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

卡里姆乳腺癌是女性最常被诊断出的癌症。在目前筛查乳房X光检查的时代，大多数妇女被诊断为局部早期疾病，治疗方法包括保乳手术和乳房外放射治疗(XRT)。与XRT相比，最近在加速部分乳房照射(APBI)技术(如高剂量率(HDR)近距离治疗)方面的工作表明，通过向缩小的乳腺组织提供更高的每部分剂量，可以显著减少辐射引起的急性皮肤反应，并缩短总体治疗时间。与需要对患者进行5天治疗的HDR近距离放射治疗不同，Sunnybrook最近开发了一种新技术，在局部麻醉下，使用103-Pd的永久性乳房种子植入物(PBSI)在一小时的局部麻醉下进行，患者可以在同一天出院。这里的目标是确保在手术中准确放置种子，并通过引导种子植入并允许在患者仍在手术室和麻醉的情况下纠正不太理想的植入，来评估植入过程中和植入结束时的种子剂量分布，从而实现乳腺癌的有效治疗。这项研究的目标是开发一种选择性、光子计数、固态、基于半导体的伽马相机，专门用于对103-钯的低能(20keV)同位素进行成像，以提供植入过程中放射性粒子的清晰可视化和剂量分布，从而提高当前乳腺癌治疗的最新水平。

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.