Development of functional magnetic resonance imaging-guided adaptive radiotherapy for head and neck cancer patients using novel MR-Linac device

使用新型 MR-Linac 设备开发功能性磁共振成像引导的头颈癌患者自适应放疗

• 批准号: 10389660
• 负责人: John Paul Christodouleas
• 金额: $ 1.87万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10389660
• 关键词: Affect; Anatomy; Biological; Cancer Center; Cancer Patient; Clinical; Clinical Trials; Computer software; Correlation Studies; Data; Development; Device or Instrument Development; Devices; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Disease Resistance; Doctor of Medicine; Dose; Evaluation; Frequencies; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Head and Neck Cancer; Head and Neck Neoplasms; Head and neck structure; Healthcare; Human Papillomavirus; Image; Imaging Techniques; In complete remission; Incidence; Industrialization; Infrastructure; Linear Accelerator Radiotherapy Systems; Magnetic Resonance Imaging; Malignant Neoplasms; Maps; Medical; Methods; Modification; Monitor; Motion; Neck Cancer; Normal tissue morphology; Organ; Outcome; Patients; Positioning Attribute; Primary Neoplasm; Probability; Protocols documentation; Quality Control; Quality of life; Radiation; Radiation Dose Unit; Radiation therapy; Resistance; Roentgen Rays; Series; Standardization; Structure; System; Technology; Texas; Therapeutic; Time; Toxic effect; Tracer; Translating; Treatment Side Effects; Tumor Tissue; Universities; Vendor; anatomic imaging; base; digital; first-in-human; head and neck cancer patient; image guided; image guided radiation therapy; image reconstruction; image registration; imaging biomarker; imaging modality; imaging system; improved; in silico; in vivo; interest; magnetic field; malignant oropharynx neoplasm; next generation; novel; prospective; prototype; quality assurance; quantitative imaging; radiation response; radioresistant; real-time images; response; risk minimization; side effect; technology development; tumor; validation studies

PROJECT SUMMARY/ABSTRACT Delivering dose to cancers while sparing normal tissue is the ultimate goal in radiotherapy treatment, especially in the head and neck. By identifying tumors which are more likely to respond early in treatment, as well as subvolumes of resistant tumor, radiotherapy plans could be changed each day to take advantages of biological alteration in the tumor, resulting in reduced side effects with equivalent probability of cure. Functional imaging techniques, such as diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM), have demonstrated utility in clinical series in discriminating early responders to radiation therapy in head and neck cancers, as well as identifying radiation resistant disease post-therapy. These functional imaging techniques could be utilized to actively adapt radiation therapy with high frequency during the radiation treatment course, without requiring exogenous contrast or tracer administration. The University of Texas M.D. Anderson Cancer Center, Elekta Medical Systems and Philips Healthcare are jointly developing a combination imaging/therapy delivery device, which combines a 1.5 Tesla MRI with a linear accelerator. The MR-LinAc device provides the capacity to acquire functional and anatomic imaging data daily, in the treatment position, while simultaneously delivering radiotherapy. The proposed project is a five-year technology development strategy that will ultimately result in a unified workflow for quantitative functional imaging guided semi-automated dose modification during head and neck radiotherapy. This project will implement state of the art simultaneous anatomic and DWI image acquisition, spatially accurate dose and image registration, physical and digital phantom-based quality assurance, software tracking of cumulative region of interest dose, serial tracking of apparent diffusion coefficient (ADC) maps, and anatomic and functional imaging constraint based serial re-optimization. Finally, we will leverage data from prospective head and neck cancer MRI clinical trials to validate and harden the proposed imaging acquisition/quality assurance/software workflow in order to demonstrate clinical feasibility and estimate potential for toxicity reduction and clinical utility. Successful completion of this project will result in a method for monitoring functional imaging changes to tumor and normal tissue daily during radiotherapy. This method can be used to generate data to assess the dose to the organs and critical structures and can be used to maximize the dose to the tumor and/or minimize the risk of complications to normal tissue. The resulting data can also be used to study dose-related treatment side effects. The ultimate goal of utilizing this technology is to improve the delivery of radiotherapy treatments and the quality of life of radiotherapy patients.

项目摘要/摘要 在放映正常组织的同时向癌症剂量是放射治疗的最终目标， 特别是在头和脖子上。通过识别更可能在治疗早期反应的肿瘤作为 以及抗性肿瘤的亚参数，可以改变放射治疗计划，以获取优势 肿瘤的生物学改变，导致副作用减少，同等的治愈概率。功能 成像技术，例如扩散加权成像（DWI）和玻璃体内不相干运动（IVIM），具有 在临床系列中证明了效用，以区分早期响应者对头部和颈部的放射治疗 癌症，并鉴定在治疗后抗辐射疾病。这些功能成像技术 可以用来在辐射治疗过程中以高频的高频来主动调整辐射疗法， 不需要外源对比度或示踪剂给药。 德克萨斯大学医学博士安德森癌症中心，Elekta医疗系统和飞利浦医疗保健 正在共同开发组合成像/治疗递送装置，该设备将1.5 Tesla MRI与A结合 线性加速器。 MR-LINAC设备提供了获取功能和解剖成像数据的能力 每天，在治疗位置，同时进行放疗。 拟议的项目是一项五年的技术发展策略，最终将导致 统一的工作流程，用于定量功能成像指导的半自动剂量修饰，并在头部和 颈部放疗。该项目将同时实施ART的解剖和DWI图像 获取，空间准确的剂量和图像注册，基于物理和数字幻影的质量 保证，感兴趣累积区域的软件跟踪剂量，明显扩散的串行跟踪 系数（ADC）图，以及基于解剖和功能成像约束的序列重新优化。最后， 我们将利用前瞻性头颈癌MRI临床试验的数据来验证和硬化 提议的成像采集/质量保证/软件工作流程以证明临床可行性 并估计降低毒性和临床实用性的潜力。 成功完成该项目将导致一种监视功能成像变化的方法 放疗期间每天进行肿瘤和正常组织。该方法可用于生成数据以评估 剂量至器官和临界结构，可用于最大化对肿瘤的剂量和/或最小化 正常组织并发症的风险。所得数据也可用于研究与剂量有关的治疗 副作用。利用这项技术的最终目标是改善放射治疗的交付 以及放射治疗患者的生活质量。