POSITRON EMISSION TOMOGRAPHY INCERVICAL CANCERGrant Number: 5R01CA085797-02PI Name: Miller, Tom R.

Abstract: Description (Verbatim from the Applicant’s Ab-stract): The overall goal of this project is improved radio-therapy treatment of patients with cervical cancer with use ofpositron emission tomography (PET). PET with F-18 fluoro-deoxyglucose (FDG) will be used to provide three-dimen-sional definition of the primary tumor volume and regionalspread of disease to more accurately administer brachyther-apy. PET-based prognostic indicators will be developed. Thefirst step will be verification of the ability of PET to accu-rately define tumor volume and to differentiate recurrent tu-mor from radiation-induced inflammation. Tumor size andextent of disease will be correlated with the results of mag-netic resonance imaging in patients receiving radiotherapywith evaluation of FDG uptake before, during and after ra-diotherapy. Techniques will be developed to accurately de-termine the position of the brachytherapy applicator in rela-tion to the tumor volume. FDG-PET images showing theprimary tumor and regional spread of disease will be spa-tially registered with the position of the brachytherapy appli-cator after placement of the applicator in the patient, thuspermitting modification of the source loading in the future tooptimize the dose to the tumor while minimizing radiation ofthe adjacent normal structures. The dose to the tumor andnormal structures will be evaluated and follow-up will beperformed to assess the rate of recurrence and complicationsin relation to the calculated doses the patients actually re-ceived. The potential impact of PET-guided alterations insource loading and treatment duration will be evaluated. To

determine the prognostic value of PET, the volume of theprimary tumor and the tracer uptake and heterogeneity ofuptake within the tumor, obtained from FDG-PET images,will be correlated with the rate of tumor recurrence to deter-mine PET markers that will identify patients at high risk forearly recurrence who may need more aggressive initial treat-ment.

Thesaurus Terms: cervix neoplasm, diagnosis design/evalu-ation, neoplasm/cancer diagnosis, positron emission tomogra-phy, prognosis deoxyglucose, fluorine, inflammation, methoddevelopment, neoplasm/cancer radiation therapy, neoplasm/cancer relapse/recurrence, radiobiology, radionuclide clinicalresearch, female, human subject, magnetic resonance imag-ing, women’s health

Institution: Washington UniversityLindell And Skinker BlvdSt. Louis, MO 63130

Fiscal Year: 2002Department: RadiologyProject Start: 03-Apr-2001Project End: 31-Mar-2005ICD: National Cancer InstituteIRG: RNM

IMPROVED QUANTITATIVE GA-65 SPECTIMAGING

Grant Number: 5R01CA078936-05PI Name: Moore, Stephen C.

Abstract: Description (Adapted from Applicant’s Abstract):The goal of the proposed research is to improve the acquisi-

1

Research Corner

Abstracts of Funded NationalInstitutes of Health Grants

The following abstracts of diagnostic radiology research and training grants funded by the National Institutes of Health (NIH)were awarded to principal investigators (PIs) whose primary appointments are in medical school departments of radiology.These abstracts are listed on the NIH Web page (http://www-commons.cit.nih.gov/crisp/) and are printed here verbatim.

The grant identification number (eg, 1RO1AI12345-01) contains a three-digit activity code (in the previous example, RO1)that identifies a specific category of extramural activity. All current NIH activity code titles and definitions can be ob-tained at the NIH Web page http://silk.nih.gov/silk/brownbooks/actcod.

IRG (Internal Review Group) refers to the study section that reviewed the application. ICD (Institute, Center, Division) re-fers to the NIH funding source.

The abstracts of the funded grants are printed alphabetically by author according to the funding institute or center.

