REAL-TIME ROBOTIC IMAGE-GUIDED PROSTATE BRACHYTHERAPY

提出了一种技术，用于开发一种实时的、基于三维超声的可视化和植入系统，该系统具有用于术中剂量规划的机器人增强、放射性植入物的实时机器人引导和前列腺癌治疗过程中的在线植入物评估。该新系统包括实时三维直肠内成像探头和支持可视化界面，以及与可选剂量测定计划完全一致的针/源机器人插入。目前使用经直肠超声引导进行近距离放射治疗的技术难以实施，并且经常导致不可接受的并发症发生率。所提出的技术旨在通过在3D超声引导近距离放射治疗期间将实时术中剂量测定与机器人辅助源植入相结合来巩固整个植入手术，降低并发症发生率并改善局部控制。第I阶段的主要目的是确定在体模中植入机器人针/粒子的可行性，并确定可达到的准确度水平。拟议的商业应用：这项研究的结果可能对前列腺癌的治疗有直接的好处，使用更高剂量的辐射，更准确的定位和更少的毒性1更低的发病率。它将提供在植入物的机器人放置期间真实的时间可视化3D前列腺体积的能力，提供即使在经验较少的临床医生手中也能反映最佳剂量测定的植入物。一大群患有早期疾病的患者是候选人，包括通常由于公共拱门干扰而被排除在外的患者。

A technique is proposed for the development of a real-time, 3- dimensional ultrasound-based visualization and implant system with robotic augmentation for intraoperative dose planning, real-time robotic guidance of radioactive implants and on-line implant assessment during the procedure for treatment of prostate cancer. This new system includes a real-time 3-dimensional endorectal imaging probe and supporting visualization interfaces coupled with robotic insertion of needles/sources in exact concurrence with optional dosimetry plan. Present techniques using transrectal ultrasound guidance for brachytherapy are difficult to implement and often result in unacceptable rates of complication. The aim of the proposed technique is to consolidate the total implant procedure, reduce Complication rates and improve local control by linking real-time intraoperative dosimetry with robotic-assisted source implantation during 3D ultrasound-guided brachytherapy. The primary objective of Phase I is to establish feasibility of robotic needle/seed implantation in phantoms and determine achievable levels of accuracy. PROPOSED COMMERCIAL APPLICATIONS: The outcome of this research could be of immediate benefit in the treatment of prostate cancer using higher dose radiation with more accurate localization and fewer toxicities1less morbidity. It would provide the ability to visualize in real time the 3D prostate volume during robotic placement of implants, providing implants which reflect optimal dosimetry even in the hands of less experienced clinicians. A large group of patients with early-stage disease are candidates, including patients which would have normally been excluded because of public arch interference.