Selective photon counting semiconductor pixel array for real-time imaging of 103-palladium seed in permanent breast seed implantation

乳腺癌是女性中最常见的癌症。在目前的乳房x光筛查时代，大多数妇女被诊断为局部早期疾病，治疗包括保乳手术和乳房外束放疗（XRT）。与XRT相比，最近在加速部分乳房照射（APBI）技术方面的研究，如高剂量率（HDR）近距离放射治疗，显示出辐射引起的急性皮肤反应的显著减少，并通过向缩小的乳房组织体积提供更高的剂量，缩短了总体治疗时间。与需要患者治疗5天的HDR近距离治疗不同，Sunnybrook最近开发了一种新技术，在局部麻醉下使用103-钯进行永久性乳房种子植入（PBSI），只需一小时，患者即可出院。我们的目标是通过确保手术中粒子的准确放置，以及在植入过程中和植入结束时评估粒子的剂量分布，通过指导粒子植入，并允许在患者仍在手术室麻醉时纠正不理想的植入物，从而实现对乳腺癌的有效治疗。本研究的目的是开发一种选择性的、光子计数的、固态的、基于半导体的伽马照相机，专门用于103-钯的低能量（20 keV）同位素成像，以便在植入过程中提供放射性种子的清晰可视化和剂量分布，从而提高目前乳腺癌治疗的水平。

Karim Breast cancer is the most commonly diagnosed cancer in women. In the current era of screening mammography, most women are diagnosed with localized, early stage disease for which treatment will include breast-conserving surgery followed by breast external beam radiotherapy (XRT). Compared to XRT, recent work in Accelerated Partial Breast Irradiation (APBI) techniques such as high dose rate (HDR) brachytherapy, show a dramatic reduction of radiation induced acute skin reactions and a reduction of the overall treatment time by delivering a higher dose per fraction to a reduced volume of breast tissue. In contrast to HDR brachytherapy that requires treatment of the patient for five days, a novel technique was recently developed at Sunnybrook where a permanent breast seed implant (PBSI) using 103-Palladium is administered under local anesthesia in a single one-hour session allowing patients to be discharged the same day. The goals here are to enable effective treatment of breast cancer by ensuring the accurate placement of seeds during surgery and evaluating the seed dose distribution during and at the end of the implantation by guiding the seed implantation and allowing for correction of a less than optimal implant while the patient is still in the operating room and anesthetized. The objective of this research is to develop a selective, photon counting, solid state, semiconductor based gamma-camera dedicated to imaging of low-energy (20 keV) isotopes of 103-Palladium to provide clear visualization and dose distribution of radioactive seeds during the implantation procedure and thus improve state-of-the-art for current breast cancer therapy.