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

 描述(申请人提供)：旋转屏蔽近距离放射治疗(RSBT)是一种新型的高剂量率近距离放射治疗(HDR-BT)，它通过屏蔽、旋转的导管提供前所未有的对辐射剂量分布的控制。与任何现有的放射治疗方式相比，RSBT有望提供更好的亚体积增加和毒性，导致许多癌症部位HDR-BT的范式转变。虽然RSBT在十多年前就被概念化了，但它的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。近年来，随着放射源的发展，有效和高效的RSBT治疗计划系统已成为限制RSBT临床发展的因素。为此，该项目将从根本上开发新的技术和算法，以打破将RSBT引入临床的强大计算障碍。我们假设，与传统的HDR-BT相比，采用先进的治疗计划技术和软件的旋转屏蔽式近距离放射治疗将在肿瘤覆盖和关键结构避免方面提供显著的剂量学改进，并具有临床可接受的交付时间。我们建议：1)开发一种有效的基于压缩传感的RSBT逆剂量优化方法，在最终的治疗计划中实现稀疏强度调制和优化剂量分布的均匀性。2)开发高效的屏蔽排序方法，以优化RSBT治疗计划的交付，努力在计划质量和治疗时间之间实现最佳折衷，并帮助临床医生选择最佳的针对患者的治疗计划。3)以既往接受HDR-BT治疗的宫颈癌、前列腺癌患者为对象，对RSBT治疗计划系统进行剂量学验证。因此，我们的项目将为RSBT临床应用铺平道路，引发 近距离放射治疗接生。

 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.