Prospective 3-D Treatment Planning for MR-Guided Laser Induced Thermal Therapy Pr

MR 引导激光诱导热疗法的前瞻性 3D 治疗计划

• 批准号: 8136671
• 负责人: R JASON STAFFORD
• 金额: $ 22.78万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8136671
• 关键词: 3-Dimensional; Address; Aftercare; Algorithms; Anatomy; Area; Brain; Cancerous; Canis familiaris; Clinical Research; Clinical Trials; Complement; Computational algorithm; Computer Simulation; Conventional Surgery; Data; Decision Making; Devices; Dose; Environment; Evaluation; Feedback; Fiber; Generations; Goals; Government; Heating; Hemorrhage; Human; Image; Lasers; Lesion; Magnetic Resonance Imaging; Measures; Modeling; Monitor; Noise; Outcome; Patients; Perfusion; Positioning Attribute; Predisposition; Procedures; Process; Relative (related person); Research; Retreatment; Rosa; Safety; Signal Transduction; Simulate; Slice; System; Technology; Temperature; Therapeutic; Time; Tissues; Translating; Treatment outcome; Uncertainty; United States; Update; base; dosimetry; experience; high risk; in vivo; innovation; minimally invasive; novel; open source; operation; programs; prospective; public health relevance; real time model; spatiotemporal; tool; treatment planning; virtual

DESCRIPTION (provided by applicant): MR-guided laser induced thermal therapy (MRgLITT) for treatment of cancerous lesions in the brain presents a minimally invasive alternative to conventional surgery, gaining use worldwide with multiple on-going clinical trials currently. These therapies incorporate real-time MR temperature imaging (MRTI) to provide feedback which makes these procedures safe and feasible. However, as these therapies translate into clinical studies, there are two deficiencies worth addressing. Firstly, laser heating in the presence of tissue interfaces and convective heat transfer (e.g., ventricles, vessels and tissue perfusion) may render planning of treatments by assuming symmetric ellipsoidal lesion generation difficult, particularly when multiple applicators with arbitrary placement are used. Second, MRTI information may become corrupt in some regions (e.g., from temperature dependent signal losses, blood, or susceptibility effects at interfaces) and the temperature information may be lost or become extremely uncertain, making decisions about treatment outcome difficult. Therefore, in order to enhance the safety, efficacy and conformality of treatment delivery, there exists a critical need for prospective 3D treatment planning of MRgLITT procedures as well as more robust real-time monitoring to complement MRTI. The primary goal of the proposed research is to develop and validate algorithms to provide both prospective 3D treatment planning and real-time model driven treatment monitoring for MRgLITT procedures in the brain. Such a system will incorporate the use of 3D MRI acquisitions currently used for neurosurgical and stereotactic treatment planning and allow the user to interactively navigate the tissue and simulate the effects of various applicator trajectories and laser exposures, update these plans once the laser is positioned, as well as provide real-time 3D estimation of damage based on the acquired multi-slice MR temperature imaging input. Completion of this project will provide not only the tools outlined above, but a framework for our long term goal of applying these models for computer optimized inverse treatment planning as well as real-time modeling for adaptive control of therapy. This project is both innovative and timely in that no technology presently exists for prospective 3D planning of this emerging therapeutic option, much less, integration of such an algorithm with data driven model prediction assistance for monitoring and treatment assessment. This research is high risk in that the complexity of the computational problems to be addressed in near real-time present both physical and theoretical hurdles to overcome, but our previous experience in this area indicate it is feasible. PUBLIC HEALTH RELEVANCE: MR-guided laser induced thermal therapy (MRgLITT) for the treatment of cancerous lesions in the brain is a minimally invasive alternative to conventional surgery and is now available as a commercialized product with many clinical trials in operation or beginning. The primary goal of the proposed research is to develop, investigate and validate 3D prospective treatment planning and real-time MRTI driven model prediction assisted monitoring for MRgLITT procedures in the brain in order to enhance the efficacy and safety of these procedures. This project is both innovative and timely in that no technology presently exists to support prospective 3D treatment planning of this emerging therapeutic option nor data driven real-time modeling for prediction of temperature and tissue damage.

描述（由申请人提供）：MR引导激光诱导的热疗法（MRGLITT）用于治疗大脑中的癌性病变，提出了一种最少的侵入性替代常规手术替代品，目前在全球范围内使用多项正在进行的临床试验。这些疗法结合了实时MR温度成像（MRTI），以提供反馈，从而使这些程序安全可行。但是，随着这些疗法转化为临床研究，有两种值得解决的缺陷。首先，在组织界面和对流传热（例如，心室，血管和组织灌注）的存在下激光加热可能会通过假设对称的椭圆形损伤产生困难，尤其是使用多个具有任意放置的涂抹器时，可以通过假设对称的椭圆形病变来进行处理。其次，在某些区域（例如，界面依赖温度的信号损失，血液或易感性效应）可能会丢失或极其不确定的温度信息，从而使有关治疗结果的决策变得困难。因此，为了增强治疗递送的安全性，功效和保征性，对MRGLITT程序的前瞻性3D治疗计划以及更强大的实时监控以补充MRTI的至关重要的需求。 拟议的研究的主要目标是开发和验证算法，以提供前瞻性的3D治疗计划和实时模型驱动的治疗监测，用于大脑中MRGLITT程序。这样的系统将结合当前用于神经外科和立体定向治疗计划的3D MRI获取，并使用户可以交互性地导航组织并模拟各种施加器轨迹和激光暴露的效果，一旦将激光器定位为位置，并且基于获得的多人损坏，更新这些计划，并提供了3D估算，并提供了经过多级损坏。该项目的完成不仅将提供上面概述的工具，而且还提供了我们的长期目标的框架，即将这些模型应用于计算机优化的逆治疗计划以及实时建模，以适应治疗的自适应控制。该项目既创新又及时，因为目前尚无技术对这种新兴治疗选择的前瞻性3D规划，更少的是将这种算法与数据驱动的模型预测援助进行监测和治疗评估的整合。这项研究是高风险，因为要克服的物理和理论障碍都需要解决的计算问题的复杂性，但我们以前在该领域的经验表明这是可行的。 公共卫生相关性：MR引导激光诱导的热疗法（MRGLITT）用于治疗大脑中癌性病变是一种微创替代常规手术的替代方法，现在可以作为商业化产品可用，在手术或开始进行许多临床试验。拟议研究的主要目标是开发，调查和验证3D前瞻性治疗计划和实时MRTI驱动的模型预测有助于大脑中MRGLITT程序的监测，以增强这些程序的功效和安全性。该项目既创新又及时，因为目前尚无技术来支持这种新兴治疗选择的前瞻性3D治疗计划，也没有数据驱动的实时建模来预测温度和组织损伤。