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

这项小型企业技术转移（STTR）一期项目的更广泛影响/商业潜力是在头颈癌患者放射治疗（RT）领域。放射治疗计划包括设计放射治疗方案，使肿瘤照射到确定剂量，同时尽量减少对正常结构的照射。为了设计最佳的放射治疗方案，需要在医学图像上精确地勾画出目标肿瘤和关键解剖结构的轮廓。在目前的临床实践中，由于缺乏自动轮廓软件，器官轮廓描绘主要是手动进行的。这使得放疗计划容易出错，阻碍了通量，并且不允许重新轮廓来处理放疗期间发生的变化。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，美国估计将出现1,658,370例新癌症病例，其中近三分之二将进行RT。鉴于美国有超过2,100个RT中心，因此生产自动轮廓软件系统具有强大的商业机会。与目前的临床实践相比，预期的临床结果是显着提高了轮廓的速度，吞吐量和准确性，并改善了患者的治疗效果并节省了成本。这个小型企业技术转移（STTR）一期项目解决了与癌症患者RT计划中自动轮廓相关的技术障碍。由于现有的轮廓方法大多是针对特定模态图像上的特定物体而开发的，因此当前自动轮廓的技术挑战就出现了。该项目将通过一种新颖的自动解剖识别方法来克服这些障碍，该方法将采用来自患者群体的解剖模型，包括身体区域的所有主要物体。该模型将编纂丰富的对象解剖关系，并将利用这些信息在任何给定的患者图像中自动定位和轮廓对象。该项目将有两个目标。目标1涉及在CT和PET/CT图像上绘制主要头颈部器官轮廓的方法和原型软件的开发。模型将从已有的200名癌症患者的图像和轮廓数据中建立。目标1的结果将是原型软件在技术上经过验证，与地面真实值相比，在1像素边界距离内准确，每次研究需要3分钟或更短的时间。目的2将是对该软件在头颈部恶性肿瘤患者的放疗计划中的初步临床评估。

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.