Integrated 3D X-Ray/ultrasound guided radiation therapy of soft tissue targets

软组织靶区的集成 3D X 射线/超声引导放射治疗

• 批准号: 8517631
• 负责人: John W Wong
• 金额: $ 38.76万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8517631
• 关键词: Abdomen; Anatomy; Childhood; Clinic; Communities; Complement; Detection; Development; Docking; Dose; Electromagnetics; Engineering; Ensure; Generations; Image; Implant; Institution; Laboratories; Lesion; Liver; Manufacturer Name; Medical; Methods; Monitor; Motion; Nature; Noise; Pancreas; Patients; Pelvis; Performance; Photons; Positioning Attribute; Procedures; Prostate; Prostatic Neoplasms; Radiation; Radiation Oncology; Radiation therapy; Reproducibility; Research; Resort; Retinal Cone; Robotics; Roentgen Rays; Science; Site; Solutions; System; Testing; Three-Dimensional Imaging; Time; Tissues; Ultrasonography; Universities; Validation; commercialization; cone-beam computed tomography; design and construction; detector; expectation; image guided radiation therapy; improved; in vivo; irradiation; novel; operation; prototype; response; sensor; soft tissue; treatment planning; tumor

DESCRIPTION (provided by applicant): Hypofractionated high dose radiation therapy is an increasingly important treatment approach. Image guidance is imperative to ensure accurate patient positioning and to allow the use of tight treatment margin for high dose delivery. At present, the prevailing guidance method employs x- ray imaging to provide 3D volumetric and/or 2D projection information. Unfortunately, the approach is found wanting for tumors at low radiographic contrast with the surrounding tissue. These include important abdominal sites such as prostate, pancreas and liver. Consequently, detection of implanted markers has been employed as an alternative. However, these surrogates are also less than ideal due to the lack of anatomic information and the invasive nature of the procedure. In response to PAR10-169, an academic-industrial partnership is formed between Johns Hopkins University (JHU), Elekta-Resonant and Cleveland Clinic (CC), to develop an integrated 3D x-ray/ultrasound imaging system to provide on-board guidance for hypofractionated radiation therapy. The partnership has significant expertise in x-ray and ultrasound imaging, robotic engineering and radiation therapy. We have 3 specific aims. Specific Aim 1 is to design and construct the system. A 3D ultrasound imaging system will be docked onto a medical accelerator equipped with on-board x-ray cone-beam CT (CBCT) imaging. Ultrasound imaging overcomes the hurdle of detecting low contrast soft tissue target with x-ray imaging, while CBCT provides the anatomic information for setting up the patient in the machine frame of reference and for dose re-calculation if necessary. Robotic control with force sensors will be employed to automate the positioning of the ultrasound system which will remain on the patient throughout the treatment session to provide real-time monitoring. The procedure is non-invasive. The monitoring is non-ionizing and desirable for applications with pediatric patients. Specific Aim 2 focuses on optimizing the IGRT workflow for planning, radiation delivery to avoid the interference of imaging and irradiation procedures with each other. For Specific Aim 3, we will validate the performance of the integrated imaging system at JHU and CC. We will test the hypothesis that guidance using the integrated robotic system is superior to CBCT or ultrasound imaging alone by demonstrating that the target definition is more reproducible and less user-dependent. The expertise of partners is well suited to fulfill the expectations of PAR10-169. Two commercial grade systems will be constructed. JHU and CC represent the end-users to conduct in-field validation of these systems. Elekta-Resonant is also an ideal industrial partner to pursue commercialization for dissemination in the community.

