PRECISION IN PATIENT SET-UP AND TARGET LOCALIZATION

患者设置和目标定位的精确度

• 批准号: 6102923
• 负责人: RANDALL K TEN HAKEN
• 金额: --
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-02-01 至 1999-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6102923
• 关键词: artificial intelligence; behavioral /social science research tag; bioengineering /biomedical engineering; biomedical automation; body movement; brain neoplasms; clinical biomedical equipment; computer assisted patient care; computer human interaction; computer program /software; computer simulation; computer system design /evaluation; diagnosis design /evaluation; digital imaging; head /neck neoplasm; human subject; immobilization of body part; liver neoplasms; lung neoplasms; mathematical model; neoplasm /cancer radiation therapy; neoplasm /cancer radiodiagnosis; patient care planning; patient monitoring device; phantom model; prostate neoplasms; radiation dosage

The overall objective of Project 3 is to quantify, and through improvements, maximize the precision with which target volumes within patients can be localized at the time of treatment. A fundamental goal of conformal radiation therapy is to confine regions of high dose as tightly as possible to target volumes. currently, immobile biologic target volumes need to be expanded to form planning target volumes to account for uncertainties in patient setup between treatments and for organ motion within patients. However, to escalate dose safely beyond current standards, it is necessary to minimize the volume of tissue irradiated. In this project it is hypothesized that through use of improved patient immobilization, real-time diagnostic and megavoltage flat-panel imagers, software to compute corrections for repositioning patients, and a computer controlled treatment machine, it will be possible to accurately and rapidly setup a patient before and/or during each treatment session. It is further hypothesized that, through use of a combination of radio-opaque markers visible on diagnostic and megavoltage studies, the influence of organ motion on target volume localization can be accounted for on a quantitative basis. Thus, Project 3 has two specific aims, which will be addressed through completion of three major subtasks associated with each aim. Aim 1: To develop and implement procedures that enable the reduction of "patient" setup inaccuracies to a level consistent with the precision with which patient position can be measured; with subtasks related to 1a) patient immobilization utilizing improved devices and techniques, 1b) patient localization by means of diagnostic x-ray sources located at the treatment unit in conjunction with innovative composite diagnostic- megavoltage, online flat-panel imagers, and 1c) computer-assisted patient repositioning using a redesigned computer-controlled table top system. Aim 2: To account for "target" motion due to patient organ motion in an otherwise immobilized patient; through subtasks which 2a) determine the stability of inter-treatment patient structure and organ localization, 2b) directly quantify target volume motion in the prostate, liver and lung using implanted radio-opaque markers, and 2c) employ advanced techniques to compensate for organ motion on a daily basis through adjustment of treated volumes or use of physiological gating techniques.

项目3的总体目标是量化， 改进，最大限度地提高精度， 患者可以在治疗时进行定位。 一个基本目标 适形放射治疗的主要目的是限制高剂量区域， 尽可能地接近目标卷。 目前，固定生物 需要扩展目标卷以形成规划目标卷， 考虑到治疗之间患者设置的不确定性， 患者体内的器官运动。 然而，为了安全地增加剂量， 根据当前标准，有必要最小化组织体积， 辐射。 在这个项目中，假设通过使用 改进的患者固定、实时诊断和兆伏 平板成像器，计算重新定位校正的软件 病人和计算机控制的治疗机，它将是 可以在手术前和/或手术期间准确和快速地设置患者 每一次治疗。 进一步假设，通过使用 诊断上可见的不透射线标记的组合， 兆伏研究，器官运动对靶体积的影响 可以在定量的基础上解释局部化。 因此，Project 3有两个具体目标，将通过完成 与每个目标相关的三个主要子任务。 目标1：发展和 实施能够减少“患者”设置的程序 不准确度达到与患者 可以测量位置;子任务涉及1a）患者 利用改进的装置和技术的固定，1b）患者 通过位于中心的诊断X射线源进行定位 治疗单位结合创新的复合诊断- 兆伏，在线平板成像仪，以及1c）计算机辅助患者 重新定位使用重新设计的计算机控制的桌面系统。 目的2：为了解释由于在一个实施例中患者器官运动而引起的“目标”运动， 否则固定的病人;通过子任务，2a）确定 治疗间患者结构和器官定位的稳定性， 2b）直接量化前列腺、肝脏中的目标体积运动， 使用植入的不透射线标记物的肺，以及2c）使用先进的 技术，以补偿器官运动的日常基础上， 调整治疗体积或使用生理门控技术。