Sharpening the edge in pencil-beam proton therapy: an aftermarket collimation system to better spare normal tissue during radiation treatment

锐化笔形束质子治疗的优势：一种售后准直系统，可在放射治疗期间更好地保护正常组织

• 批准号: 10463607
• 负责人: Daniel E. Hyer
• 金额: $ 42.11万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10463607
• 关键词: Air; Algorithms; Area; Benchmarking; Biological Models; Brain; Brain Neoplasms; Cancer Patient; Childhood; Clinical; Collimator; Community Clinical Oncology Program; Data; Development; Devices; Distal; Dose; Ensure; Equipment; Exposure to; Extravasation; Foundations; Goals; Head and Neck Neoplasms; Individual; Industrialization; Institutes; Intercept; Ions; Lateral; Malignant Neoplasms; Measurement; Measures; Mechanics; Methodology; Mission; Modeling; Motion; National Institute of Biomedical Imaging and Bioengineering; Normal tissue morphology; Outcome; Patient-Focused Outcomes; Patients; Performance; Photons; Plant Leaves; Positioning Attribute; Protons; Public Health; Quality of life; Radiation Dose Unit; Radiation Oncology; Radiation Toxicity; Radiation therapy; Research; Risk; Scanning; Shapes; Spottings; Structure; Surface; System; Techniques; Technology; Testing; Time; Tissues; Translating; Treatment Efficacy; Validation; Work; base; brain tissue; care delivery; clinical care; commercialization; computer design; cost; cost effective; design; fight against; improved; in silico; innovation; model design; new technology; next generation; proton beam; proton therapy; prototype; quality assurance; side effect; treatment planning; tumor

Project Summary/Abstract: There is currently a technological gap in pencil beam scanning (PBS) proton therapy that is resulting in excess spillage of radiation dose outside of the intended target tissue. Existence of this gap represents an important problem because, until a technological solution is developed, patients undergoing PBS proton therapy will be exposed to unwanted radiation dose and the normal tissue complications. The long-term goal is to increase therapeutic efficacy and reduce the risk of side effects associated with PBS proton therapy. The overall objective of this project is to translate and validate a new collimator technology, called the dynamic collimation system (DCS), with an existing commercial PBS proton therapy delivery system in a clinical setting to limit the dose spillage. The DCS makes use of four independently controlled trimmer blades that are designed to move in synchrony with the scanned proton beam during PBS delivery. By intercepting the beam as it arrives at the lateral boundaries of the tumor, the dose distribution can be sharpened and dose to surrounding normal structures can be substantially reduced. Unlike other proposed solutions, the DCS can provide unique collimation for each energy layer of a PBS proton therapy treatment and a footprint small enough to allow placement near the surface of the patient. The rationale for the project is that the addition of the DCS to existing PBS equipment, at only a small fraction of the cost of a $30M+ proton therapy center, can rapidly translate to improved clinical care delivery. Guided by strong preliminary data from our in-silico treatment planning studies, development of the DCS will be carried out by pursing three specific aims: 1) Design, build, and validate a DCS prototype based on our extensive modeling, 2) Minimize the treatment time penalty associated with the DCS, and 3) Provide appropriate methodologies for centers to use the DCS. Under specific aim 1, an existing computer designed model will drive the physical construction of an integrated prototype system and the dosimetric performance will be validated against a model of the system. Under specific aim 2, a trimmer sequencing algorithm will be developed and tested that allows dynamic motion of trimmer leaves simultaneously with beam scanning. The purpose of this algorithm is to minimize the treatment time penalty associated with the DCS, with a target treatment time penalty of less than 2 minutes per treatment session. Under specific aim 3, a quality assurance and commissioning approach will be developed to facilitate safe and effective clinical use of the DCS by the radiation oncology community. The research proposed in this application is innovative because it represents a new and substantial departure from current collimation technologies with the introduction of a compact collimator with dynamic motion for shaping individual pencil beams layer-by-layer. This contribution is expected to be significant as the collimation system will decrease the dose to healthy tissue surrounding the target, leading to improved patient outcomes. Ultimately, such a device has the potential to reduce normal tissue complications for patients undergoing PBS proton therapy.

项目摘要/摘要： 目前，铅笔梁扫描（PBS）质子疗法有一个技术差距，导致过量 辐射剂量的溢出在预期目标组织之外。这个差距的存在代表了一个重要的 问题是因为，在开发技术解决方案之前，接受PBS质子治疗的患者将是 暴露于不良的辐射剂量和正常组织并发症。长期目标是增加 治疗功效并降低与PBS质子治疗相关的副作用的风险。总体 该项目的目的是翻译和验证一种新的准直仪技术，称为动态准则 系统（DC），现有的商业PBS质子治疗输送系统在临床环境中以限制 剂量溢出。 DCS利用四个独立控制的修剪器叶片，这些刀片旨在移动 在PBS传递过程中，与扫描的质子束同步。通过拦截光束到达 肿瘤的横向边界，剂量分布可以锐化并剂量为正常 结构可以大大减少。与其他提议的解决方案不同，DC可以提供独特的 PBS质子疗法治疗的每个能量层的准确层和足够小的足迹 放置在患者表面附近。该项目的理由是将DC添加到 现有的PBS设备仅占3000万美元以上质子治疗中心的一小部分，可以迅速 转化为改进的临床护理。在我们的硅内治疗中的强大初步数据的指导下 计划研究，DC的开发将通过追求三个具体目标来进行：1）设计，建造， 并根据我们的广泛建模验证DCS原型 与DC相关，3）为中心提供适当的方法来使用DC。在具体下 AIM 1，现有的计算机设计模型将推动集成原型的物理结构 系统和剂量学性能将根据系统模型进行验证。在特定目标2下， 将开发和测试修剪测序算法，以允许修剪叶子的动态运动 同时进行光束扫描。该算法的目的是最大程度地减少治疗时间罚款 与DC相关，目标治疗时间罚款少于每次治疗时间少于2分钟。 在特定目标3下，将开发出质量保证和调试方法，以促进安全和 辐射肿瘤学社区对DC的有效临床使用。这项研究提出了 应用具有创新性，因为它代表了与当前准直的新差异 通过引入紧凑的准直仪的技术，并具有动态运动以塑造单个铅笔 梁逐层。预计此贡献将是重要的，因为准直系统将降低 剂量为靶标周围的健康组织，从而改善患者的结局。最终，这样的设备 有可能减少接受PBS质子治疗的患者的正常组织并发症。