Oncological Engineering - A new concept in the treatment of bone metastases

肿瘤工程——治疗骨转移的新概念

• 批准号: EP/W007096/1
• 负责人: Richard Hall
• 金额: $ 714.69万
• 依托单位: University of Leeds
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FW007096%2F1
• 关键词: Oncological; Engineering; new; concept; treatment

Approximately 2 million people are living with cancer in the UK and this number is set to rise considerably over the next decade to 3.2M. A significant complication of late stage (stage 4) cancer is metastases or secondary tumours which are caused by tumour cells spreading to different locations in the body. Metastases are particularly associated with breast cancer, which is the most common cancer in females and the leading cause of cancer deaths in this group. Figures vary but some studies put a figure of about 50-60 % of patients will have bone metastases in late stage cancer. The tumours weaken the bone and lead to a variety of problems for the patients at a time when quality of life is a paramount consideration, especially as the prognosis is usually terminal. Significant issues include severe pain and spinal fracture which made lead to spinal cord injury. These complications often require major surgery which encroaches, significantly, on the patients' quality of life, when life expectancy is a matter of months and may, in certain cases, provide a mechanism of further spread of the cancer. Currently, there are no implants for supporting the bones before fracture as we cannot identify which vertebrae are likely to fail. OncoEng will deliver a paradigm shift in the current treatment technologies and stratification of care based on the application of core enabling engineering technologies. A more patient-friendly approach is realised in OncoEng in which we predict which vertebrae with tumours are likely to fail in the future enabling informed decision on care. Advanced computational modelling and imaging will be used to look at the growth of the tumour so that predictions of the strength of the vertebrae can be calculated a different points in time. These strengths can then be compared to spinal loads and an assessment of fracture risk undertaken. Those vertebrae at his risk would then receive special implant to support the weakened bone and prevent fracture. This implant would only require key-hole surgery and would not impinge on the patient's quality of life through a lengthy recuperation period or additional pain. The research proposed responds to the Cancer Strategy in the NHS Long Term Plan and the EU's Beating Cancer Plan.Three Universities in the UK, University of Leeds, Imperial College and University College London, have come together to deliver this research so as to make a big change in the way these patients are treated. In addition we have formed an international network of academic, industrial and clinical collaborators from Europe, USA and Australia (OncoEng+ Network) with a focus on novel modelling, imaging, advanced materials and innovative medical devices to overcome the challenges of predicting fracture and producing a new implant. Impacts from the research include (1) new diagnostic tools for predicting bone failure using imaging and advanced computational modelling, which can be used in this and other disease such as osteoporosis, (2) a new patient-specific implant that can be inserted using minimally invasive surgery reducing the trauma to the patient and having a shorter recovery period (days rather than weeks or months); the implant would be inserted before the vertebrae is susceptible to fracture, (3) new manufacturing techniques for the delivery of the minimally invasive implant, which have wide ranging applications outside medicine including the aerospace and automotive sector, and (4) new test methodologies for spinal implants to ensure that these devices are tested under a range of activities including adverse conditions such as high patient loading. Importantly, the programme grant will train and up-skill a new generation engineers and scientists in a novel area of application-based research, that of devices for skeletal cancers and software for fracture prediction, and aims to bring together activities in the UK and internationally to form a holistic integrated activity.

在英国，大约有200万人患有癌症，这一数字将在未来十年大幅上升至320万。晚期（第4期）癌症的一个重要并发症是肿瘤细胞扩散到身体不同部位引起的转移或继发性肿瘤。乳腺癌是女性中最常见的癌症，也是该群体癌症死亡的主要原因。数字各不相同，但一些研究表明，大约50- 60%的患者在癌症晚期会发生骨转移。肿瘤会削弱骨骼，给患者带来各种各样的问题，而此时生活质量是最重要的考虑因素，尤其是当预后通常是终末的时候。严重的疼痛和脊柱骨折会导致脊髓损伤。这些并发症通常需要进行大手术，这大大损害了患者的生活质量，而患者的预期寿命只有几个月，在某些情况下，还可能提供癌症进一步扩散的机制。目前，没有植入物在骨折前支撑骨头，因为我们无法确定哪些椎骨可能会失效。OncoEng将基于核心工程技术的应用，对当前的治疗技术和护理分层进行范式转变。在OncoEng中，我们实现了一种更加患者友好的方法，我们可以预测哪些椎骨肿瘤在未来可能会失败，从而做出明智的护理决策。先进的计算模型和成像技术将用于观察肿瘤的生长情况，这样就可以在不同的时间点计算出脊椎骨强度的预测。然后可以将这些强度与脊柱负荷进行比较，并进行骨折风险评估。那些有风险的椎骨将接受特殊的植入物来支撑脆弱的骨头，防止骨折。这种植入物只需要钥匙孔手术，不会通过漫长的恢复期或额外的疼痛影响患者的生活质量。这项研究是对英国国家医疗服务体系长期计划和欧盟战胜癌症计划中的癌症战略的回应。英国的三所大学——利兹大学、帝国理工学院和伦敦大学学院——共同开展了这项研究，以期在治疗这些患者的方式上做出重大改变。此外，我们还建立了一个由来自欧洲、美国和澳大利亚的学术、工业和临床合作者组成的国际网络（OncoEng+ network），专注于新颖的建模、成像、先进的材料和创新的医疗设备，以克服预测骨折和生产新植入物的挑战。该研究的影响包括：(1)使用成像和先进的计算模型预测骨衰竭的新诊断工具，可用于骨质疏松症等疾病；(2)一种新的患者特异性植入物，可以通过微创手术植入，减少对患者的创伤，并缩短恢复期（几天而不是几周或几个月）；植入物将在椎骨易骨折之前植入，(3)微创植入物的新制造技术，在医学以外的领域有广泛的应用，包括航空航天和汽车领域，以及(4)脊柱植入物的新测试方法，以确保这些设备在一系列活动下进行测试，包括患者高负荷等不利条件。重要的是，该项目拨款将培训和提高新一代工程师和科学家在基于应用的研究领域的技能，即骨骼癌症设备和骨折预测软件，旨在将英国和国际上的活动结合起来，形成一个整体的综合活动。

项目成果

tUbe net: a generalisable deep learning tool for 3D vessel segmentation

• DOI: 10.1101/2023.07.24.550334
• 发表时间: 2023-07
• 期刊: bioRxiv
• 作者: N. Holroyd;Zhongwang Li;C. Walsh;Emmeline Brown;R. Shipley;S. Walker-Samuel

The role of physics in multiomics and cancer evolution.

• DOI: 10.3389/fonc.2023.1068053
• 发表时间: 2023
• 期刊: Frontiers in oncology
• 影响因子: 4.7

Quantitative Image Processing for Three-Dimensional Episcopic Images of Biological Structures: Current State and Future Directions.

• DOI: 10.3390/biomedicines11030909
• 发表时间: 2023-03-15
• 期刊: BIOMEDICINES
• 影响因子: 4.7
• 作者: Holroyd, Natalie Aroha;Walsh, Claire;Gourmet, Lucie;Walker-Samuel, Simon
• 通讯作者: Walker-Samuel, Simon

Innovative approaches to cancer treatments oncological engineering

癌症治疗的创新方法肿瘤工程

• DOI: 10.56367/oag-037-10602
• 发表时间: 2023
• 期刊: Open Access Government
• 作者: Hall R