Development of a clinical 3D printing based patient-specific MRT dosimetry system

开发基于临床 3D 打印的患者特异性 MRT 剂量测定系统

基本信息

批准号：
ST/P000150/1
负责人：
David Matthew Cullen
金额：
$ 40.64万
依托单位：
University of Manchester
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2016
资助国家：
英国
起止时间：
2016 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ST%2FP000150%2F1
关键词：
Development clinical 3D printing based

项目摘要

Molecular Radiotherapy (MRT) is a relatively common procedure in counties with developed healthcare systems. In this procedure, a labelled radioisotope is administered to the body in order to irradiate and kill tumour cells whilst sparing the surrounding healthy organ tissue. In the UK alone, there are some 200 departments performing over 11000 MRTs annually and ~200,000 therapies in some 28 EU countries.In a recent development towards personalised healthcare, a new EU directive 2013/59 was introduced which requires that all Member states performing any form of radiotherapeutics (including MRT) must provide dosimetry treatment planning for each patient by 6th February 2018. Although this may sound like an obvious situation, MRT has in fact been used clinically for around 75 years with no fully established dosimetry practice for calculating the absorbed dose delivered to tumour targets or to organs at risk. Even though the general steps have been agreed, there still exists a wide variation in the current acquisition, quality and treatment of images used to determine dose. As a result, treatment protocols have often evolved locally, based on experience with a relatively small numbers of patients. Although such patients would all have received similar administered activities, the actual dose received to particular organs could have large variations.As a consequence of the complexities involved, the application of radionuclide dosimetry has been restricted to those academic groups with the facilities to develop in-house techniques. Very few therapy centres currently can validate dose calculations to a known level of accuracy and only a few academic therapy centres can perform MRT Monte Carlo (MC) calculations. Our group, established between The University of Manchester and The Christie, has developed the ability to deliver this within a very large MRT practice. We were recently selected to lead the EU work on validating dose calculations from simulated patient phantoms and physical 3D printed phantoms in the EMPIR MRTDosimetry project (2016-19). The project will provide a standardised European framework for clinical implementation of MRT dose planning. In our approach, developed with an STFC Mini-IPS grant, 3D-printed patient analogues (phantoms) are constructed based on patient CT images. This novel technique has clear potential to provide the foundation of a clinical service to provide a basis for improved activity quantification to all clinical centres and MRT patients in the UK.We are uniquely positioned to deliver this work, having access to a large data base of MRT patient data at The Christie. Working with these data, we can provide the foundation for establishing a future national clinical service. The Christie has the experience in both MRT dosimetry research and in providing training and support for a national clinical service (PET/CT) required to provide a MRT dosimetry service. In addition our collaboration has strong links with industry, in particular Hermes Medical Solutions Ltd, a leading provider of nuclear medicine workstation software. By developing a comprehensive validation methodology for clinical dosimetry systems, and thereby demonstrating that the HERMES dosimetry system meets this standard, our collaboration will be able to provide a de-facto validation standard for clinical dosimetry systems and a market leading package. These links provide a pathway to distribute the techniques to the wider EU and international nuclear medicine market. In turn, this improves patient outcomes by allowing modification of therapy based on disease response and also benefits the healthcare provider by maximising outcome for the same or reduced resource.

分子放射治疗（MRT）在医疗保健系统发达的县是一种相对常见的手术。在此过程中，将标记的放射性同位素注入体内，以照射并杀死肿瘤细胞，同时保护周围的健康器官组织。仅在英国，就有约 200 个部门每年在约 28 个欧盟国家执行超过 11,000 次 MRT 和约 200,000 次治疗。在个性化医疗保健的最新发展中，引入了新的欧盟指令 2013/59，该指令要求所有成员国执行任何放射治疗形式（包括 MRT）必须在 2018 年 2 月 6 日之前为每位患者提供剂量测定治疗计划。虽然这听起来似乎是一个显而易见的情况，但 MRT事实上，它在临床上使用了大约 75 年，但没有完全建立的剂量测定实践来计算传递到肿瘤靶点或危险器官的吸收剂量。尽管一般步骤已经达成一致，但用于确定剂量的图像的当前采集、质量和处理仍然存在很大差异。因此，治疗方案往往是根据相对少数患者的经验在当地发展起来的。尽管这些患者都接受了类似的管理活动，但特定器官收到的实际剂量可能会有很大差异。由于所涉及的复杂性，放射性核素剂量测定的应用仅限于那些具有开发设施的学术团体。房屋技术。目前，很少有治疗中心可以验证剂量计算达到已知的准确度，并且只有少数学术治疗中心可以执行 MRT 蒙特卡罗 (MC) 计算。我们的团队由曼彻斯特大学和科视Christie 联合成立，已经具备在大型 MRT 实践中实现这一目标的能力。我们最近被选为领导欧盟在 EMPIR MRTDosimetry 项目 (2016-19) 中验证模拟患者体模和物理 3D 打印体模的剂量计算的工作。该项目将为 MRT 剂量规划的临床实施提供标准化的欧洲框架。在我们利用 STFC Mini-IPS 资助开发的方法中，3D 打印的患者类似物（体模）是根据患者 CT 图像构建的。这项新技术具有明显的潜力，可以为临床服务奠定基础，为英国所有临床中心和 MRT 患者改进活动量化奠定基础。我们拥有独特的优势来开展这项工作，可以访问大量数据库克里斯蒂的 MRT 患者数据。利用这些数据，我们可以为建立未来的国家临床服务奠定基础。科视在 MRT 剂量测定研究以及为提供 MRT 剂量测定服务所需的国家临床服务 (PET/CT) 提供培训和支持方面拥有丰富的经验。此外，我们的合作与行业有着密切的联系，特别是核医学工作站软件的领先提供商 Hermes Medical Solutions Ltd。通过开发临床剂量测定系统的全面验证方法，从而证明 HERMES 剂量测定系统符合该标准，我们的合作将能够为临床剂量测定系统提供事实上的验证标准和市场领先的软件包。这些链接提供了将这些技术推广到更广泛的欧盟和国际核医学市场的途径。反过来，这通过允许根据疾病反应修改治疗来改善患者的治疗结果，并且通过在相同或减少的资源下最大化结果而使医疗保健提供者受益。