Development of a Novel Lung Function Imaging Modality for comprehensive management of lung cancer

我们的项目提出了一个学术-产业合作伙伴关系来翻译一种新的肺功能成像模式 进入接受放射治疗的肺癌患者的临床护理。正在接受治疗的肺癌患者 放射治疗可能会产生严重的、有时危及生命的胸部副作用。的确有 新的数据显示，一种新的肺功能成像方式可以减少副作用并改善 接受放射治疗的肺癌患者的生活质量。新的肺功能成像方式， 被称为‘4DCT-通风’，使用4DCT数据和图像处理技术来创新性地 计算肺通气图。4DCT-通风可通过使患者能够 功能回避放射治疗计划的生成。功能回避使用4DCT-通风来 避免肺的功能部分，假设减少对功能肺的剂量就会减少 胸腔副作用。我们的4DCT-通风研究已经从回溯性研究发展到早期- 使用4DCT-呼吸机进行功能性避免放射治疗的阶段试验。早期有希望的毒性结果 来自4DCT的临床试验为国家试验和扩大临床试验提供了强有力的理由 跨各个诊所的整合。问题是，扩大4DCT-通风的临床集成是 由于缺乏一致的、有效的和临床验证的方法，目前还不可能。我们提出了一个 与MIM Software建立学术-行业合作伙伴关系，以应对这些阻碍临床集成的挑战 4DCT-通风。我们研究的目的是开发能够安全、有效和临床应用的方法 经验证的4DCT-通风功能回避临床整合方法。我们最重要的假设 我们开发的4DCT-通风功能回避创新将被证明可以减少肺 既往没有4DCT-机械通气经验的诊所的毒性。该项目将在3个目标下进行。目标1将 开发实现自动4DCT通风计算的方法，包括自动分段、 统计稳健的计算方法和临床上有效的质量保证工具。目标2将会发展 4DCT通风功能回避放射治疗的方法包括图像异质性评价， 开发基于知识的功能规划方法，并评估在 降低毒性。与我们的行业合作伙伴一起，目标1和目标2中开发的方法将是 集成在商业级软件工具中。AIM 3将通过评估4DCT- 在没有预先进行4DCT-机械通气的临床中，可以证明避免通风功能可以减少毒性 经验。我们的项目将生成所需的工具和数据，以提供指导如何正确地 将4DCT-通风纳入临床护理。这些方法和数据最终将达到商业级 适合繁忙诊所的站台。4DCT-机械通气在改善肺癌预后方面有很大潜力 患者和我们的项目将使这一新的成像模式集成到临床护理中。

Our project proposes an academic-industrial partnership to translate a novel lung function imaging modality into clinical care for lung cancer patients receiving radiation therapy. Lung cancer patients being treated with radiation can experience serious and sometimes life threatening thoracic side effects from treatment. There is emerging data demonstrating that a novel lung function imaging modality can reduce side-effects and improve quality of life for lung cancer patients undergoing radiation therapy. The novel lung function imaging modality, referred to as `4DCT-ventilation,' uses 4DCT data along with image processing techniques to innovatively calculate lung ventilation maps. 4DCT-ventilation can improve outcomes for lung cancer patients by enabling the generation of functional avoidance radiotherapy plans. Functional avoidance uses 4DCT-ventilation to avoid functional portions of the lung, with the hypothesis that reducing dose to functional lung will reduce thoracic side effects. Our 4DCT-ventilation research has progressed from retrospective studies to an early- phase trial using 4DCT-ventilation for functional avoidance radiotherapy. The early promising toxicity results from 4DCTventilation clinical trials is providing a strong rationale for national trials and expanded clinical integration across individual clinics. The problem is that expanded clinical integration of 4DCT-ventilation is currently not possible due to a lack of consistent, efficient, and clinically validated methods. We propose an academic-industry partnership with MIM Software to address these challenges precluding clinical integration of 4DCT-ventilation. The purpose of our study is to develop methods that enable safe, efficient, and clinically validated methods for clinical integration of 4DCT-ventilation functional avoidance. Our overarching hypothesis is that the 4DCT-ventilation functional avoidance innovations we develop will be demonstrated to reduce lung toxicity in clinics with no prior 4DCT-ventilation experience. The project will be carried out in 3 aims. Aim 1 will develop methods that enable automated 4DCT-ventilation calculations including auto-segmentation, statistically-robust calculation methods, and clinically-efficient quality assurance tools. Aim 2 will develop methods for 4DCTventilation functional avoidance radiotherapy including image heterogeneity assessment, development of knowledge-based functional planning methods, and evaluation of metrics most critical in reducing toxicity. In conjunction with our industry partner, the developed methods from Aims 1 and 2 will be integrated in a commercial-grade software tool. Aim 3 will evaluate feasibility by assessing whether 4DCT- ventilation functional avoidance can be demonstrated to reduce toxicity in clinics with no prior 4DCT-ventilation experience. Our project will generate both the tools and data needed to provide guidance on how to properly incorporate 4DCT-ventilation into clinical care. The methods and data will culminate in a commercial-grade platform suitable for busy clinics. 4DCT-ventilation has great potential to improve outcomes for lung cancer patients and our project will enable the integration of this novel imaging modality into clinical care.