Development of functional magnetic resonance imaging-guided adaptive radiotherapy for head and neck cancer patients using novel MR-Linac device

使用新型 MR-Linac 设备开发功能性磁共振成像引导的头颈癌患者自适应放疗

• 批准号: 10620868
• 负责人: John Paul Christodouleas
• 金额: $ 22.36万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-13 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10620868
• 关键词: Affect; Anatomy; Biological; Cancer Center; Cancer Patient; Clinical; Clinical Trials; Computer software; Correlation Studies; Data; Development; Device or Instrument Development; Devices; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Disease Resistance; Doctor of Medicine; Dose; Evaluation; Frequencies; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; HPV oropharyngeal cancer; Head and Neck Cancer; Head and Neck Neoplasms; Head and neck structure; Healthcare; Human Papillomavirus; Image; Imaging Techniques; In complete remission; Incidence; Industrialization; Infrastructure; Linear Accelerator Radiotherapy Systems; Magnetic Resonance Imaging; Malignant Neoplasms; Maps; Medical; Methods; Modification; Monitor; Motion; Neck Cancer; Normal tissue morphology; Organ; Outcome; Patients; Positioning Attribute; Primary Neoplasm; Probability; Protocols documentation; Quality Control; Quality of life; Radiation; Radiation Dose Unit; Radiation therapy; Resistance; Roentgen Rays; Series; Standardization; Structure; System; Technology; Texas; Therapeutic; Time; Toxic effect; Tracer; Translating; Treatment Side Effects; Tumor Tissue; Universities; Vendor; anatomic imaging; base; digital; first-in-human; head and neck cancer patient; image guided; image guided radiation therapy; image reconstruction; image registration; imaging biomarker; imaging modality; imaging system; improved; in silico; in vivo; interest; magnetic field; next generation; novel; prospective; prototype; quality assurance; quantitative imaging; radiation response; radioresistant; real-time images; response; risk minimization; side effect; technology development; tumor; validation studies

PROJECT SUMMARY/ABSTRACT Delivering dose to cancers while sparing normal tissue is the ultimate goal in radiotherapy treatment, especially in the head and neck. By identifying tumors which are more likely to respond early in treatment, as well as subvolumes of resistant tumor, radiotherapy plans could be changed each day to take advantages of biological alteration in the tumor, resulting in reduced side effects with equivalent probability of cure. Functional imaging techniques, such as diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM), have demonstrated utility in clinical series in discriminating early responders to radiation therapy in head and neck cancers, as well as identifying radiation resistant disease post-therapy. These functional imaging techniques could be utilized to actively adapt radiation therapy with high frequency during the radiation treatment course, without requiring exogenous contrast or tracer administration. The University of Texas M.D. Anderson Cancer Center, Elekta Medical Systems and Philips Healthcare are jointly developing a combination imaging/therapy delivery device, which combines a 1.5 Tesla MRI with a linear accelerator. The MR-LinAc device provides the capacity to acquire functional and anatomic imaging data daily, in the treatment position, while simultaneously delivering radiotherapy. The proposed project is a five-year technology development strategy that will ultimately result in a unified workflow for quantitative functional imaging guided semi-automated dose modification during head and neck radiotherapy. This project will implement state of the art simultaneous anatomic and DWI image acquisition, spatially accurate dose and image registration, physical and digital phantom-based quality assurance, software tracking of cumulative region of interest dose, serial tracking of apparent diffusion coefficient (ADC) maps, and anatomic and functional imaging constraint based serial re-optimization. Finally, we will leverage data from prospective head and neck cancer MRI clinical trials to validate and harden the proposed imaging acquisition/quality assurance/software workflow in order to demonstrate clinical feasibility and estimate potential for toxicity reduction and clinical utility. Successful completion of this project will result in a method for monitoring functional imaging changes to tumor and normal tissue daily during radiotherapy. This method can be used to generate data to assess the dose to the organs and critical structures and can be used to maximize the dose to the tumor and/or minimize the risk of complications to normal tissue. The resulting data can also be used to study dose-related treatment side effects. The ultimate goal of utilizing this technology is to improve the delivery of radiotherapy treatments and the quality of life of radiotherapy patients.

项目概要/摘要 在不伤害正常组织的情况下向癌症提供剂量是放射治疗的最终目标， 尤其是在头部和颈部。通过识别在治疗早期更有可能产生反应的肿瘤， 以及耐药肿瘤的亚体积，可以每天更改放射治疗计划以利用 肿瘤的生物学改变，从而减少副作用并具有同等的治愈可能性。功能性 成像技术，例如扩散加权成像（DWI）和体素内不相干运动（IVIM） 在临床系列中证明了其在区分头颈部放射治疗早期反应者方面的实用性 癌症，以及识别治疗后的抗辐射疾病。这些功能成像技术 可用于在放射治疗过程中主动适应高频放射治疗， 无需外源性造影剂或示踪剂管理。 德克萨斯大学 M.D. 安德森癌症中心、医科达医疗系统公司和飞利浦医疗保健公司 正在联合开发一种组合成像/治疗输送设备，该设备将 1.5 特斯拉 MRI 与 直线加速器。 MR-LinAc 设备能够采集功能和解剖成像数据 每天，在治疗位置，同时进行放射治疗。 拟议的项目是一项为期五年的技术开发战略，最终将导致 定量功能成像引导半自动剂量修改的统一工作流程 颈部放射治疗。该项目将实现最先进的同步解剖和 DWI 图像 采集、空间精确剂量和图像配准、基于物理和数字模型的质量 保证、累积感兴趣区域剂量的软件跟踪、表观扩散的连续跟踪 系数（ADC）图，以及基于解剖和功能成像约束的串行重新优化。最后， 我们将利用前瞻性头颈癌 MRI 临床试验的数据来验证和强化 提议的成像采集/质量保证/软件工作流程，以证明临床可行性 并估计毒性降低和临床实用性的潜力。 该项目的成功完成将产生一种监测功能成像变化的方法 放疗期间每天对肿瘤和正常组织进行治疗。该方法可用于生成数据来评估 器官和关键结构的剂量，可用于最大化肿瘤的剂量和/或最小化 正常组织出现并发症的风险。所得数据还可用于研究剂量相关治疗 副作用。利用该技术的最终目标是改善放射治疗的效果 以及放射治疗患者的生活质量。