PIPER: PROSTATE IMPLANT PLANNING ENGINE FOR RADIOTHERAPY

本二期研究的主要目标是为前列腺种子植入近距离放射治疗开发一种自适应优化和剂量学指导系统，用于手术室的实时治疗计划和植入后剂量测定。具体目标是(a)实现加速遗传算法优化，(b)开发自动图像分割和区域识别工具，以及(c)提供实时剂量学验证和优化指导。近距离放射治疗是目前公认的治疗局限性前列腺癌的主要方法。然而，传统的技术包括三个互不相关的步骤——预先计划、植入和植入后剂量测定——所有步骤相隔1-4周。在这些步骤中产生了不确定性链，因此任何剂量不足都是在治疗完成后才发现的。因此，前列腺近距离放射治疗目前非常依赖操作者。该项目旨在提供优化和图像处理方面的智能技术，使整个治疗过程的术中计划和验证一步到位。通过提供“所见即所得”的环境，临床医生使用者将在离开手术室之前对每个植入物进行充分的剂量测定完全有信心。社会价值是通过每位患者的成本节约和减少当地失败和/或发病率来实现的。PIPER将作为独立的计算机治疗计划系统上市，用于前列腺种子植入近距离治疗的术中剂量优化和手术指导。目标用户是放射肿瘤学家、泌尿科医生、医学物理学家、剂量测定师和放射科医生。

The major goal of this Phase II effort is to develop an adaptive optimization and dosimetric guidance system for prostate seed implant brachytherapy, to be deployed in the operating room for real-time treatment planning and postimplant dosimetry. The specific aims are (a) to implement accelerated genetic algorithm optimization, (b) to develop automated image segmentation and region recognition tools, and (c) to deliver real-time dosimetric verification and optimized guidance. Seed implant brachytherapy is now widely recognized as a major treatment modality for localized prostate cancer. However, conventional techniques involve three disjoined steps -pre-planning, implantation and postimplant dosimetry -all separated by 1-4 weeks. An uncertainty chain is propogated in these steps, such that any under-dosage is only discovered after the completion of treatment. For this reason, prostate brachytherapy is currently very operator-dependent. This project aims to deliver intelligent technologies in optimization and image processing to enable intraoperative planning and verification of the entire treatment in one step. By providing a what-you-see-is-what-you- get environment, clinician-users will have complete confidence of adequate dosimetry for every implant before leaving the operating room. Societal value is to be achieved through cost savings per patient and reduced local failures and/or morbidities. PROPOSED COMMERCIAL APPLICATION PIPER will be marketed as a standalone computer treatment planning system for intraoperative dose optimization and surgical guidance in prostate seed implant brachytherapy. The target users are radiation oncologists, urologists, medical physicists, dosimetrists, and radiologists.