A Novel 3D Surface-Image Guided Adaptive Therapy System (IGAT) for Breast Irradia

描述(由申请者提供)：每8名美国女性中就有一人在一生中的某个时候患上乳腺癌。据估计，美国女性每年新增的乳腺癌病例超过22.5万例。乳腺保乳治疗(BCT)是指切除原发肿瘤和邻近乳腺组织，然后放射治疗乳腺和/或区域淋巴结，已被广泛接受为大多数临床I期或II期浸润性乳腺癌的治疗选择。在各种治疗机制中，巧妙地使用兆伏外照射(在本建议中称为部分乳房照射(PBI))进行部分放射治疗是一种侵入性更小、更有针对性的治疗方法。它使用治疗计划CT扫描，并结合多个放射治疗领域，将精确剂量的辐射从外部输送到肿块切除术腔内。成功的PBI治疗的主要技术挑战是准确地将辐射剂量输送到地下靶区。靶体积定位不准确可能导致PBI治疗失败，原因是肿瘤几何未命中导致复发，和/或每日以高剂量照射正常组织造成不可接受的毒性。该SBIR计划的主要目标是开发一种新的三维(3D)、图像引导、自适应治疗(3D IGAT)技术，以提高部分乳房照射(PBI)治疗过程中放射治疗的精度。我们建议开发一种新的方法，基于治疗计划的计算机断层扫描(CT)扫描和在治疗过程中获得的患者乳房的3D表面轮廓之间的准确配准，来进行患者重新定位和纠错。由于三维表面图像可以实时获取，并且不会引起额外的照射，因此提出的重新定位方法为解决传统的基于激光线条的对准系统的两个困难提供了一种很好的方法。一个是精确定位肿块切除野以进行剂量传递，另一个是为回访患者准确和快速地重新定位。这种新技术的主要优点包括：三维表面图像。该SBIR项目的研究成果将直接为放射治疗领域的精确和自适应治疗系统带来新一代商业产品。该SBIR项目的研究成果将直接为放射治疗领域的自适应治疗系统带来新一代商业化产品。美国有2000多台放射治疗机，全球还有更多，临床上可以接受的基于3D摄像机的自适应治疗系统的市场规模很大。

DESCRIPTION (provided by applicant): One in every 8 American women develops breast cancer at some point in their lifetime. It is estimated that more than 225,000 new cases of breast cancer occur among American women each year. Breast Conserving Therapy (BCT), defined as excision of the primary tumor and adjacent breast tissue followed by radiation therapy of the breast and/or regional lymph nodes, has been widely accepted as a treatment option for most women with clinical Stage I or II invasive breast cancer. Among the various treatment mechanisms, partial Irradiation treatment through the clever use of megavoltage external beams (called partial breast irradiation (PBI) in this proposal) is a less invasive more focused treatment. It uses a treatment planning CT scan and combines multiple radiation treatment fields to deliver precise doses of radiation externally to the lumpectomy cavity. The major technical challenge for a successful PBI treatment is the precise delivery of radiation dose to the subsurface target volume. Inaccurate localization of the target volume could result in PBI treatment failure due to recurrence caused by geometric miss of the tumor, and/or unacceptable toxicity caused by daily irradiating normal tissue at a high fractional dose. The primary objective of this SBIR program is to develop a novel, three-dimensional (3D), image-guided, adaptive therapy (3D IGAT) technique to improve the precision of radiation delivery during the procedure of Partial Breast Irradiation (PBI) treatment. We propose to develop a novel approach of patient repositioning and error correction based on accurate registration between the treatment-planning computed tomography (CT) scan and the 3D surface profiles of a patient's breast acquired during the treatment. Since 3D surface images can be acquired in real-time and will cause no additional irradiation, the proposed repositioning approach provides an elegant way to solve the two difficulties of the traditional laser line based alignment system. One is accurate localization of the lumpectomy field for dose delivery, and the other is accurate and fast patient repositioning for return visits. The major advantages of this novel technique include the following: 3D surface images. The research results of this SBIR project will lead directly to a new generation of commercial products for accurate and adaptive therapy systems in radiotherapy field. The research results of this SBIR project will lead directly to a new generation of commercial products for adaptive therapy systems in radiotherapy field. With over 2,000 radiation treatment machines in the US and many more worldwide, the market for a clinically acceptable 3D-Camera-based adaptive therapy system is significant.