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

描述（由申请人提供）：每8名美国妇女中就有一名在一生中的某个时候患上乳腺癌。据估计，每年有超过225，000例新的乳腺癌病例发生在美国女性中。保乳治疗（BCT）定义为切除原发肿瘤和邻近乳腺组织，然后对乳腺和/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期浸润性乳腺癌女性的治疗选择。在各种治疗机制中，通过巧妙使用兆伏外部射束的部分照射治疗（在本提案中称为部分乳房照射（PBI））是一种侵入性较小的更集中的治疗。它使用治疗计划CT扫描，并结合多个放射治疗野，向肿瘤切除术腔体外部提供精确剂量的放射。成功的PBI治疗的主要技术挑战是将辐射剂量精确输送到表面下靶体积。靶体积的不准确定位可能导致PBI治疗失败，这是由于肿瘤的几何错过引起的复发和/或由以高分数剂量每日照射正常组织引起的不可接受的毒性。该SBIR计划的主要目标是开发一种新型的三维（3D）图像引导自适应治疗（3D IGAT）技术，以提高部分乳腺照射（PBI）治疗过程中的辐射输送精度。我们建议开发一种新的方法，患者重新定位和误差校正的基础上，治疗计划的计算机断层扫描（CT）扫描和3D表面轮廓的患者的乳房在治疗过程中获得的准确登记。由于3D表面图像可以实时获取，不会引起额外的照射，所提出的重新定位方法提供了一种优雅的方式来解决传统的基于激光线的对准系统的两个困难。一个是肿瘤切除术野的精确定位以进行剂量输送，另一个是患者的准确和快速重新定位以进行回访。这种新技术的主要优点包括：3D表面图像。该SBIR项目的研究成果将直接导致放射治疗领域的新一代精确和自适应治疗系统的商业产品。该SBIR项目的研究成果将直接导致放射治疗领域自适应治疗系统的新一代商业产品。在美国有超过2,000台放射治疗机，在全球范围内还有更多，临床上可接受的基于3D摄像机的自适应治疗系统的市场非常重要。

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.