ERC-Small Business: Ultrasound-Guided Robotic Brachytherapy Needle-Insertion System with Intraoperative Re-Optimization

前列腺癌每年影响超过241,740名美国男性，使其成为男性最常见的癌症类型和第二大癌症死亡原因。治疗前列腺癌的一种常用方法是近距离放射治疗(BT)，即将放射性种子植入前列腺。近距离放射治疗的成功主要取决于术中根据患者的个体解剖量身定做辐射剂量的能力，即在充分覆盖前列腺的同时避免对周围器官的过度辐射。许多限制近距离放射治疗的挑战可以通过在近距离放射治疗植入过程中加入闭环反馈来解决。也就是说，当种子被植入前列腺时，它们的实际位置被测量并反馈到治疗计划系统，该系统重新计算剂量测量并重新优化计划。这项建议利用CISST ERC和声学医疗系统公司之间先前和正在进行的研究，以提供一个集成的、具有商业可行性的系统，具有以下功能：(1)植入的放射性种子的术中精确定位；(2)术中剂量测量和快速重新优化近距离放射治疗植入计划；以及(3)准确和有效地执行更新的植入计划的能力。改进后的程序的主要目标是，通过一种具有反馈机制的程序将人为错误降至最低，该程序具有准确和优化的剂量测定和机器人辅助，根据程序的进展，根据重新优化的植入物进行针的输送。

Prostate cancer affects over 241,740 U.S. males annually, making it the most prevalent cancer type and second leading cause of cancer mortality in men. One frequently utilized method of treating prostate cancer is brachytherapy (BT), or implantation of radioactive seeds into the prostate. The success of brachytherapy chiefly depends on the ability to intra-operatively tailor the radiation dose to the patient's individual anatomy, i.e. adequately cover the prostate with sufficient radiation while simultaneously avoiding excessive radiation to surrounding organs. Many of the challenges that limit brachytherapy can be addressed by incorporating closed-loop feedback in the brachytherapy implant procedure. That is as seeds are implanted into the prostate, their actual positions are measured and fed back to the treatment planning system, which recalculates the dosimetry and re-optimizes the plan. This proposal leverages prior and ongoing research between the CISST ERC and Acoustic MedSystems to provide an integrated, commercially-viable system with following capabilities: (1) precise intra-operative localization of the implanted radioactive seeds; (2) intra-operative dosimetry and rapid re-optimization of the brachytherapy implant plan; and (3) the ability to accurately and efficiently execute the updated implant plan. The major goal of the improved process is to minimize human errors with a procedure that has a feedback mechanism for accurate and optimized dosimetry and robotic assistance in the delivery of needles in accordance with a re-optimized implant as the procedure progresses.