Periodic Reporting for period 4 - SPCCT (In Vivo Spectral Photon Counting CT Molecular Imaging in Cardio- and Neuro-Vascular Diseases)
Reporting period: 2020-01-01 to 2021-06-30
Spectral Photon Counting CT European Project: SPCCT, a project that heralds a new generation of scanners enabling early diagnosis in neurology and cardiology.
Spectral Photon Counting CT is a new and promising imaging modality based on a new energy resolving detector technology. A 4-year collaborative European Project led by the Université Claude Bernard Lyon 1 was selected and granted (6.4 M€) under the “Horizon 2020” European Research and Innovation program. The SPCCT project using two unique Philips prototypes involved 11 European partners and lasted 66 months from January 2016 to June 2021.
Computed Tomography is the most widely used imaging method in the world and has transformed patient care. Spectral Photon Counting CT is a new imaging modality based on the usual CT concept with the key difference of energy resolving detector technology. The additional spectral information can be used for material separation and can deliver additional, new contrast with clinically relevant new information. The most important novel capability of Spectral CT is K-Edge imaging for selective and quantitative detection of specific elements including among others iodine, gold, bismuth, gadolinium or ytterbium. The full potential of Spectral CT can be exploited in combination with targeted contrast materials carrying a payload with a compatible K-edge.
This multidisciplinary project at the interface between medicine, biology, health technology assessment, and high-end technology is composed by academic and industrial European partners involved in this project namely Lyon University (Université Claude Bernard Lyon ; UCBL, Erasmus University of Rotterdam, (The Netherlands), University of Turin (Italy), King’s College London (UK), Cliniques universitaires Saint-Luc of Brussels (Belgium), Philips Medical Systems Technologies (Israel), Philips Research (Germany) and Bracco Imaging (Italy).
The health technology assessment focuses on two major cardiovascular disorders: ischemic stroke and coronary artery disease (CAD), with ACS and non-obstructive coronary artery disease (NOCAD), as being associated with a high humanistic and economic burden globally.
Spectral Photon Counting CT is a new and promising imaging modality based on a new energy resolving detector technology. A 4-year collaborative European Project led by the Université Claude Bernard Lyon 1 was selected and granted (6.4 M€) under the “Horizon 2020” European Research and Innovation program. The SPCCT project using two unique Philips prototypes involved 11 European partners and lasted 66 months from January 2016 to June 2021.
Computed Tomography is the most widely used imaging method in the world and has transformed patient care. Spectral Photon Counting CT is a new imaging modality based on the usual CT concept with the key difference of energy resolving detector technology. The additional spectral information can be used for material separation and can deliver additional, new contrast with clinically relevant new information. The most important novel capability of Spectral CT is K-Edge imaging for selective and quantitative detection of specific elements including among others iodine, gold, bismuth, gadolinium or ytterbium. The full potential of Spectral CT can be exploited in combination with targeted contrast materials carrying a payload with a compatible K-edge.
This multidisciplinary project at the interface between medicine, biology, health technology assessment, and high-end technology is composed by academic and industrial European partners involved in this project namely Lyon University (Université Claude Bernard Lyon ; UCBL, Erasmus University of Rotterdam, (The Netherlands), University of Turin (Italy), King’s College London (UK), Cliniques universitaires Saint-Luc of Brussels (Belgium), Philips Medical Systems Technologies (Israel), Philips Research (Germany) and Bracco Imaging (Italy).
The health technology assessment focuses on two major cardiovascular disorders: ischemic stroke and coronary artery disease (CAD), with ACS and non-obstructive coronary artery disease (NOCAD), as being associated with a high humanistic and economic burden globally.
The Spectral Photon Counting CT European Project (SPCCT) is coming to an end and opening up great prospects for the future of photon counting imaging.
The first results with a preclinical spectral photon counting CT prototype defined the actual sensitivity threshold of Gold, Gadolinium, Holmium, and iodine. Development of contrast agents dedicated to a large spectrum of application particularly in neurology, cardiovascular and imaging in small animals were already performed during first two year including vascular imaging heart, brain and kidney perfusion imaging. Developments for a fully functional clinical Spectral CT acquisition system are still in progress, including detector developments and data processing, but also energy dependent image reconstruction. Development of target specific contrast agents dedicated to a large spectrum of application particularly in neurology, cardiovascular and imaging in larger animals and in humans are still in progress.The first phase comprised the development of a first small animal prototype with new photon counting detectors and adapted new reconstruction methods with innovative contrast agents (gold, gadolinium, holmium and iodine) dedicated to a wide spectrum of pre-clinical applications .The results of this phase demonstrated the potential of this new technology by in vivo multicolor molecular imaging, and allowed the project to move in humans during a second phase. Synthesis of tropoelastin targeted I-NP was achieved; scale-up of the synthesis of Gd4-TESMA to produce 12 grams suitable for in vivo use successfully achieved; Scale-up of the synthesis of Gd fluoride nanoparticles coated with PEG was successfully demonstrated.
