Developing a Treatment Planning System for Next Generation Rotating-Shield Brachytherapy

 描述（由申请人提供）：旋转屏蔽近距离放射治疗（RSBT）是一种通过屏蔽旋转导管输送的高剂量率近距离放射治疗（HDR-BT）的新型形式，可对辐射剂量分布进行前所未有的控制。预计RSBT相对于任何现有的放射治疗方式提供上级子体积增强和毒性，导致许多癌症部位的HDR-BT的范式转变。尽管RSBT在十多年前就被概念化了，但其临床实施带来了巨大的挑战，需要从根本上先进的创新技术。随着放射源的发展，有效和高效的RSBT治疗计划系统已成为RSBT临床发展的限制因素。为此，该项目将从根本上开发新的技术和算法，以打破将RSBT带入临床的强大计算障碍。 我们假设，旋转屏蔽近距离放射治疗，先进的治疗计划技术和软件供电，将提供显着的剂量学改善肿瘤覆盖和关键结构的避免相对于传统的HDR-BT，具有临床上可接受的输送时间。我们建议：1）开发一种有效的基于压缩感测的RSBT反向剂量优化方法，在所得到的治疗计划中实现稀疏强度调制和优化的剂量分布均匀性以及平滑的注量图。2)开发有效的屏蔽排序方法，以优化RSBT治疗计划的交付，努力实现计划质量和治疗时间之间的最佳权衡，并促进临床医生选择最佳患者特定治疗计划的决策。3)回顾性地用先前用HDR-BT治疗的宫颈癌和前列腺癌的临床病例对RSBT治疗计划系统进行剂量学验证。因此，我们的项目将铺平道路，使RSBT临床可用，引发一个新的时代， 近距离放射治疗

 DESCRIPTION (provided by applicant): Rotating shield brachytherapy (RSBT) is a novel form of high-dose-rate brachytherapy (HDR-BT) delivered through shielded, rotating, catheters, which provide unprecedented control over radiation dose distributions. RSBT is expected to provide superior sub-volume boosting and toxicity relative to any existing radiotherapy modality, resulting in a paradigm shift in HDR-BT for many cancer sites. Although RSBT was conceptualized more than ten years ago, its clinical implementation poses tremendous challenges, demanding fundamentally advanced innovative technologies. With recent development of radiation sources, an effective and efficient RSBT treatment planning system has become a limiting factor for clinical development of RSBT. To this end, this project will develop fundamentally novel technology and algorithms to break the formidable computational barriers to bring RSBT into clinic. We hypothesize that rotating shield brachytherapy, powered with advanced treatment planning techniques and software, will provide significant dosimetric improvements in tumor coverage and critical structure avoidance relative to conventional HDR-BT, with a clinically acceptable delivery time. We propose to: 1) Develop an efficient compressed sensing based RSBT inverse dose optimization method, enabling sparse intensity modulation and optimized homogeneity of dose distributions with smooth fluence maps in the resulting treatment plan. 2) Develop efficient shield sequencing methods to optimize the delivery of RSBT treatment plans, striving to achieve the best tradeoff between plan quality and treatment time, and to facilitate clinicians' decision making on selecting the best patient-specifi treatment plan. 3) Dosimetrically validate the RSBT treatment planning system retrospectively with clinical cases of cervical cancers and prostate cancers previously treated with HDR-BT. As a result, our project will pave the road to make RSBT clinically available, triggering a new era in brachytherapy delivery.