PIPER: PROSTATE IMPLANT PLANNING ENGINE FOR RADIOTHERAPY

第二阶段工作的主要目标是为前列腺粒子植入近距离放射治疗开发一个自适应优化和剂量测定指导系统，部署在手术室进行实时治疗计划和植入后剂量测定。 具体目标是（a）实施加速遗传算法优化，（B）开发自动图像分割和区域识别工具，以及（c）提供实时剂量测定验证和优化指导。 粒子植入近距离放射治疗目前被广泛认为是局限性前列腺癌的主要治疗方式。 然而，传统技术涉及三个不连贯的步骤-预计划、植入和植入后剂量测定-所有步骤都间隔1 - 4周。 在这些步骤中传播不确定性链，使得任何剂量不足仅在治疗完成后才被发现。 因此，前列腺近距离放射治疗目前非常依赖于操作者。 该项目旨在提供优化和图像处理方面的智能技术，以便在一步中实现整个治疗的术中规划和验证。 通过提供一个所见即所得的环境，临床医生-用户在离开手术室之前将完全有信心对每个植入物进行充分的剂量测定。 社会价值将通过节省每位患者的成本和减少局部失败和/或发病率来实现。PIPER将作为一种独立的计算机治疗计划系统上市，用于前列腺粒子植入近距离放射治疗的术中剂量优化和手术指导。 目标用户是放射肿瘤学家、泌尿科医生、医学物理学家、剂量学家和放射科医生。

The major goal of this Phase II effort is to develop an adaptive optimization and dosimetric guidance system for prostate seed implant brachytherapy, to be deployed in the operating room for real-time treatment planning and postimplant dosimetry. The specific aims are (a) to implement accelerated genetic algorithm optimization, (b) to develop automated image segmentation and region recognition tools, and (c) to deliver real-time dosimetric verification and optimized guidance. Seed implant brachytherapy is now widely recognized as a major treatment modality for localized prostate cancer. However, conventional techniques involve three disjoined steps -pre-planning, implantation and postimplant dosimetry -all separated by 1-4 weeks. An uncertainty chain is propogated in these steps, such that any under-dosage is only discovered after the completion of treatment. For this reason, prostate brachytherapy is currently very operator-dependent. This project aims to deliver intelligent technologies in optimization and image processing to enable intraoperative planning and verification of the entire treatment in one step. By providing a what-you-see-is-what-you- get environment, clinician-users will have complete confidence of adequate dosimetry for every implant before leaving the operating room. Societal value is to be achieved through cost savings per patient and reduced local failures and/or morbidities. PROPOSED COMMERCIAL APPLICATION PIPER will be marketed as a standalone computer treatment planning system for intraoperative dose optimization and surgical guidance in prostate seed implant brachytherapy. The target users are radiation oncologists, urologists, medical physicists, dosimetrists, and radiologists.