STTR Phase I: Automated object contouring methods and software for head and neck radiotherapy planning

这个小企业技术转让（STTR）第一阶段项目的更广泛的影响/商业潜力是在头颈癌患者的放射治疗（RT）领域。RT计划涉及设计放射治疗方案，以便肿瘤被照射到确定的剂量，同时最大限度地减少对正常结构的照射。为了设计最佳的RT计划，需要在医学图像上精确地勾画目标肿瘤和关键解剖结构。在当前的临床实践中，由于缺乏自动轮廓绘制软件，器官轮廓描绘主要是手动进行的。这使得RT计划容易出错，阻碍了吞吐量，并且不允许重新勾画轮廓以处理RT期间发生的变化。这种变化可能导致对肿瘤的剂量不足和对正常周围器官的剂量过量。2015年，美国估计将发生1，658，370例新发癌症病例，其中近三分之二将接受RT。鉴于美国有2，100多个RT中心，生产自动轮廓软件系统具有很大的商业机会。预期的临床结果是显着提高速度，吞吐量和准确性的轮廓相比，目前的临床practice.This小企业技术转让（STTR）第一阶段项目的改善患者的结果和成本节约解决了技术障碍有关的自动轮廓在RT规划癌症患者。当前自动轮廓绘制的技术挑战出现，因为可用的轮廓绘制方法主要是针对特定模态图像上的特定对象开发的。该项目将通过一种新的自动解剖识别方法克服这些障碍，该方法将采用从患者人群中获得的解剖模型，包括身体区域中的所有主要对象。这些模型将编码丰富的对象解剖关系，并将利用这些信息自动定位和轮廓的对象在任何给定的患者图像。该项目将有两个目标。目标1涉及在CT和PET/CT图像上勾画主要头颈器官轮廓的方法和原型软件的开发。模型将从200名癌症患者的现有图像和轮廓数据中构建。目标1结果将是原型软件，经技术验证，与地面实况相比，其准确度在1像素边界距离内，每次研究所需时间不超过3分钟。目标2是对头颈部恶性肿瘤患者的RT计划软件进行初步临床评估。

The broader impact/commercial potential of this Small Business Technology Transfer (STTR) Phase I project is in the field of radiation therapy (RT) for head & neck cancer patients. RT planning involves designing a radiation treatment regimen so that tumors are irradiated to definitive doses while minimizing irradiation to normal structures. For devising an optimal RT plan, target tumors and critical anatomic structures need to be accurately contoured on medical images. In current clinical practice, organ contour delineation is performed mostly manually due to lack of automated contouring software. This makes RT planning error prone, hampers throughput, and does not allow re-contouring to handle changes taking place during RT. Such changes can cause under dosing to tumor and overdosing to normal surrounding organs. In 2015, 1,658,370 new cancer cases are estimated to occur in the US, where nearly two-thirds will have RT. Given that there are over 2,100 RT centers in the US, there is a strong commercial opportunity for producing an auto-contouring software system. Expected clinical outcomes are significantly improved speed, throughput, and accuracy of contouring compared to current clinical practice, and improved patient outcomes and cost-savings.This Small Business Technology Transfer (STTR) Phase I project addresses a technical hurdle related to auto-contouring in RT planning for cancer patients. Current technical challenges for auto-contouring occur since available contouring methods have been developed mostly for a specific object on images of a particular modality. This project will overcome these hurdles through a novel automatic anatomy recognition methodology which will employ anatomy models derived from patient populations by including all major objects in a body region. The models will codify the rich object anatomic relationship, and will exploit this information to automatically locate and contour objects in any given patient image. The project will have two aims. Aim 1 involves the development of the method and prototype software for contouring major head & neck organs on CT and PET/CT images. Models will be built from already existing image and contour data of 200 cancer patients. Aim 1 outcome will be prototype software technically validated to be accurate within 1 pixel boundary distance compared to ground truth and requiring 3 minutes or less per study. Aim 2 will be a preliminary clinical assessment of the software in RT planning in patients with head & neck malignancies.