Feedback Control of Respiration Induced Tumor Motion with a Treatment Couch

使用治疗床对呼吸引起的肿瘤运动进行反馈控制

• 批准号: 8134253
• 负责人: WARREN D D'SOUZA
• 金额: $ 26.7万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8134253
• 关键词: Abdomen; Accounting; Algorithms; Biological; Biomedical Engineering; Breathing; Cine Magnetic Resonance Imaging; Clinical Trials; Computer software; Conformal Radiotherapy; Development; Discipline; Dose; Effectiveness; Ensure; Evaluation; Feedback; Financial compensation; Funding; Goals; Hot Spot; Image; Individual; Intensity-Modulated Radiotherapy; Lead; Least-Squares Analysis; Length; Linear Accelerator Radiotherapy Systems; Lung; Magnetic Resonance Imaging; Malignant neoplasm of abdomen; Medical; Methods; Modeling; Morphologic artifacts; Motion; Normal tissue morphology; Organ; Outcome; Patients; Pattern; Performance; Physics; Positioning Attribute; Radiation; Radiation therapy; Request for Proposals; Research; Research Personnel; Research Project Grants; Resources; Respiration; Risk; Safety; Shapes; Signal Transduction; Site; Skin; Solutions; System; Technology; Testing; Time; Tissues; Toxic effect; Tumor Volume; X-Ray Computed Tomography; clinical practice; college; computerized data processing; design; design and construction; image processing; improved; irradiation; medical schools; novel; optical imaging; programs; sensor; technique development; time use; treatment duration; treatment planning; tumor

DESCRIPTION (provided by applicant): Respiration induced tumor motion leads to inaccuracies in the planning and delivery of radiation therapy treatments. This is particularly important for highly conformal therapies such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT). Conventional solutions included adding a 'safety margin" around the tumor which can often result in unnecessary irradiation of normal tissue thereby increasing normal tissue toxicity. Current commercially available methods with linear accelerators include breath-holds and gating during radiation delivery. The former is not tolerated well by patients while the later increases treatment delivery time, thereby increasing the risk of spurious patient motion and even reducing the biological effectiveness of the delivered radiation. We propose to develop a novel tumor motion compensation system using a treatment couch that will ensure accurate delivery of radiation treatment without increasing discomfort or treatment time and without decreasing the biological effectiveness. The goal of this proposal is to develop a real-time motion-synchronized treatment couch system using feedback control. The specific aims of this proposal are to 1) use cine MR to dynamically image the tumor and an infrared camera to image skin markers simultaneously during normal respiration, 2) develop an inferential model that will correlate the position of the skin markers with the tumor position using partial-least squares (PLS) regression, 3) design and test a treatment couch and control system that will compensate for respiration induced motion using feedback control, 4) use autoregressive modeling to predict the tumor position ahead of time in order to improve the performance of the feedback control system by overcoming the dead time in the system and adaptive filtering to identify anamolous tumor positions. The results from our proposal have the potential to significantly impact radiation therapy of lung and upper abdominal cancers. The proposed research effort will lead to the development of a novel motion management framework using a real-time motion-synchronized treatment couch. Its eventual implementation in clinical practice will lead to reduced normal tissue toxicity through the use of smaller tumor margins and accurate tumor motion compensation. This will enable more widespread use of highly conformal treatments such as intensity- modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) in a reliable manner.

描述(由申请人提供)：呼吸引起的肿瘤运动导致放射治疗的计划和实施不准确。这对于高度适形治疗尤其重要，例如调强放射治疗(IMRT)和立体定向全身放射治疗(SBRT)。传统的解决方案包括在肿瘤周围增加“安全边际”，这往往会导致正常组织受到不必要的照射，从而增加正常组织的毒性。目前商业上可用的直线加速器方法包括屏气和辐射传递期间的门控。前者不能被患者很好地耐受，而后者增加了治疗传递时间，从而增加了患者虚假运动的风险，甚至降低了所传递的辐射的生物有效性。我们建议开发一种新的肿瘤运动补偿系统，使用治疗床，在不增加不适感或治疗时间的情况下，在不降低生物有效性的情况下，确保准确地提供放射治疗。该方案的目标是开发一种使用反馈控制的实时运动同步治疗床系统。该建议的具体目标是：1)使用电影MR对肿瘤进行动态成像，并在正常呼吸期间同时使用红外摄像机对皮肤标志物进行成像；2)利用偏最小二乘(PLS)回归建立皮肤标志物位置与肿瘤位置之间的关联推理模型；3)设计并测试使用反馈控制补偿呼吸诱导运动的治疗床和控制系统；4)使用自回归建模提前预测肿瘤位置，以便通过克服系统中的滞后时间和自适应过滤来识别异常肿瘤位置来提高反馈控制系统的性能。我们建议的结果有可能对肺癌和上腹部癌症的放射治疗产生重大影响。这项拟议的研究工作将导致开发一种使用实时运动同步治疗床的新型运动管理框架。通过使用较小的肿瘤边缘和精确的肿瘤运动补偿，它最终在临床实践中的实施将导致正常组织毒性的降低。这将使更广泛地使用高度适形治疗，如调强放射治疗(IMRT)和立体定向身体放射治疗(SBRT)以可靠的方式。