ERC-Small Business: Ultrasound-Guided Robotic Brachytherapy Needle-Insertion System with Intraoperative Re-Optimization

前列腺癌每年影响超过241,740名美国男性，使其成为最普遍的癌症类型和男性癌症死亡的第二大原因。一种常用的治疗前列腺癌的方法是近距离放射治疗（BT），或将放射性种子植入前列腺。近距离放射治疗的成功主要取决于术中根据患者个体解剖结构调整放射剂量的能力，即以足够的辐射充分覆盖前列腺，同时避免对周围器官的过度辐射。许多限制近距离治疗的挑战可以通过在近距离治疗植入过程中结合闭环反馈来解决。也就是说，当种子被植入前列腺时，它们的实际位置被测量并反馈给治疗计划系统，该系统重新计算剂量并重新优化计划。该提案利用CISST ERC和Acoustic MedSystems之间先前和正在进行的研究，提供一个集成的、商业上可行的系统，具有以下功能：(1)手术中植入放射性种子的精确定位；(2)术中剂量测定和快速再优化近距离治疗植入计划；(3)准确、高效地执行更新后的种植计划的能力。改进过程的主要目标是通过一个具有精确和优化剂量测定的反馈机制和机器人辅助的过程来最大限度地减少人为错误，以配合重新优化的植入物随着过程的进行。

Prostate cancer affects over 241,740 U.S. males annually, making it the most prevalent cancer type and second leading cause of cancer mortality in men. One frequently utilized method of treating prostate cancer is brachytherapy (BT), or implantation of radioactive seeds into the prostate. The success of brachytherapy chiefly depends on the ability to intra-operatively tailor the radiation dose to the patient's individual anatomy, i.e. adequately cover the prostate with sufficient radiation while simultaneously avoiding excessive radiation to surrounding organs. Many of the challenges that limit brachytherapy can be addressed by incorporating closed-loop feedback in the brachytherapy implant procedure. That is as seeds are implanted into the prostate, their actual positions are measured and fed back to the treatment planning system, which recalculates the dosimetry and re-optimizes the plan. This proposal leverages prior and ongoing research between the CISST ERC and Acoustic MedSystems to provide an integrated, commercially-viable system with following capabilities: (1) precise intra-operative localization of the implanted radioactive seeds; (2) intra-operative dosimetry and rapid re-optimization of the brachytherapy implant plan; and (3) the ability to accurately and efficiently execute the updated implant plan. The major goal of the improved process is to minimize human errors with a procedure that has a feedback mechanism for accurate and optimized dosimetry and robotic assistance in the delivery of needles in accordance with a re-optimized implant as the procedure progresses.