tion, reconstruction, and extraction of quantitative informa-tion from Ga-67 SPECT data, and to assess these improve-ments to the imaging system using task-dependent criteria.Gallium has proven to be a useful nuclear medicine tracerfor imaging certain tumors, and it is known that galliumavidity is correlated with histopathologic tumor grade. Imag-ing Ga-67, however, is challenging because it emits manyhigh-energy photons. Quantitative estimates of Ga-67 tumoruptake are degraded by three principal sources of error: alocation-dependent bias caused by imperfect correction forphoton scatter and nonuniform attenuation, a size-dependentbias due to blurring by the nonstationary detector responsefunction, and stochastic variability arising from Poissonnoise in the acquired data. The proposed research will ad-dress these challenges by (1) optimizing for Ga-67 imagingseveral methods of correcting images for the effects of scat-ter and attenuation in the patient, (2) modifying for Ga-67SPECT methods that have previously been developed forestimating activity within volumes of interest using a prioriboundary information from registered CT images, and (3)designing a new collimator, tailored for Ga-67 quantitationin body imaging. These aspects of the imaging system willbe optimized and evaluated on the basis of performance inseveral quantitative imaging tasks. The tasks to be consid-ered, prototypes of tumor quantitation in the chest and abdo-men, will involve estimation of activity concentration andsize of lesions located in anatomically realistic backgrounds.For each of these tasks, Cramer-Rao lower bounds on vari-ance or mean-squared error will be computed to determinethe best possible performance for different correction meth-ods, while maximum-likelihood or Bayesian parameter esti-mation will be used to measure best realized performance.Volume-of-interest activity estimation with resolution recov-ery will be used to assess clinically realizable performance.The investigators will measure, by simulation and phantomexperiment, the improvements in performance in these tasks,and compare the results with theoretical bounds on perfor-mance. They will also consider clinical classification tasksrelated to non-Hodgkin s lymphoma. It is expect that theproposed imaging system improvements will lead to moreaccurate staging of lymphoma patients and, consequently,improved patient care due to enhanced capability to followthe progression of disease, choose the best treatment, andmonitor the response to therapy.

Thesaurus Terms: biomedical equipment development, gal-lium, image enhancement, neoplasm/cancer diagnosis, singlephoton emission computed tomography, statistics/biometrycomputer assisted diagnosis, computer simulation, diagnosisdesign/evaluation, diagnosis quality/standard, non-Hodgkin’slymphoma, phantom model bioimaging/biomedical imaging,clinical research, human subject

Institution: Brigham And Women’s Hospital75 Francis StreetBoston, MA 02115

Fiscal Year: 2002Department:Project Start: 09-Jan-1998Project End: 14-May-2003ICD: National Cancer InstituteIRG: ZRG7

ULTRASOUND SYSTEMS FORSIMULTANEOUSTHERMORADIOTHERAPY

Grant Number: 5R01CA063121-07PI Name: Moros, Eduardo G.

Abstract: Our long term goal is to maximize the benefits ofhyperthermia by developing systems capable of inducingtherapeutic thermal doses in entire tumor volumes (to maxi-mize hyperthermic cytotoxicity) and that allow simultaneousdelivery of ionizing radiation (to maximize thermal radiosen-sitization). This application seeks to translate into the radio-therapy clinic a superficial ultrasound hyperthermia systemdesigned for sequential and simultaneous thermoradiotherapyand to evaluate its performance in a human clinical trial. Thesystem (SURLAS for Scanning Ultrasound Reflector LinearArray System) will be based on device developments, nu-merical modeling and laboratory studies performed under thecurrent funding period. Simultaneous irradiation using elec-tron beams will be tested clinically for the first time. Thespecific aims are: (1) Develop a SURLAS suitable for super-ficial sequential/simultaneous thermoradiotherapy clinicaltrials with human subjects, compatible with electron/photonbeam irradiation, and with 3D heating pattern control. Pre-clinical testing is also part of this aim. (2) Develop a Linac-SURLAS-Patient portable interface to minimize the utiliza-tion time of the linear accelerator (linac). The goal is to startthe hyperthermia treatment outside the linac room; then mid-way through the heat treatment the patient and the SURLASare transported into the room and interfaced with the linac.The radiation fraction is then given without interruption ofhyperthermia. The final step is to transport the Linac- SUR-LAS-Patient portable interface out of the linac room to com-plete the hyperthermia. (3) Develop a practical hyperthermiatreatment planning tool to select initial insonation parameterfor the SURLAS depending on target volume characteristics,and to assist the physician in evaluating ultrasound isopowercontours with respect to radiation isodoses. We will incorpo-rate ultrasound power deposition distributions into treatmentplanning tools/programs (CT/MRI-based) developed in ourdepartment for 3D radiotherapy. And (4), perform a simulta-neous hyperthermia and external beam radiation clinical trialwith human patients to: (i) Evaluate the thermal performanceof the SURLAS against that of the presently used commer-cial ultrasound hyperthermia system. (ii) Establish quantita-tively, using thermal dosimetry indicators, that heating with

ABSTRACTS OF NIH GRANTS Academic Radiology, Vol 11, No 1, January 2004

2