Product Development of Intensity Modulation for Bolus Electron Conformal Therapy

用于推注电子适形治疗的强度调制产品开发

• 批准号: 10024062
• 负责人: Kevin James Erhart
• 金额: $ 105.91万
• 依托单位: DECIMAL, INC.
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-13 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10024062
• 关键词: Acute; Algorithms; Bolus Infusion; Caliber; Cancer Center; Cancer Control; Cancerous; Chest wall structure; Clinic; Clinical; Clinical Treatment; Collimator; Computer software; Computers; Conformal Radiotherapy; Data; Data Set; Development; Devices; Distal; Dose; Ear; Effectiveness; Electron Beam; Electron Beam Therapy; Electrons; Ensure; Evaluation; Evaluation Reports; Eye; Failure; Feedback; Grant; Health Benefit; Heterogeneity; Individual; Institution; Intensity-Modulated Radiotherapy; Island; Malignant Neoplasms; Mastectomy; Measurement; Measures; Medical; Medical center; Methods; Modality; Modeling; Monte Carlo Method; Normal tissue morphology; Optics; Pathway interactions; Patients; Phase; Positioning Attribute; Procedures; Process; Protons; Radiation; Radiation Oncologist; Radiation therapy; Radiotherapy Research; Research; Research Design; Risk; Roentgen Rays; Salivary Glands; Scalp structure; Second Primary Cancers; Site; Skin; Small Business Innovation Research Grant; Software Tools; Surface; System; Techniques; Technology; Testing; Tissues; Translating; Treatment Cost; Tungsten; Water; base; cancer risk; cancer therapy; commercialization; cost; density; design; electron energy; hazard; improved; innovation; novel strategies; phase 2 designs; product development; quality assurance; radiation adverse effect; research and development; sarcoma; software development; success; tool; treatment planning; tumor; usability

Project Summary/Abstract Objective: This project aims to elevate electron beam therapy (EBT) technology, which provides effective radiation treatment for superficial cancers (depth<6 cm), to that of other external beam radiotherapies (XRT), e.g. x-rays and protons, by bringing electron intensity modulation into the clinic. Challenge: Approximately 10% of radiotherapy patients (173,000 in USA annually) receive EBT for a portion of their treatment, and as many as 10% of these (17,300 annually) might benefit from bolus electron conformal therapy (BECT), which conforms the distal 90% dose surface to the cancerous planning target volume (PTV), protecting adjacent healthy tissue. Currently, radiation oncologists are limited in using BECT because PTV dose spread can be as great as 30% due to irregular bolus surface. This can be reduced to 10% by spatially modulating incident electron beam intensity. Heretofore, electron intensity modulation delivery technology has been unavailable. Innovation: Using our research collaborator’s recently invented electron intensity modulator design, Phase I demonstrated proof-of-principle for a PRIME (Passive Radiotherapy Intensity Modulator for Electrons), a low cost technology for which .decimal developed a fabrication method. PRIME consists of a matrix of small- diameter, cylindrical tungsten island blocks imbedded in a low-density foam in the beam-defining, collimating aperture. Varying diameters of island blocks placed on a hexagonal grid achieves desired intensity modulation. However, because current treatment planning systems (TPS) cannot manage PRIMEs, an electron TPS needs to be developed as well. Research Design: Phase II specific aims include (1) refining the pencil beam redefinition algorithm used for dose calculation under island blocks, (2) creating and evaluating an electron specific TPS, COMET-Plan (Computer Optimized & Modulated Electron Therapy Planning), which plans intensity modulated bolus electron conformal therapy (IM-BECT) and conventional EBT, managing treatment aids such as skin collimators and eye shields, (3) developing factory and clinical PRIME quality assurance methods, (4) performing a multi-institutional treatment planning study to determine the degree to which IM-BECT improves BECT dose plans, and (5) validating IM-BECT planning and delivery by comparing doses measured in anthropomorphic phantoms with planned (calculated) doses. Health Benefit: PRIME devices and COMET-Plan software will allow a new technique, IM-BECT, which provides uniform dose conforming to the PTV, resulting in (1) equally high chance of cancer control, (2) equally or better low chance of acute normal tissue complications, and (3) decreased chance of secondary cancers. For some patients, this will provide a better dose distribution than other XRT modalities, such as volumetric arc therapy or helical tomotherapy, improving their cancer treatment. Commercialization: As the world’s leading company producing patient-specific radiotherapy devices we are well equipped for bringing PRIME intensity modulators and COMET-Plan software to radiotherapy clinics, supporting the exciting, new IM-BECT.

