Augmenting Dual Energy CT for Novel Contrast Agents

Project SummaryAbstract Our long term goal is to revolutionize the effectiveness of CT imaging for millions of Americans across a broad range of abdominal diseaseDual energy CTDECTprovides powerful clinical diagnostic potential but remains heavily underutilized despite wide scanner availabilityDECT allows materials to be differentiated based on their relative X ray attenuation at low versus high energy X ray spectraUnfortunatelycurrent DECT workflow is highly fragmentedNone of therd party Picture Archiving and Communications SystemsPACSthat physicians use to view clinical images can process DECT imageseach DECT scannerandapos s images can only be processed by that specific scanner vendorandapos s softwareWorseDECT signal units are scanner specific and not compatible with historicalkVp single energy CTSECTHounsfield UnitsHUwhich remain the most commonly used CT signal unit todayand the basis of most diagnostic CT threshold criteriaThe profound future of multi contrast DECTwhereby multiple simultaneously imaged contrast agents are separated at DECT to give rich diagnostic information of complex anatomyalso remains unrealizedCommercial DECT software fails in quantitative separation of current iodine contrast from novel high Z and silicon agentsIn our STTR Phase I we developed a novel Contrast Material Extraction ProcessCMEPthat vividly separates individual contrast agent signalsincluding that of calciumat DECTWe propose to further validate these methods across all commercial clinical DECT scanner types and integrate them into an urgently needed Vendor Agnostic DECT processing SoftwareVADSfor wide low cost distribution and integration into clinical PACS workflowOur overall hypothesis is that images from each of the four available clinical DECT scanner types can be processed and displayed using a common interfaceand this interface can allow quantitative scan comparisons between all DECT and SECT scanners through a UnifiedkVp SECT like HUOnce FDA approvedVADS will enable FDA approval of many urgently needed DECT contrast agents to fulfill the promise of multi contrast DECTOur Specific Aims are toConstruct standardized DECT phantoms spanning the range of human tissues and contrast agents currently available and in development to obtain a comprehensive image library for each of the commercial clinical DECT scannersImplement and validate VADS on this image library to allow all DECT images to be processed in a common software interface designed to bekapprovable and readily integrated into PACS or otherrd party viewing workstationsUse the image library to define aUnified Hounsfield Unitcompatible withkVp SECTto allow all DECT scanner types and SECTregardless of kVp settingto be quantitatively comparedAt the conclusion of this proposalwe will have developed disruptivekapprovable software to streamline daily clinical DECT workflow and provide necessary infrastructure for future transformative highly diagnostic multi contrast enhanced DECT PROJECT NARRATIVE The clinical implementation of dual energy CT is obstructed by fragmented software interfaces in current clinical radiology workflow and software imposed limitations on capabilityWe will interrogate dual energy CT imaging with each of the commercially available clinical scanners to develop disruptive vendor agnostic software that will streamline dual energy image processingimprove material separation capabilityallow quantitative comparison of images from all CT scannersand allow double contrast enhanced dual energy CT to give richly detailed co registered images of complex abdominal anatomy for millions of Americans at a low radiation dose and major cost savings to the healthcare system