US 2019/0159744 A1 · COMPUTED TOMOGRAPHY PERFUSION (CTP) METHOD AND APPARATUS USING BLOOD FLOW FOR DISCRIMINATING TYPES OF CANCER

Abstract

Computed tomography perfusion (CTP) is used in a method to identify cancerous lesions having genetic mutations and treat them accordingly. Also, CTP values are used to distinguish primary versus metastatic lesions. For example, pulmonary blood flow is identified as one biomarker for EGFR and KRAS genetic mutations in lung cancer, lesion having dual-input pulmonary blood flow exceeding a threshold (e.g., 103 ml/min/100 mL with sensitivity 100% and specificity 62%) are determined as having mutations. The CTP values are calculated using a lesion region-of-interest (ROI) placed to include the area of maximum perfusion intensity within the lesion bass and surrounding blush, while avoiding regions of perfusion inhomogeneity (e.g., due to necrosis). In certain implementations, instead of a binary determination, the method can generate probabilities associated with respective alternatives (e.g., mutation/non-nutation and/or primary/secondary), and the method can use multivariable statistical analysis that incorporates patient and/or medical information in addition to CTP values.

Claims25

Dependent claims

A method of using computed tomography perfusion to determine a treatment of a pulmonary lesion, the method comprising:

obtaining a computed tomography perfusion (CTP) image representing blood flow in a region of a lung that includes the pulmonary lesion;
identifying, using the CTP image, a region of interest (ROI) of the pulmonary lesion,
determining, using the ROI and the CTP image, CTP values representing perfusion in the ROI of the lesion;
and
classifying the pulmonary lesion according to whether the pulmonary lesion has a genetic mutation based on the CTP values and using one or more predefined thresholds corresponding respectively to one or more of the CTP values.

2 more elements

A computed tomography perfusion (CTP) apparatus, comprising:

a gantry including an annular rotating member with a central opening to accommodate a cancer patient, the gantry including
an X-ray source fixed to the annular rotating member and configured to emit a beam of X-rays,
an X-ray detector fixed to the annular rotating member and configured across the central opening diametrically opposed to the X-ray source, the X-ray detector including a plurality of detector elements arranged to detect the X-rays and generate projection data representing an intensity of the X-rays detected at the plurality of detector elements;
and
processing circuitry configured to
obtain CTP projection data that is the projection data obtained by computed tomography (CT) scans of a lung region of the cancer patient before and after an injection of a contrast agent,
generate, using the CTP projection data, a computed tomography perfusion (CTP) image representing blood flow in the lung region, which includes a pulmonary lesion,
identify, using the CTP image, a region of interest (ROI) of the pulmonary lesion,
determine, using the ROI and the CTP image, CTP values representing perfusion in the ROI of the lesion, and
classify the pulmonary lesion according to whether the pulmonary lesion has a genetic mutation based on the CTP values and using one or more predefined thresholds corresponding respectively to one or more of the CTP values.

7 more elements

Dependencies are inferred from the claim text.

Computed tomography perfusion (ctp) method and apparatus using blood flow for discriminating types of cancer

Life of this patent

Computed tomography perfusion (ctp) method and apparatus using blood flow for discriminating types of cancer

Life of this patent

Abstract

Claims25