项目摘要/摘要 目的：该项目旨在提升电子束疗法（EBT）技术，该技术提供有效 浅表癌（深度<6 cm）的辐射处理，对其他外束放射线（XRT）的辐射处理， 例如X射线和质子，通过将电子强度调制带入诊所。挑战：大约 10％的放射治疗患者（美国每年173,000例）接受了一部分治疗的EBT，AS 其中有10％（每年17,300）可能受益于推注电子保形治疗（BECT），这可能会受益于此 将远端的90％剂量表面符合取消计划目标体积（PTV），以保护相邻 健康的组织。目前，使用BECT的辐射肿瘤学家受到限制，因为PTV剂量扩散可以作为 由于推注表面不规则，高达30％。通过空间调节事件可以将其降低至10％ 电子束强度。迄今为止，电子强度调制输送技术一直无法使用。 创新：使用我们的研究合作者最近发明的电子强度调制器设计，第一阶段 为素数（电子的被动放疗强度调节剂）展示了原则证明 低成本的技术为此开发了一种制造方法。 Prime由小型矩阵组成 直径，圆柱形钨岛阻塞在梁定义的低密度泡沫中嵌入 准直孔。放置在六角形网格上的岛块的直径变化 调制。但是，由于当前的治疗计划系统（TPS）无法管理素数，所以 电子TPS也需要开发。研究设计：第二阶段的特定目的包括（1）完善 铅笔梁重新定义用于在岛块下计算剂量计算的算法，（2）创建和评估 电子特异性TPS，彗星计划（计算机优化和调制电子疗法计划）， 哪个计划强度调节推注电子保形疗法（IM-BECT）和常规EBT， 管理治疗辅助物，例如皮肤直接剂和眼罩，（3）开发工厂和临床质量 质量保证方法，（4）进行多机构治疗计划研究以确定 Im-bect改善BECT剂量计划的程度，以及（5）通过 比较在拟人化幻象中测得的剂量与计划的（计算）剂量。健康益处： Prime设备和彗星计划软件将允许采用新技术，即提供统一 符合PTV的剂量，导致（1）同样高的癌症控制机会，（2）平均或更好 急性正常组织并发症的机会，（3）次级癌症的机会降低。对于某些人 患者，这将提供比其他XRT模式更好的剂量分布，例如体积弧治疗 或螺旋疗法，改善其癌症治疗。商业化：作为世界领先的 公司生产特定于患者的放射治疗设备，我们有能力带来优质强度 调节器和彗星计划软件可放射疗法诊所，支持令人兴奋的新IM-BECT。

项目成果

Planning and delivery of intensity modulated bolus electron conformal therapy.

• DOI: 10.1002/acm2.13386
• 发表时间: 2021-10
• 期刊: Journal of applied clinical medical physics
• 影响因子: 2.1
• 作者: Hilliard EN;Carver RL;Chambers EL;Kavanaugh JA;Erhart KJ;McGuffey AS;Hogstrom KR
• 通讯作者: Hogstrom KR

Factory quality assurance of passive radiotherapy intensity modulators for electrons using kilovoltage x-ray imaging.

• DOI: 10.1002/acm2.13943
• 发表时间: 2023-07
• 期刊: JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
• 影响因子: 2.1
• 作者: McGuffey, Andrew S.;Pitcher, Garrett M.;Guidry, Rebecca L.;Erhart, Kevin J.;Hogstrom, Kenneth R.
• 通讯作者: Hogstrom, Kenneth R.