During the final two years of the project, the teams developed a fully functional clinical Spectral CT acquisition system prototype with a large field of view designed for humans. This innovative scanner, composed of a new generation of CZT detector providing ultra-high resolution up to ~160um, radiation dose reduction and multi-color imaging, produces remarkable images of the human body, particularly of the coronary arteries and the heart. The first results obtained with this system are very promising for the future of human medical imaging. The SPCCT ultra-high-resolution imaging system will help enable early diagnosis of various disorders such as neurovascular and cardiovascular diseases, cancers or strokes. These steps were a prerequisite for the evolution of this technology towards simultaneous nonradioactive anatomo-molecular imaging with human computed tomography, a new imaging modality that is expected to be accessible, cost-effective and safe. The gains for both patients and healthcare systems will therefore be significant. Variation in acute stroke diagnosis across European countries appeared to be limited regarding the first-line imaging test, however increases at later stages of diagnostic workup and choice of treatment. Compared to current care, in stroke patients, advanced imaging and late mechanical thrombectomy improve QALYs, taking into account the international variation in the incremental value of SPCCT. In ACS patients, considerable variation was found between European countries regarding diagnostic modalities and treatment strategies. SPCCT appeared cost-effective in the diagnostic workup and subsequent treatment in CAD patients.
The first results with a preclinical spectral photon counting CT prototype defined the actual sensitivity threshold of Gold, Gadolinium, Holmium, and iodine. Development of contrast agents dedicated to a large spectrum of application particularly in neurology, cardiovascular and imaging in small animals were already performed during first two year including vascular imaging heart, brain and kidney perfusion imaging. Developments for a fully functional clinical Spectral CT acquisition system are still in progress, including detector developments and data processing, but also energy dependent image reconstruction. Development of target specific contrast agents dedicated to a large spectrum of application particularly in neurology, cardiovascular and imaging in larger animals and in humans are still in progress.The first phase comprised the development of a first small animal prototype with new photon counting detectors and adapted new reconstruction methods with innovative contrast agents (gold, gadolinium, holmium and iodine) dedicated to a wide spectrum of pre-clinical applications .The results of this phase demonstrated the potential of this new technology by in vivo multicolor molecular imaging, and allowed the project to move in humans during a second phase. Synthesis of tropoelastin targeted I-NP was achieved; scale-up of the synthesis of Gd4-TESMA to produce 12 grams suitable for in vivo use successfully achieved; Scale-up of the synthesis of Gd fluoride nanoparticles coated with PEG was successfully demonstrated.
During the final two years of the project, the teams developed a fully functional clinical Spectral CT acquisition system prototype with a large field of view designed for humans. This innovative scanner, composed of a new generation of CZT detector providing ultra-high resolution up to ~160um, radiation dose reduction and multi-color imaging, produces remarkable images of the human body, particularly of the coronary arteries and the heart. The first results obtained with this system are very promising for the future of human medical imaging. The SPCCT ultra-high-resolution imaging system will help enable early diagnosis of various disorders such as neurovascular and cardiovascular diseases, cancers or strokes. These steps were a prerequisite for the evolution of this technology towards simultaneous nonradioactive anatomo-molecular imaging with human computed tomography, a new imaging modality that is expected to be accessible, cost-effective and safe. The gains for both patients and healthcare systems will therefore be significant. Variation in acute stroke diagnosis across European countries appeared to be limited regarding the first-line imaging test, however increases at later stages of diagnostic workup and choice of treatment. Compared to current care, in stroke patients, advanced imaging and late mechanical thrombectomy improve QALYs, taking into account the international variation in the incremental value of SPCCT. In ACS patients, considerable variation was found between European countries regarding diagnostic modalities and treatment strategies. SPCCT appeared cost-effective in the diagnostic workup and subsequent treatment in CAD patients.
These preliminary and encouraging results result from a close collaboration between all the partners involved in the project. Academics and industry players worked hand in hand to move forward together and achieve the sought objectives. Following this successful collaboration and thanks to the support of the European Union, some of the partners of the project obtained a new H2020 grant for the project "SCAN n TREAT" - while other proposals have been submitted to further exploit the results of SPCCT project.