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

描述（由申请人提供）：每8名美国女性中就有1名在其一生中的某个阶段患上乳腺癌。据估计，每年在美国女性中有超过22.5万例新的乳腺癌病例。保乳治疗（Breast preservation Therapy， BCT），定义为切除原发肿瘤和邻近乳腺组织，然后对乳房和/或区域淋巴结进行放射治疗，已被广泛接受为大多数临床I期或II期浸润性乳腺癌妇女的治疗选择。在各种治疗机制中，通过巧妙地使用巨电压外部光束的部分照射治疗（在本提案中称为部分乳房照射（PBI））是一种侵入性更小、更集中的治疗方法。它使用治疗计划CT扫描，并结合多个放射治疗领域，从外部向乳房肿瘤切除腔提供精确剂量的辐射。成功的PBI治疗的主要技术挑战是将辐射剂量精确地输送到地下目标体积。靶体积定位不准确可能导致PBI治疗失败，因为肿瘤的几何缺失导致复发，和/或每天以高分数剂量照射正常组织造成不可接受的毒性。该SBIR项目的主要目标是开发一种新的三维（3D），图像引导，适应性治疗（3D IGAT）技术，以提高乳房部分照射（PBI）治疗过程中的放射传递精度。我们建议开发一种基于治疗计划计算机断层扫描（CT）扫描与治疗期间获得的患者乳房三维表面轮廓之间精确注册的患者重新定位和纠错的新方法。由于可以实时获取三维表面图像，并且不会产生额外的辐射，因此所提出的重新定位方法提供了一种很好的方法来解决传统的基于激光线的对准系统的两个难题。一个是准确定位乳房肿瘤切除区域，以便给药，另一个是准确快速的患者重新定位，以便复诊。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导致放射治疗领域精确和适应性治疗系统的新一代商业产品。该SBIR项目的研究成果将直接导致放射治疗领域适应性治疗系统的新一代商业产品。美国有超过2000台放射治疗机，全球有更多，临床可接受的基于3d相机的适应性治疗系统的市场是重要的。

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.