Development of a versatile robotic radiation therapy system

意义：广泛使用非共面光束的机器人放射治疗已被证明 有效地显著改善放射治疗剂量学，从而改善治疗 结果。然而，目前CyberKnife实施这项技术的效率很低 而且在剂量上也不是最优的。这严重限制了符合条件的患者的数量 机器人放射治疗和那些已经接受治疗的人的可实现的临床结果。在……里面 为了克服这些限制，将开发一种新型的机器人放射治疗系统，该系统 可以有效地利用非共面交付空间的全部潜力来治疗大多数 放射治疗患者。 创新点：本系统在以下几个方面具有很强的创新性：1)集成 束流定向和注量优化。2)更紧凑的直线加速器，允许后部 波束。3)灵活的场大小和MLC分辨率，可有效处理大多数目标大小。4) 将实施体积成像和实时IGRT。本项目拟设计 实现这种机器人放射治疗系统的硬件和软件平台。按顺序 为了减小门架尺寸，直线加速器的长度和源与电源之间的距离 MLC需要大幅减少。设计了一种新的3 mV电源，以减少直线加速器 并提供治疗所需的剂量率。物理MLC叶厚度不能 实质上要比1毫米薄。为了在治疗距离处实现高MLC分辨率， 在CyberKnife中，在初级准直器和MLC之间使用间隔器，增加了 门架尺寸标注。这个建议的系统将消除间隔区，但改变肿瘤的焦点。 距离(FTD)，以达到所需的场大小和MLC分辨率。这需要在 一个巨大的解空间，这一能力由4π算法唯一地展示。 研究目标：1.研制一台3 MV激光直线加速器，每分钟能产生800 cGy100 cm的激光。1B.将直线加速器安装在 一台工业机器人，并测试其机械稳健性。1C。集成微型多叶准直器 (MLC)。2A。给出了静态强度调制的全局最优直接孔径解 放射治疗(IMRT)。2B。开发全球容量调制弧疗(GVMAT)解决方案。 2C。开发了一种导航算法，使机器人能够高效地旅行和传递辐射。3A. 进行安全和碰撞模型试验。3B.剂量学端到端测试。3C。QA测试。 影响：成功实现这三个目标将提供一个原型来证明可行性 用于放射治疗的多功能机器人系统。这将具有科学和临床意义， 为进一步的商业开发做好系统的定位。

Significance: Robotic radiotherapy using extensively non-coplanar beams has been shown effective to significantly improve radiation therapy dosimetry, leading to improved treatment outcomes. However, the current implementation of this technique by CyberKnife is inefficient and not dosimetrically optimal. This has severely limited both the number of patients eligible for robotic radiotherapy and the achievable clinical outcome for those who have been treated. In order to overcome these limitations, a novel robotic radiotherapy system will be developed that can efficiently utilize the full potential of the non-coplanar delivery space to treat the majority of radiotherapy patients. Innovation: The proposed system is highly innovative in the following aspect: 1) Integrated beam orientation and fluence optimization. 2) Significantly more compact linac to allow posterior beams. 3) Flexible field sizes and MLC resolution to efficiently treat most target sizes. 4) Volumetric imaging and real-time IGRT will be implemented. This project is proposed to design the hardware and software platforms materializing such a robotic radiotherapy system. In order to reduce the gantry size, both the linac length and the distance between the source and the MLC need to be significantly reduced. A new 3 MV source has been designed to reduce linac length and provide the required dose rate for treatment. The physical MLC leaf thickness cannot be substantially thinner than 1 mm. To achieve a high MLC resolution at the treatment distance, a spacer is used in CyberKnife between the primary collimator and the MLC, increasing the gantry dimension. This proposed system will eliminate the spacer but vary the focus-to-tumor distances (FTD) to achieve desired field size and MLC resolution. This requires optimization in an enormous solution space, a capacity uniquely demonstrated by the 4π algorithm. Aims: 1a: Build the 3MV linac that can produce 800 cGy/min at 100 cm. 1b. Mount the linac on an industrial robot and test its mechanical robustness. 1c. Integrate a micro multi-leaf collimator (MLC). 2a. Develop a global optimal direct aperture solution for the static intensity modulated radiotherapy (IMRT). 2b. Develop a global volumetric modulated arc therapy (gVMAT) solution. 2c. Develop a navigation algorithm for the robot to travel and deliver the radiation efficiently. 3a. Perform safety and collision model test. 3b. Dosimetry end-to-end testing. 3c. QA test. Impact: Successfully achieving these three aims will provide a prototype to prove the feasibility of the versatile robotic system for radiotherapy. It will be scientifically and clinically significant, positioning the system well for further commercial development.