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.

项目总结/文摘