Prospective 3-D Treatment Planning for MR-Guided Laser Induced Thermal Therapy Pr

MR 引导激光诱导热疗法的前瞻性 3D 治疗计划

• 批准号: 7991264
• 负责人: R JASON STAFFORD
• 金额: $ 19.75万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7991264
• 关键词: 3-Dimensional; Address; Aftercare; Algorithms; Anatomy; Area; Brain; Cancerous; Canis familiaris; Clinical Research; Clinical Trials; Complement; Computational algorithm; Computer Simulation; Conventional Surgery; Data; Decision Making; Devices; Dose; Environment; Evaluation; Feedback; Fiber; Generations; Goals; Government; Heating; Hemorrhage; Human; Image; Lasers; Lesion; Magnetic Resonance Imaging; Measures; Modeling; Monitor; Noise; Outcome; Patients; Perfusion; Positioning Attribute; Predisposition; Procedures; Process; Relative (related person); Research; Retreatment; Rosa; Safety; Signal Transduction; Simulate; Slice; System; Technology; Temperature; Therapeutic; Time; Tissues; Translating; Treatment outcome; Uncertainty; United States; Update; base; dosimetry; experience; high risk; in vivo; innovation; minimally invasive; novel; open source; operation; programs; prospective; public health relevance; real time model; spatiotemporal; tool; treatment planning; virtual

DESCRIPTION (provided by applicant): MR-guided laser induced thermal therapy (MRgLITT) for treatment of cancerous lesions in the brain presents a minimally invasive alternative to conventional surgery, gaining use worldwide with multiple on-going clinical trials currently. These therapies incorporate real-time MR temperature imaging (MRTI) to provide feedback which makes these procedures safe and feasible. However, as these therapies translate into clinical studies, there are two deficiencies worth addressing. Firstly, laser heating in the presence of tissue interfaces and convective heat transfer (e.g., ventricles, vessels and tissue perfusion) may render planning of treatments by assuming symmetric ellipsoidal lesion generation difficult, particularly when multiple applicators with arbitrary placement are used. Second, MRTI information may become corrupt in some regions (e.g., from temperature dependent signal losses, blood, or susceptibility effects at interfaces) and the temperature information may be lost or become extremely uncertain, making decisions about treatment outcome difficult. Therefore, in order to enhance the safety, efficacy and conformality of treatment delivery, there exists a critical need for prospective 3D treatment planning of MRgLITT procedures as well as more robust real-time monitoring to complement MRTI. The primary goal of the proposed research is to develop and validate algorithms to provide both prospective 3D treatment planning and real-time model driven treatment monitoring for MRgLITT procedures in the brain. Such a system will incorporate the use of 3D MRI acquisitions currently used for neurosurgical and stereotactic treatment planning and allow the user to interactively navigate the tissue and simulate the effects of various applicator trajectories and laser exposures, update these plans once the laser is positioned, as well as provide real-time 3D estimation of damage based on the acquired multi-slice MR temperature imaging input. Completion of this project will provide not only the tools outlined above, but a framework for our long term goal of applying these models for computer optimized inverse treatment planning as well as real-time modeling for adaptive control of therapy. This project is both innovative and timely in that no technology presently exists for prospective 3D planning of this emerging therapeutic option, much less, integration of such an algorithm with data driven model prediction assistance for monitoring and treatment assessment. This research is high risk in that the complexity of the computational problems to be addressed in near real-time present both physical and theoretical hurdles to overcome, but our previous experience in this area indicate it is feasible. PUBLIC HEALTH RELEVANCE: MR-guided laser induced thermal therapy (MRgLITT) for the treatment of cancerous lesions in the brain is a minimally invasive alternative to conventional surgery and is now available as a commercialized product with many clinical trials in operation or beginning. The primary goal of the proposed research is to develop, investigate and validate 3D prospective treatment planning and real-time MRTI driven model prediction assisted monitoring for MRgLITT procedures in the brain in order to enhance the efficacy and safety of these procedures. This project is both innovative and timely in that no technology presently exists to support prospective 3D treatment planning of this emerging therapeutic option nor data driven real-time modeling for prediction of temperature and tissue damage.

描述（由申请人提供）：用于治疗脑部癌性病变的 MR 引导激光诱导热疗法 (MRgLITT) 提供了传统手术的微创替代方案，目前在全球范围内获得了多项正在进行的临床试验的使用。这些疗法结合了实时 MR 温度成像 (MRTI) 来提供反馈，使这些程序安全可行。然而，当这些疗法转化为临床研究时，有两个缺陷值得解决。首先，在存在组织界面和对流热传递（例如心室、血管和组织灌注）的情况下进行激光加热可能会导致通过假设对称椭圆形病变生成变得困难来制定治疗计划，特别是当使用任意放置的多个施用器时。其次，MRTI 信息在某些区域可能会被损坏（例如，由于温度相关的信号丢失、血液或界面处的磁化率影响），并且温度信息可能会丢失或变得极其不确定，从而使有关治疗结果的决策变得困难。因此，为了提高治疗实施的安全性、有效性和适形性，迫切需要 MRgLITT 程序的前瞻性 3D 治疗计划以及更强大的实时监测来补充 MRTI。 拟议研究的主要目标是开发和验证算法，为大脑中的 MRgLITT 程序提供前瞻性 3D 治疗计划和实时模型驱动的治疗监测。这样的系统将结合目前用于神经外科和立体定向治疗计划的 3D MRI 采集的使用，并允许用户交互式导航组织并模拟各种施放器轨迹和激光照射的效果，在激光定位后更新这些计划，以及根据获取的多切片 MR 温度成像输入提供实时 3D 损伤估计。该项目的完成不仅将提供上述工具，还将为我们的长期目标提供一个框架，即应用这些模型进行计算机优化的逆向治疗计划以及治疗自适应控制的实时建模。该项目既具有创新性又很及时，因为目前还没有技术可以对这种新兴治疗方案进行前瞻性 3D 规划，更不用说将这种算法与用于监测和治疗评估的数据驱动模型预测辅助相集成。这项研究风险很高，因为要近实时解决的计算问题的复杂性存在需要克服的物理和理论障碍，但我们之前在该领域的经验表明它是可行的。 公共健康相关性：用于治疗脑部癌性病变的 MR 引导激光诱导热疗法 (MRgLITT) 是传统手术的微创替代方案，现已作为商业化产品提供，许多临床试验正在进行或正在开始。拟议研究的主要目标是开发、调查和验证 3D 前瞻性治疗计划和实时 MRTI 驱动模型预测辅助监测大脑 MRgLITT 程序，以提高这些程序的有效性和安全性。该项目既具有创新性又很及时，因为目前尚无技术支持这种新兴治疗方案的前瞻性 3D 治疗计划，也没有数据驱动的实时建模来预测温度和组织损伤。