IMPROVED DOSIMETRY--QUANTITATIVE TEMPERATURE, ULTRASOUND & GEOMETRIC MODELS

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The objective of this project is to integrate quantitative thermal modeling tools into clinical hyperthermia to improve treatment planning, delivery, and evaluation. We focus particularly on the application and validation of these models, in combination with extensive thermometry and perfusion measurements, to prostate disease. This allows us to validate thermal models ina a consistent, reproducible, and relatively accessible anatomic site that can be well instrumented for temperature, perfusion and SAR. In the current grant period, efforts have been strongly technology oriented; the development and evaluation of thermal models and algorithms for predictive and reconstructive temperature field calculations. We developed the Basis Element Method (BEM), a rapid, tunable technique for temperature field calculations in the clinical setting. Initial experimental validation of the BEM thermal model in animal (pig) experiments and selected patient treatment sessions show that the BEM, with sparsely measured SAR and perfusion, is able to predict temperatures with RMS differences of 0.9 degree C. The renewal is clinically oriented; to transfer to the clinic and integrate into the patient treatment system these quantitative thermal modeling techniques. The BEM and associated reconstruction and visualization modules will be transferred to the DFCI, along with clinical refinements that include optimization for clinical use and customization for the specific anatomic sites of interest in the Program Project. Additional clinically driven refinements to the BEM include the real-time application of the thermal reconstruction algorithm for use in the control of treatment delivery. To support and enhance these models, we also provide the hyperthermia clinic with the necessary dense temperature and perfusion measurement capability. These modeling and analysis capabilities will be used to establish a rational basis for therapy planning and optimization based on individual patient geometric and anatomic data. Equally important, this will allow the evaluation of treatment efficacy by reconstruction of the treatment temperature field from data gathered at discrete measurement sites, calculation of volumetric thermal dose distributions over the entire tumor volume, and correlation with outcome. This will enable more effective and quantitative assessment of the therapeutic value of hyperthermia.