Multiparametric MRI-guided Prostate HDR Brachytherapy with Focal Tumor Boost

多参数 MRI 引导前列腺 HDR 近距离放射治疗与局灶性肿瘤增强

• 批准号: 10330434
• 负责人: Xiaofeng Yang
• 金额: $ 35.69万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-02-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10330434
• 关键词: Affect; Algorithms; Anatomy; Award; Biometry; Brachytherapy; Cancer Patient; Cancerous; Catheters; Cessation of life; Clinic; Clinical; Collaborations; Complication; Data; Disease; Dose; Dose-Rate; Failure; Goals; Gold; High-Dose Rate Brachytherapy; Image; Imaging Device; Individual; Lesion; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Medical; Medical Imaging; Methods; Modality; Normal tissue morphology; Organ; Pathology; Patients; Pattern; Performance; Physics; Positioning Attribute; Probability; Prostate; Quality of life; Radiation; Radiation Dose Unit; Radiation Oncology; Radiation therapy; Radiology Specialty; Rectum; Recurrence; Relapse; Reporting; Research; Risk; Science; Scientist; Site; Source; System; Techniques; Technology; Testing; Time; Toxic effect; Treatment Efficacy; Urethra; X-Ray Computed Tomography; advanced prostate cancer; anatomic imaging; base; cancer radiation therapy; clinical practice; cost; disorder risk; experience; high risk; image guided; image registration; imaging Segmentation; imaging modality; improved; improved outcome; irradiation; mathematical model; men; novel; physical model; prostate cancer risk; prostate radiotherapy; radiation delivery; treatment planning; tumor; ultrasound

Project Summary/Abstract Prostate cancer affects 1 in 6 men in USA. Despite the technological advances, prostate radiotherapy still results in poor local control and survival for patients with high-risk prostate cancer – over 50% of the patients with high-risk disease will experience relapses following prostate radiotherapy. Histopathologic studies showed that dominant cancer foci within the prostate are associated with sites of local recurrence post radiotherapy. It has been proven that the state-of-the-art multiparametric MRI (mp-MRI) combining anatomic imaging with functional MRI techniques can provide the best performance to define dominant intraprostatic lesion (DIL). High-dose-rate (HDR) brachytherapy, with precise radiation-dose delivery, radiobiological advantage and lower cost, has become an increasing popular treatment modality for patients with prostate cancer. A few studies in HDR brachytherapy have shown that radiotherapy boost for a DIL with whole prostate treatment can improve local tumor control without causing excess toxicity. However, due to the anatomic location and size of a DIL, approximate 60% patients could not achieve the expected DIL boost dose coverage without increasing organ- at-risk (OAR) tolerances in current HDR boost practice. We hypothesize that DIL-targeted HDR catheter placement will significantly improve achievable boost dose coverage for DILs in focal boost HDR brachytherapy. The proposed research is to develop a DIL-targeted, US-guided HDR prostate brachytherapy with focal boost. Specifically, we propose to develop a novel MRI-US-CT deformable registration, which can incorporate mp-MRI-defined DIL into real-time US to guide HDR catheters placement to improve the probability of achievable optimal dose boost, and panning CT to guide focal DIL boost dose delivery in HDR treatment. This overall project is built on three integral components: 1) the PI’s award-winning prostate segmentation and registration technologies, 2) the DIL information provided by mp-MRI, and 3) a precise radiation delivery system offered by the HDR brachytherapy technique. The potential benefit of introducing DIL-targeted HDR boost brachytherapy that can irradiate the whole prostate while simultaneously and focally boost a higher dose to mp-MRI-defined DILs is enormous. In this project, we will 1) develop and optimize prostate segmentation and registration algorithms, 2) quantitatively evaluate the consistency and accuracy of these algorithms using phantom and patient data, and 3) evaluate the performance of the proposed DIL-targeted boost HDR with conventional HDR brachytherapy and examine its clinical benefit. Successful completion of this project will overcome a critical barrier to advance personalized HDR brachytherapy for prostate cancer, thus providing a way to focally boost the radiation dose to the DILs while sparing the normal tissue to improve local control, long-term survival and quality of life for prostate-cancer patients, particularly those with advanced prostate cancer.

