Rotating PET and linear accelerator system for PET-guided radiation therapy

描述（由申请人提供）：消融放射治疗是一种非常有效的非侵入性破坏肿瘤的方法。然而，体内的肿瘤随着呼吸而移动，并且需要这种高剂量治疗的精确靶向。有多种技术可以实现肿瘤跟踪以实现体内消融性放射治疗;然而，由于必要的运动管理技术的复杂性和侵入性，这些技术仅限于治疗患者的少数病变。因此，存在具有多于几个转移部位（例如5-10个病灶）的晚期疾病的患者不能用消融性放疗治疗。RefleXion Medical正在开发第一种基于生物指导的直接实时靶向肿瘤的通用方法。利用患者的正电子发射断层扫描（PET）发射，这种新技术允许对多个病变进行连续和自动的剂量调整，从而使靶点的剂量递增和敏感组织的毒性降低。这一概念已被证明与幻影实验和蒙特-卡罗软件模拟。该提案有两个具体目标，以缓解第一个临床原型硬件系统开发过程中的关键风险。目标1将评估辐射源或直线加速器（linac）系统可能对工作台上PET系统的影响，反之亦然。目标2将演示直线加速器和PET系统在闭环机架上的同时操作。这些目标的成功将使完整的临床原型得以完成，并随后使第一个生物引导放射治疗系统商业化。

DESCRIPTION (provided by applicant): Ablative radiotherapy is a very effective way to non-invasively destroy a tumor. Tumors in the body, however, move with respiration and require precise targeting for this high dose treatment. There are a variety of technologies that implement tumor tracking to achieve ablative radiotherapy in the body; however, these are limited to treat just a few lesions in a patient due to the complexity and invasiveness of the necessary motion management techniques. Therefore, patients that present with later stage disease with more than a few metastatic sites (e.g. 5-10 lesions) are not treatable with ablative radiotherapy. RefleXion Medical is developing the first universal method for direct real-time targeting of tumors based on biological guidance. Utilizing positron emission tomography (PET) emissions from the patient, this new technique allows for continuous and automatic dose conformation to multiple lesions, enabling dose escalation to the target(s) and toxicity reduction to sensitive tissues. The concept has been proven with phantom experiments and monte-carlo software simulations. This proposal has two specific aims to mitigate the key risks in the development of the first clinical prototype hardware system. Aim 1 will evaluate the effects that the radiation source or linear accelerator (linac) system may have on the PET system on a bench-top, and vice-versa. Aim 2 will demonstrate simultaneous operation of the linac and PET systems on a closed-ring gantry. Success of these aims will enable the full clinical prototype to be completed and subsequent commercialization of the first biologically guided radiotherapy system.