描述（由申请人提供）：大分割高剂量放射治疗是一种日益重要的治疗方法。图像引导对于确保准确的患者定位并允许使用紧密的治疗余量进行高剂量输送至关重要。目前，流行的引导方法采用X射线成像来提供3D体积和/或2D投影信息。不幸的是，该方法被发现不适用于与周围组织放射照相对比度较低的肿瘤。这些包括重要的腹部部位，如前列腺、胰腺和肝脏。因此，植入标记物的检测已被用作替代方案。然而，由于缺乏解剖信息和手术的侵入性，这些替代物也不太理想。为了响应 PAR10-169，约翰霍普金斯大学 (JHU)、Elekta-Resonant 和克利夫兰诊所 (CC) 建立了学术-工业合作伙伴关系，开发集成的 3D X 射线/超声成像系统，为大分割放射治疗提供机载指导。该合作伙伴在 X 射线和超声成像、机器人工程和放射治疗方面拥有丰富的专业知识。我们有 3 个具体目标。具体目标1是设计和构建该系统。 3D 超声成像系统将对接至配备机载 X 射线锥形束 CT (CBCT) 成像的医疗加速器上。超声成像克服了 X 射线成像检测低对比度软组织目标的障碍，而 CBCT 提供了解剖信息，用于在机器参考系中设置患者并在必要时重新计算剂量。将采用带有力传感器的机器人控制来自动定位超声系统，该系统将在整个治疗过程中保留在患者身上以提供实时监测。该过程是非侵入性的。该监测是非电离的，非常适合儿科患者的应用。具体目标 2 侧重于优化 IGRT 规划、辐射输送工作流程，以避免成像和照射程序相互干扰。对于特定目标 3，我们将在 JHU 和 CC 验证集成成像系统的性能。我们将通过证明目标定义更具可重复性且更少依赖于用户来测试以下假设：使用集成机器人系统的引导优于单独的 CBCT 或超声成像。合作伙伴的专业知识非常适合满足 PAR10-169 的期望。将建造两个商业级系统。 JHU 和 CC 代表最终用户对这些系统进行现场验证。 Elekta-Resonant 也是追求商业化并在社区传播的理想工业合作伙伴。

项目成果

System Integration and Preliminary In-Vivo Experiments of a Robot for Ultrasound Guidance and Monitoring during Radiotherapy.

• DOI: 10.1109/icar.2015.7251433
• 发表时间: 2015-07
• 期刊: Proceedings of ... International Conference on Advanced Robotics. International Conference on Advanced Robotics
• 作者: Şen HT;Lediju Bell MA;Zhang Y;Ding K;Wong J;Iordachita I;Kazanzides P
• 通讯作者: Kazanzides P

Comparative analysis of traditional and coiled fiducials implanted during EUS for pancreatic cancer patients receiving stereotactic body radiation therapy.

• DOI: 10.1016/j.gie.2012.07.006
• 发表时间: 2012-11
• 期刊: Gastrointestinal endoscopy
• 影响因子: 7.7
• 作者: Khashab MA;Kim KJ;Tryggestad EJ;Wild AT;Roland T;Singh VK;Lennon AM;Shin EJ;Ziegler MA;Sharaiha RZ;Canto MI;Herman JM
• 通讯作者: Herman JM

A Cooperatively Controlled Robot for Ultrasound Monitoring of Radiation Therapy.

• DOI: 10.1109/iros.2013.6696791
• 发表时间: 2013-11
• 期刊: Proceedings of the ... IEEE/RSJ International Conference on Intelligent Robots and Systems. IEEE/RSJ International Conference on Intelligent Robots and Systems
• 作者: Tutkun Şen H;Lediju Bell MA;Iordachita I;Wong J;Kazanzides P
• 通讯作者: Kazanzides P

System Integration and In Vivo Testing of a Robot for Ultrasound Guidance and Monitoring During Radiotherapy.

• DOI: 10.1109/tbme.2016.2612229
• 发表时间: 2017-07
• 期刊: IEEE transactions on bio-medical engineering
• 作者: Sen HT;Bell MAL;Zhang Y;Ding K;Boctor E;Wong J;Iordachita I;Kazanzides P
• 通讯作者: Kazanzides P

Assessing feasibility of real-time ultrasound monitoring in stereotactic body radiotherapy of liver tumors.

评估实时超声监测在肝脏肿瘤立体定向放射治疗中的可行性。

• DOI: 10.7785/tcrt.2012.500323
• 发表时间: 2013
• 期刊: Technology in cancer research & treatment
• 影响因子: 2.8
• 作者: Zhong,Yahua;Stephans,Kevin;Qi,Peng;Yu,Naiching;Wong,John;Xia,Ping
• 通讯作者: Xia,Ping