REAL-TIME ROBOTIC IMAGE-GUIDED PROSTATE BRACHYTHERAPY

提出了一种用于开发基于三维超声的实时可视化和植入系统的技术，该系统具有机器人增强功能，用于术中剂量规划、放射性植入的实时机器人引导和前列腺癌治疗过程中的在线植入评估。这一新系统包括一个实时三维直肠成像探头和支持的可视化界面，与机器人插入的针/源相结合，精确地同时进行可选的剂量测定计划。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，并且常常导致不可接受的并发症发生率。该技术的目的是在3D超声引导的近距离放射治疗中将实时剂量测量与机器人辅助的放射源植入相结合，以巩固整个植入过程，减少并发症发生率，并改善局部控制。第一阶段的主要目标是确定在模体中植入机器人针/种子的可行性，并确定可实现的精度水平。建议的商业应用：这项研究的结果可能在前列腺癌的治疗中立即受益，使用更高剂量的辐射，更准确的定位和更少的毒副作用1较少的发病率。它将提供在机器人放置植入物的过程中实时可视化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学的植入物。一大群早期疾病患者是候选对象，包括通常会因为公共弓形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.