Robotic ultrasound guidance for real-time motion compensated radiation therapy (RobUST), Phase II

该项目将分析在放射治疗中合作使用两个机器人系统的可能性。临床使用的CyerKnife系统的优点是在选择用于治疗的射束的方向时具有大量的自由度，并且其能够通过同步移动辐射源来补偿呼吸运动。这允许创建具有陡峭梯度的非常精确和均匀的剂量分布。到目前为止，最先进的临床技术是使用外部测量的替代信号和不频繁的X射线或CBCT成像进行运动跟踪。该项目第二阶段的目标是进一步评估使用3D超声的实时目标跟踪，最终允许在不需要替代信号的情况下进行治疗。此外，该方法还将能够处理非呼吸运动（如肠运动、膀胱充盈的变化等）。在第一个项目阶段，研究了使用机器人安全放置超声探头的基础知识，结果表明，在计划质量和照射时间方面，将超声机器人集成到治疗过程中是可能的。该项目的基本目标“RobUST II现在是在第一个应用阶段的初步工作的基础上，研究机器人辅助超声在多大程度上可以在治疗部分的持续时间内连续对目标区域进行高质量成像，是否以及如何能够足够快地检测结构的运动和变形以及如何能够使治疗参数适应于检测到的真实的变化受此启发，该项目包括三个研究领域：快速超声图像处理，安全机器人控制和实时自适应治疗计划。虽然每个研究领域都需要非常具体的专业知识和技能，但该项目的最终目标是将其整合到优化的工作流程中，并对整个系统进行实验评估，以实现适应分次内几何变化的运动补偿放射治疗的目标。

The project will analyse the possibility of cooperative use of two robotic systems in radiation therapy. An advantage of the clinically used CyerKnife system is the large number of degrees of freedom when selecting the directions of the beams used for treatment and its capability of compensating for respiratory motion by synchronously moving the radiation source. This allows for creating very precise and homogeneous dose distributions with steep gradients. Until now, the clinical state of the art is motion tracking with externally measured surrogate signals and infrequent X-ray or CBCT imaging. The goal of the second phase of the project is the further evaluation of real-time target tracking using 3D ultrasound, ultimately allowing treatment without the need for surrogate signals. Additionally, this approach will also be able to deal with non-respiratory motion (like bowel motion, changes in bladder filling, etc.). In the first project phase, the basics of safe ultrasonic probe placement using robots were investigated and it was shown that the integration of the ultrasound robot into the treatment process is possible with regard to plan quality and irradiation time. Essential goal of the project "RobUST II is now to investigate, on the basis of the preliminary work of the first application phase, to what extent robot-assisted ultrasound can continuously image the target area in high-quality over the duration of a treatment fraction, whether and how movements and deformations of the structures can be detected sufficiently quickly and how the treatment parameters can be adapted to detected changes in real time.Motivated by this, the project comprises three research areas: fast ultrasound image processing, safe robot control and real-time adaptive treatment planning. While each of these research areas requires very specific expertise and skills, the final goal of the project is their integration into an optimized workflow and experimental evaluation of the entire system with respect to the goal of motion-compensated radiotherapy adapted to intra-fractional geometry changes.