Integration of endoscopic and CT data for radiation therapy treatment planning

描述(申请人提供)现代放射治疗计划依赖于体积(CT，或有时MRI)成像来确定肿瘤的位置和扩散。此外，治疗头颈部癌症的放射肿瘤学家长期以来一直使用一种特殊的内窥镜--鼻咽镜--来增强治疗计划的体积扫描。在内窥镜检查中，一根细长的、带有摄像头的柔性光管被插入患者体内，以获得光学视频。进行内窥镜检查是因为有经验的临床医生清楚地知道，对肿瘤及其周围解剖的直接可视化可以揭示CT或MRI扫描中看不到的有价值的信息。然而，目前临床医生没有办法在内窥镜视频上描绘肿瘤体积，并将该信息正确地放置到用于治疗计划的CT数据集中。此外，目前还无法查看CT/视频组合数据集。这样的配准尚未完成，部分原因是将鼻咽镜检查期间拍摄的视频与计划中的CT扫描准确配准存在巨大的问题。在这项提案中，我们将创建一种新的方法，将CT扫描与内窥镜视频配准，以产生融合的表示，然后显示给临床医生，以改进放射治疗计划。为了实现这一目标，我们将进一步发展和集成变形配准、机械建模、运动估计、计算机视觉和3D交互显示等方法。有了这样的软件，放射治疗计划将拥有一个全新的补充信息源，用来确定肿瘤的范围。虽然超出了这个项目的直接范围，但我们相信这项技术可以扩展到 人体解剖学，可用于外科手术计划以及放射治疗计划。

DESCRIPTION (provided by applicant) Modern radiation therapy treatment planning relies on volumetric (CT, or sometimes MRI) imaging to determine tumor location and spread. In addition, radiation oncologists treating head and neck cancer have long used a specific endoscopy - nasopharyngoscopy - to augment the treatment planning volumetric scan. In endoscopy, a thin, flexible light-pipe with a camera is inserted into the patient to obtain optical videos. Endoscopy is done because it is clear to the experienced clinician that direct visualization of a tumor and the surrounding anatomy can reveal valuable information not seen on CT or MRI scans. However, there is currently no way for the clinician to delineate the tumor volume on the endoscopic video and have that information placed correctly into the CT dataset used for treatment planning. Also, there is currently no way to view a combined CT/video dataset. Such a registration has not yet been accomplished in part because of the formidable problems of accurately registering a video taken during nasopharyngoscopy with a planning CT scan. In this proposal we will create a new method to register CT scans with endoscopic videos to produce a fused representation that can then displayed to the clinician to improve radiation treatment planning. To accomplish this, we will further develop and integrate methods of deformable registration, mechanical modeling, motion estimation, computer vision, and 3D interactive display. With such software, radiation treatment planning will have an entirely new and complementary source of information with which to determine tumor extent. Although outside the direct scope of this project, we believe that this technology can be extended to other parts of human anatomy and can be useful for surgical planning as well as radiation treatment planning.