REAL-TIME ROBOTIC IMAGE-GUIDED PROSTATE BRACHYTHERAPY

在前列腺癌治疗过程中，提出了一种基于机器人增强的实时三维超声可视化和植入系统，用于术中剂量计划、放射性植入物的实时机器人指导和在线植入物评估。这个新系统包括一个实时三维直肠内成像探头和支持可视化界面，以及机器人插入针/源，与可选的剂量测定计划精确同步。目前使用经直肠超声引导进行近距离治疗的技术很难实施，并且经常导致不可接受的并发症发生率。所提出的技术的目的是在3D超声引导近距离治疗期间，通过将实时术中剂量测定与机器人辅助源植入相结合，巩固整个植入过程，减少并发症发生率并改善局部控制。第一阶段的主要目标是确定机器人针头/粒子植入幽灵的可行性，并确定可实现的精度水平。拟议的商业应用：这项研究的结果可能对使用更高剂量的放射治疗前列腺癌有直接的好处，更准确的定位和更少的毒性和更低的发病率。在机器人植入植入物的过程中，它将提供实时三维前列腺体积可视化的能力，即使在经验不足的临床医生手中，也能提供反映最佳剂量的植入物。一大群早期疾病患者是候选患者，包括通常因公众弓干扰而被排除在外的患者。

A technique is proposed for the development of a real-time, 3- dimensional ultrasound-based visualization and implant system with robotic augmentation for intraoperative dose planning, real-time robotic guidance of radioactive implants and on-line implant assessment during the procedure for treatment of prostate cancer. This new system includes a real-time 3-dimensional endorectal imaging probe and supporting visualization interfaces coupled with robotic insertion of needles/sources in exact concurrence with optional dosimetry plan. Present techniques using transrectal ultrasound guidance for brachytherapy are difficult to implement and often result in unacceptable rates of complication. The aim of the proposed technique is to consolidate the total implant procedure, reduce Complication rates and improve local control by linking real-time intraoperative dosimetry with robotic-assisted source implantation during 3D ultrasound-guided brachytherapy. The primary objective of Phase I is to establish feasibility of robotic needle/seed implantation in phantoms and determine achievable levels of accuracy. PROPOSED COMMERCIAL APPLICATIONS: The outcome of this research could be of immediate benefit in the treatment of prostate cancer using higher dose radiation with more accurate localization and fewer toxicities1less morbidity. It would provide the ability to visualize in real time the 3D prostate volume during robotic placement of implants, providing implants which reflect optimal dosimetry even in the hands of less experienced clinicians. A large group of patients with early-stage disease are candidates, including patients which would have normally been excluded because of public arch interference.