Novel Ultrasonic Imaging of Brachytherapy Seeds

描述（由申请人提供）： 前列腺近距离放射治疗是一种越来越流行的治疗局限性前列腺癌的方法，它将放射性种子植入整个腺体以杀死癌组织。在美国，种植体的数量每年增加约10%，2002年估计进行了50，000至60，000例手术。前列腺近距离放射治疗的五年生存率与根治性前列腺切除术的生存率相当。在治疗前或在手术室使用剂量测定软件计划粒子的放置，该软件结合了前列腺及其周围解剖结构的常规超声图像。然而，由于在种子插入过程中腺体的运动和变形，种子经常被移位，并且传统的超声成像不能有效地显示植入种子的实际位置。因此，一些目标区域可能接收到的剂量不足。因此，2002年美国至少有15，000例手术提供的剂量不足。一种改进的可视化种子的手段将能够进行校正种子放置，并可能导致治疗效果的显着改善。本申请中提出的研究旨在开发新的先进超声成像方法，克服目前用于成像前列腺和植入种子的传统超声仪器的局限性。拟定的研究将使用组织模拟体模、体外组织标本、动物和人类受试者，研究单独和组合应用的相关性、共振、改良弹性成像方法。如果成功，该研究将提高种子超声图像的灵敏度和特异性。拟议中的研究将由滨江研究所的工程师和科学家与哥伦比亚大学纽约长老会医学中心的医学物理学家和放射肿瘤学家合作进行。以咨询、软件、种子等形式提供技术支持，将由瓦里安医疗系统公司提供，这为将研究成果转化为商业产品提供了一条潜在的途径。

DESCRIPTION (provided by applicant): Prostate brachytherapy, which implants radioactive seeds throughout the gland in order to kill cancerous tissue, is an increasingly popular method of treating localized prostate cancer. In the US, the number of implants increases by about 10% annually, and an estimated 50,000 to 60,000 procedures were performed in 2002. The five-year survival rate for prostate brachytherapy is comparable to the survival rate for radical prostatectomy. The placement of seeds is planned either in advance of treatment or in the operating room using dosimetry software that incorporates conventional ultrasonic images of the prostate and its surrounding anatomy. However, seeds often become displaced because of movement and distortion of the gland during seed insertion, and conventional ultrasonic imaging does not effectively show the actual location of implanted seeds. Consequently, some targeted regions may receive an insufficient dose. As a result, at least 15,000 procedures in the US provided inadequate dosage in 2002. An improved means of visualizing seeds would enable corrective seed placements to be performed and could result in marked improvement in treatment efficacy. The research proposed in this application seeks to develop novel advanced ultrasonic imaging methods that overcome the limitations of conventional ultrasonic instruments now used for imaging the prostate and implanted seeds. The proposed studies will investigate correlation, resonance, modified-elastographic methods applied alone and in combination, using tissue-mimicking phantoms, in vitro tissue specimens, animals and human subjects. If successful, the study will result in improved sensitivity and specificity in ultrasonic images of seeds. The proposed research will be performed collaboratively by engineers and scientists at Riverside Research Institute working with medical physicists and radiation oncologists at the New York Presbyterian Medical Center of Columbia University. Technical support in the form of consulting, software, seeds, etc., will be provided by Varian Medical Systems, Inc., which offers a potential path for translating the research results into a commercial product.