Invited Resubmission: Improved Organ Dose Determination and Imaging in 177Lu Targeted Radionuclide Therapy - towards a clinical solution.

有了这笔拨款，我们将开发一种更准确的方法来处理癌症患者使用靶向肿瘤的放射性物质治疗的医学图像，即靶向放射性核素治疗（TRT）。使用医院SPECT（单光子发射计算机断层扫描）扫描仪拍摄的这些图像通常相当模糊，并且通常难以区分肿瘤和正常健康组织。基于我们之前的发现，通过在计算机上模拟SPECT扫描仪系统，我们将创建一系列校正，以提高这些图像信息的准确性。我们的合作已经成功地表明，我们可以显著提高代表人体的各种简单模型的准确性。我们现在希望将这项工作作为一项先进技术的基础，这项技术将为来自更详细的人体模型的数据提供同样的改进，并最终为接受癌症治疗的实际患者提供同样的改进。这些信息将为医生提供准确的辐射剂量测量，以达到患者体内的肿瘤和关键器官。使用目前的商用SPECT图像，剂量估计的不确定性不允许优化治疗，因此很大一部分患者没有接受最佳治疗。由于目前剂量测量的准确性较低，对这些患者的识别存在问题。有了这些改进的剂量信息，将有助于医生改进他们的治疗方法，潜在地减少副作用和住院时间。这将改善患者的治疗体验，并通过允许医生为每个患者优化治疗来提高治疗效果。只有提高从SPECT扫描仪获得的图像的精度，我们才能提供这些信息。在欧洲各国，准确的剂量信息被认为非常重要。目前正在编写立法，建议对每一位接受靶向放射性核素治疗的患者进行准确的剂量测定。我们的研究将集中在改善使用同位素177Lu治疗的剂量信息。最近的研究表明，与其他疗法相比，使用这种同位素的新疗法可以使患者的预期寿命延长数年，尤其是对影响激素和神经系统的肿瘤。我们的研究将为开发商业解决方案提供基础，使这项资助开发的技术能够用于临床科室进行177Lu的癌症治疗。然而，它可以扩展到涵盖通常用于治疗和来自不同型号的SPECT扫描仪图像的同位素的完整范围。我们已经接触了两家有兴趣帮助将这项研究推向市场的商业公司。这有可能显著改善欧洲每年约20.1万例此类治疗的结果。

With this grant we will develop a far more accurate way of processing medical images from patients receiving cancer therapy using radioactive materials that target their tumours, known as Targeted Radionuclide Therapy (TRT). These images, taken using a hospital SPECT (Single Photon Emission Computed Tomography) scanner, are typically quite blurry and it is often difficult to distinguish tumours from normal healthy tissue. Based on our previous findings, by modelling the SPECT scanner system on a computer we will create a range of corrections that improve the accuracy of the information from these images. Our collaboration has successfully shown that we can significantly improve this accuracy for a variety of simple models representing the human body. We now wish to use this work as the basis of an advanced technique which will provide the same improvements for data from more detailed models of the human body and ultimately for actual patients receiving cancer therapy. This information will be used to provide doctors with an accurate measurement of the radiation dose delivered to the tumours and critical organs in the patient's body.Using current commercial SPECT images, the uncertainties in dose estimation do not allow treatments to be optimised and consequently a significant proportion of patients do not receive the optimal therapy. Identification of these patients is problematic due to the current low accuracy of dose measurements. Having this improved dose information will help doctors to improve their therapies, potentially reducing side effects and hospital stays. This will improve the patients' therapy experience and also improve the efficacy of the therapies by allowing the doctors to optimise the treatment for each patient. Only by improving the accuracy of the images obtained from the SPECT scanner can we provide this information. Accurate dose information is considered very important in countries across Europe. Legislation is currently being written recommending accurate dosimetry for every patient receiving Targeted Radionuclide Therapy treatment. Our research will concentrate on improving the dose information for therapies using the isotope 177Lu. Recent work has shown that new treatments using this isotope can improve a patient's life expectancy by several years compared with other therapies, particularly for tumours affecting the hormonal and nervous systems. Our research will provide the basis for developing a commercial solution that will allow the techniques developed from this grant to be used in clinical departments performing cancer therapy with 177Lu. However, it can be extended to cover the complete range of isotopes commonly used for therapy and for images from different models of SPECT scanner. We have already approached two commercial companies who are interested in helping bring this research to market. This has the potential to provide a significant improvement in the outcome of an estimated 201,000 such therapies performed annually in Europe.