TREATMENT UNCERTAINTIES IN THE THORAX & PELVIS--DETECTION, CORRECTION, MODELING

胸部治疗的不确定性

• 批准号: 6318296
• 负责人: GERALD J KUTCHER
• 金额: $ 27.16万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-07-01 至 2001-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6318296
• 关键词: artificial intelligence; bioimaging /biomedical imaging; body movement; clinical research; computed axial tomography; computers; human subject; human therapy evaluation; imaging /visualization /scanning; mathematical model; neoplasm /cancer radiation therapy; radiation therapy dosage

To improve the potential of dose escalation we shall develop methods to deliver dose more precisely, with emphasis on reducing and correcting for organ motion, a principal factor that limits the accurate treatment of the lung and prostate. Since motion in the two sites are caused by different mechanisms, two strategies are proposed. In the lung, the aim is to immobilize the target with deep inspiration breath-hold (DIBH) an dverify its location at each treatment. Thus the high dose volume of normal lung may be minimized due to the reduced apertures an ddecreased lung density. Initially, the effect of respiration on tumor motion will be measured in a cohort of patients with DIBH spiral CT scans, and patient eligibility criteria will be established. Then, we shall develop and implement DIBH treatments with spirometric monitoring of inspiration level. The target positioning will be verified by comparing the location of chest wall and diaphragm on electronic portal images and digitally reconstructed radiographs. The potential benefits will be assessed by comparing treatment plans for DIBH with currently practiced free-breathing treatments. In this pelvis, variability in bladder and rectal filling causesinterfractinal motion. We propose a two-pronged strategy: the patients are planned using the average target position obtained from two or more CT scans, and the aperture margins designed from a generic data set to account for the residual fluctuations of the organs about their mean positions. The generic organ motion data will be measured in a cohort of patients using CT scans acquied at 4 points in time during the treatment course. We shall develop computer tools for optimizing treatment apertures using the generic motion and setup error data, and plan evaluation tools for predicting the variability of dose-volume histograms due to organ motion and setup errors. In addition, we will study CT guided therapy, with a CT scanner located in the treatment room. Patients are scanned prior to treatment, and the target position corrected (if necessary) for the treatment. This task will involve identifying those patients wo have highly mobile prostate by using CT scans acquired prior to or during the early phase of therapy. The initial trial will be on 50 patients for whom the setup is adjusted to register the center-of-mass of the prostate to the isocenter for each treatment fraction. In a later phase, a change in the field shap will also be studied. Finally, the value of such procedures will be assessed with dosimetric studies.

为了提高剂量升级的潜力，我们将发展 更精确地提供剂量的方法，重点 减少和纠正器官运动，这是一个主要因素 限制对肺和前列腺的准确处理。 自从 这两个站点的运动是由不同的机制引起的 提出了策略。 在肺中，目的是固定 具有深度灵感的目标（dibh）的目标 每个处理处的位置。因此高剂量的正常体积 由于孔的减少，可以最小化肺 肺部密度降低。 最初，呼吸对 肿瘤运动将在DIBH患者队列中测量 将建立螺旋CT扫描和患者资格标准。 然后，我们将与 灵感水平的肺活量测量监测。 目标定位 将通过比较胸壁的位置和 电子门户图像和数字重建的隔膜 X光片。 潜在的好处将通过比较来评估 目前有自由呼吸的DIBH治疗计划 治疗。 在此骨盆中，膀胱和直肠填充的变异性 导致近亲运动。 我们提出了一个两管制的策略： 使用平均目标位置计划患者 从两次或多个CT扫描中，设计的光圈边缘 从通用数据集来说明剩余的波动 关于其平均位置的器官。 通用器官运动 数据将在使用CT扫描的患者队列中测量 在治疗课程中以4点的时间收购。 我们将 开发用于优化处理孔的计算机工具 通用运动和设置错误数据，并计划评估工具 用于预测由于 器官运动和设置错误。 此外，我们将研究CT 指导疗法，带有CT扫描仪位于治疗室。 治疗前对患者进行扫描，目标位置 纠正（如有必要）进行治疗。 此任务将涉及 通过使用 在治疗早期或期间获得的CT扫描。 最初的试验将针对该设置为50名患者 调整以注册前列腺的质量 每个治疗部分的同性恋。 在以后的阶段，变化 还将研究场状。 最后，这种价值 程序将通过剂量学研究进行评估。