项目摘要/摘要 在美国，前列腺癌影响6人中有1人。尽管技术进步，前列腺放疗仍在 导致高风险前列腺癌患者的局部控制和生存率不佳 - 超过50％的患者 具有高风险疾病将在前列腺放射疗法后经历继电器。组织病理学研究显示 前列腺内的主要癌症焦点与放射治疗后局部复发部位有关。它 已经证明，最先进的多参数MRI（MP-MRI）将解剖成像与 功能性MRI技术可以提供最佳性能来定义主要的肉体内病变（DIL）。 高剂量率（HDR）近距离放射治疗，具有精确的无线电剂量递送，放射生物学优势和较低 成本已成为前列腺癌患者的流行治疗方式越来越多。一些研究 HDR近距离放射治疗表明，对整个前列腺治疗的DIL的放射疗法可以改善 局部肿瘤控制而不会引起过多的毒性。但是，由于解剖位置和DIL的大小， 大约60％的患者无法达到预期的DIL增强剂量覆盖范围而不会增加器官 当前的HDR增强实践中的高风险（OAR）公差。我们假设靶向稀释的HDR导管 放置将显着提高焦点提升HDR中DIL的可实现的增强剂量覆盖率 近距离放射治疗。拟议的研究是开发一种靶向的，US引导的HDR前列腺牙治疗 特别是，我们建议开发一种新型的MRI-US-CT可变形登记，可以 将MP-MRI定义的DIL纳入实时US，以指导HDR导管的位置以提高概率 可实现的最佳剂量提升和PANNING CT，以指导HDR处理中的局灶性DIL增强剂量递送。 该整体项目建立在三个不可或缺的组件上：1）PI屡获殊荣的前列腺细分和 注册技术，2）MP-MRI提供的DIL信息和3）精确辐射输送 HDR近距离放射治疗技术提供的系统。引入靶向DIL的HDR的潜在好处 增强可以照射整个前列腺的近距离放射治疗，同时又焦化了更高的剂量 到MP-MRI定义的DIL是巨大的。在这个项目中，我们将1）开发和优化前列腺细分 和注册算法，2）使用使用这些算法的一致性和准确性进行定量评估 幻影和患者数据，以及3）评估提出的dil靶向促进hdr的性能 常规的HDR近距离放射治疗和检查其临床益处。成功完成该项目将 克服一个关键的障碍，以推动个性化的HDR近距离治疗前列腺癌，从而提供 在放大正常组织以改善局部控制的同时，将辐射剂量置于辐射剂量时， 前列腺癌患者的长期生存和生活质量，尤其是患有晚期前列腺的患者 癌症。

项目成果

Learning-Based Stopping Power Mapping on Dual-Energy CT for Proton Radiation Therapy.

• DOI: 10.14338/ijpt-d-20-00020.1
• 发表时间: 2021
• 期刊: International journal of particle therapy
• 影响因子: 1.7
• 作者: Wang T;Lei Y;Harms J;Ghavidel B;Lin L;Beitler JJ;McDonald M;Curran WJ;Liu T;Zhou J;Yang X
• 通讯作者: Yang X

A potential revolution in cancer treatment: A topical review of FLASH radiotherapy.

• DOI: 10.1002/acm2.13790
• 发表时间: 2022-10
• 期刊: JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
• 影响因子: 2.1
• 作者: Gao, Yuan;Liu, Ruirui;Chang, Chih-Wei;Charyyev, Serdar;Zhou, Jun;Bradley, Jeffrey D.;Liu, Tian;Yang, Xiaofeng
• 通讯作者: Yang, Xiaofeng

Patch-Based Label Fusion for Automatic Multi-Atlas-Based Prostate Segmentation in MR Images.

基于补丁的标签融合，用于 MR 图像中基于多图谱的前列腺自动分割。

• DOI: 10.1117/12.2216424
• 发表时间: 2016
• 期刊: Proceedings of SPIE--the International Society for Optical Engineering
• 作者: Yang,Xiaofeng;Jani,AsheshB;Rossi,PeterJ;Mao,Hui;Curran,WalterJ;Liu,Tian
• 通讯作者: Liu,Tian

A Patch-based CBCT Scatter Artifact Correction Using Prior CT.

使用先前 CT 进行基于补丁的 CBCT 散射伪影校正。

• DOI: 10.1117/12.2253935
• 发表时间: 2017
• 期刊: Proceedings of SPIE--the International Society for Optical Engineering
• 作者: Yang,Xiaofeng;Liu,Tian;Dong,Xue;Tang,Xiangyang;Elder,Eric;Curran,WalterJ;Dhabaan,Anees
• 通讯作者: Dhabaan,Anees

Synthetic CT generation from non-attenuation corrected PET images for whole-body PET imaging.

• DOI: 10.1088/1361-6560/ab4eb7
• 发表时间: 2019-11-04
• 期刊: Physics in medicine and biology
• 影响因子: 3.5
• 作者: Dong X;Wang T;Lei Y;Higgins K;Liu T;Curran WJ;Mao H;Nye JA;Yang X
• 通讯作者: Yang X