imaging of the breast can be performed with no physical compression of the breast, alleviating patient discomfort. It can provide for 3-D lesion morphology, which could serve as a diagnostic indicator, and for better quantitative assessment of breast glandular content, a likely risk factor for breast cancer. This research is to demonstrate that image quality improvements achieved with advanced image processing approaches could improve lesion visualization and provide for better delineation of its margins, using a three-dimensional (3-D) breast imaging system with isotropic voxel size. Improved visualization of lesions and its margins would improve the confidence to determine malignancy and could potentially improve detection. Determination of lesion margins and lesion volume are also necessary for surgical planning and for accurate monitoring and early determination of the effectiveness of therapeutic agents and methods. The research plan includes studies to determine the ability of the dedicated clinical prototype breast CT system to visualize lesions;to determine if the 3-D morphology provides for improved determination of malignancy;to determine if quantitative CT numbers can provide for improved confidence to determine malignancy;and to obtain volumetric estimates of breast density, a likely risk factor for breast cancer. The results from this study will allow us to better define the role of a dedicated 3-D cone-beam flat-panel CT system in breast cancer and will allow us to determine the effectiveness of image processing approaches for improved clinical image quality. A well- designed dedicated breast CT system with advanced image processing techniques can serve as a platform technology for screening and diagnostic imaging, implant imaging, 3-D presurgical planning, monitoring preoperative treatment, and guidance in minimally invasive surgery.

Public Health Relevance

Volumetric 3-D imaging with a dedicated breast CT system has the potential to be an effective tool for monitoring therapeutic treatments and can overcome the tissue superposition problem in mammography, which results in missed cancers and unnecessary recall of the patient for additional imaging. In this research, we propose to conduct a clinical feasibility study with a prototype breast CT system and develop and evaluate methods to improve contrast that could result in improved detection, diagnosis, and management of breast cancer.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21CA134128-01A2
Application #
7674447
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (51))
Program Officer
Farahani, Keyvan
Project Start
2009-07-16
Project End
2011-06-30
Budget Start
2009-07-16
Budget End
2010-06-30
Support Year
1
Fiscal Year
2009
Total Cost
$360,800
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
603847393
City
Worcester
State
MA
Country
United States
Zip Code
01655
O'Connell, Avice M; Karellas, Andrew; Vedantham, Srinivasan et al. (2018) Newer Technologies in Breast Cancer Imaging: Dedicated Cone-Beam Breast Computed Tomography. Semin Ultrasound CT MR 39:106-113
Shi, Linxi; Vedantham, Srinivasan; Karellas, Andrew et al. (2018) The role of off-focus radiation in scatter correction for dedicated cone beam breast CT. Med Phys 45:191-201
Shi, Linxi; Vedantham, Srinivasan; Karellas, Andrew et al. (2017) X-ray scatter correction for dedicated cone beam breast CT using a forward-projection model. Med Phys 44:2312-2320
Shi, Linxi; Vedantham, Srinivasan; Karellas, Andrew et al. (2016) Library based x-ray scatter correction for dedicated cone beam breast CT. Med Phys 43:4529
Vedantham, Srinivasan; Shi, Linxi; Karellas, Andrew (2014) Large-angle x-ray scatter in Talbot-Lau interferometry for breast imaging. Phys Med Biol 59:6387-400
O'Connell, Avice M; Karellas, Andrew; Vedantham, Srinivasan (2014) The potential role of dedicated 3D breast CT as a diagnostic tool: review and early clinical examples. Breast J 20:592-605
Makeev, Andrey; Glick, Stephen J (2013) Investigation of statistical iterative reconstruction for dedicated breast CT. Med Phys 40:081904
Vedantham, Srinivasan; Shi, Linxi; Glick, Stephen J et al. (2013) Scaling-law for the energy dependence of anatomic power spectrum in dedicated breast CT. Med Phys 40:011901
Vedantham, Srinivasan; Karellas, Andrew (2013) X-ray phase contrast imaging of the breast: analysis of tissue simulating materials. Med Phys 40:041906
Vedantham, Srinivasan; Shi, Linxi; Karellas, Andrew et al. (2013) Personalized estimates of radiation dose from dedicated breast CT in a diagnostic population and comparison with diagnostic mammography. Phys Med Biol 58:7921-36

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