Real-Time Image and Dose Guided Radiation Therapy System

描述(由申请人提供)：实时图像和剂量引导放射治疗系统开发和集成实时图像和剂量引导放射治疗系统早该进行了。先进放射治疗已经发现了机会，并设计了一个单一系统，该系统使用一个通用平台实时成像目标组织、固定组织、提供放射治疗和登记治疗剂量。该系统主要用于肿块切除术后乳腺癌的放射治疗，但也有可能用于其他适应症。该设计结合了用于在两个平行的桨之间固定乳房组织的乳房X光图像引导，以识别(定位)目标组织和非侵入性的近距离放射治疗施用器，这些施放器随后连接到桨上，以提供治疗剂量。因此，专利申请制度第一次允许人们练习“……你看到你治疗的东西，你治疗你看到的东西，然后你记录下你治疗过的东西。”该设计结合了多个治疗方向，每个治疗方向与先前的治疗方向垂直，并在实时图像引导下向目标组织提供立体定向治疗剂量，而不超过介入正常组织的剂量耐受性(包括皮肤剂量)。这种非侵入性设计的剂量质量优于其他局部乳腺照射技术：整个靶区剂量均匀、均匀(没有热点/冷点，剂量均匀指数为1)，与指定组织适形，并显著减少对邻近器官(心脏、肺和对侧乳房)的意外照射。第一阶段研究计划旨在补充该系统正在进行的广泛的临床前简化，并帮助建立对该方法的信心。该项目完成后，预计将确立该设计的可靠性、重复性、安全性和有效性，供临床广泛使用。与公共健康相关：AccuBoost系统代表着综合乳房近距离放射治疗发展的独特进步。该系统通过使用一个单一的成像、治疗和验证平台，为选择乳房保乳治疗(BCT)的患者提供正确的靶向和治疗肿块切除腔边缘的临床保证。该项目涉及所有程序方面，从与外科手术程序的兼容性(手术夹子的成像)开始，到对齐、提供适形(保留组织)治疗以及确认治疗提供。

DESCRIPTION (provided by applicant): Real-Time Image and Dose Guided Radiation Therapy System Development and integration of a real-time image- and dose-guided radiation therapy system is long overdue. Advanced Radiation Therapy has identified an opportunity and designed a single system that uses a common platform for imaging the target tissue in real-time, immobilizing the tissue, delivering radiotherapy, and registering the therapeutic dose. The system is designed primarily for radiotherapy of breast cancer following lumpectomy, but has the potential to be used for other indications. The design combines mammographic image guidance for immobilizing breast tissue between two parallel paddles to identify (localize) the target tissue and non- invasive brachytherapy applicators that are subsequently attached to the paddles for delivering the therapeutic dose. Thus, the patent pending system, for the first time, allows one to practice "... you see what you treat and you treat what you see and then you record what was treated." The design combines multiple treatment directions, each orthogonal to the previous treatment and delivers, under real-time image guidance, a stereotactic therapeutic dose to the target tissue without exceeding the dose tolerance of the intervening normal tissue (including skin dose). The quality of the dose from this non-invasive design is superior to other partial breast irradiation techniques: The dose is uniform throughout the target, homogeneous (no hot/cold spots with a dose homogeneity index of 1), is conformal to the designated tissue, and significantly reduces unintended exposure to neighboring organs (heart, lungs and the contralateral breast). The Phase I research program is designed to complement the extensive on- going pre-clinical streamlining of the system and help with confidence building in the approach. The project, when completed, is expected to have established the reliability, reproducibility, safety, and efficacy of the design for widespread clinical use. PUBLIC HEALTH RELEVANCE: The AccuBoost system represents a unique advancement in the development of an integrated breast brachytherapy treatment. This system provides the clinician assurance of both proper targeting and treatment of the lumpectomy cavity margin for patients electing Breast Conserving Therapy (BCT) through the use of a single platform for imaging, treatment and verification. This project addresses all procedural aspects starting from compatibility with the surgical procedure (imaging of surgical clips), through alignment, delivery of a conformal (tissue sparing) treatment as well as confirmation of treatment delivery.