Four-dimensional Adaptive Thoracic Radiotherapy

四维适应性胸部放射治疗

• 批准号: 8074386
• 负责人: PAUL J KEALL
• 金额: $ 31.6万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-16 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8074386
• 关键词: Abdomen; Accounting; Address; Affect; Algorithms; Anatomic Models; Anatomy; Biological; Breathing; Bronchi; Chest; Clinical; Clinical Data; Clinical Research; Clinical Trials; Collaborations; Cost-Benefit Analysis; Data; Data Collection; Development; Dose; Ensure; Esophagus; Four-dimensional; Fractionation; Goals; Heart; Image; Imaging Techniques; Imaging technology; Intensity-Modulated Radiotherapy; Intervention; Location; Lung; Lung Neoplasms; Malignant neoplasm of lung; Measures; Methods; Metric; Modeling; Morphologic artifacts; Motion; Non-Small-Cell Lung Carcinoma; Optics; Outcome; Patient Representative; Patients; Phase; Positioning Attribute; Process; Radiation; Radiation therapy; Relative (related person); Research Infrastructure; Research Personnel; Residual state; Respiration; Safety; Sampling; Shapes; Signal Transduction; Site; Source; Surface; System; Techniques; Testing; Therapeutic; Time; Tissue Model; Tissues; Toxic effect; Treatment Protocols; Uncertainty; Variant; X-Ray Computed Tomography; base; cancer radiation therapy; clinical application; cohort; cone-beam computed tomography; data acquisition; design; image reconstruction; image registration; improved; process optimization; programs; reconstruction; respiratory; response; simulation; skeletal; soft tissue; tool; treatment planning; tumor; vector; virtual

Recent clinical data demonstrates a clear dose-tumor response relationship for both conventional fractionation and hypofractionated nonsmall-cell lung cancer radiotherapy; several large studies confirm the dose-toxicity relationship for lung, esophagus, heart and bronchus. However, lung tumors move with respiration, change position with respect to skeletal anatomy from day to day, and generally decrease in volume during a course of radiotherapy. These anatomic changes hinder the accurate imaging, planning and delivery of thoracic radiotherapy and, hence, impede our ability to maximize the therapeutic window between local control/survival and treatment-induced complications. Developments in respiratory gating, breath-hold radiotherapy and four-dimensional (4D) radiotherapy account for some of the respiratory motion issues, however, these techniques have introduced additional problems that have yet to be addressed. For example, respiratory irregularities in the 4D CT acquisition process manifest themselves as image artifacts and subsequently as systematic errors throughout the entire treatment course. Temporal variations between anatomy motion and the respiratory signal used as a surrogate for this motion introduce significant errors, since the correlation between the surrogate and anatomy motion is location-dependent, and anatomy and surrogate motions vary from cycle to cycle and day today. The overall goal of the project is to systematically quantify anatomic variations throughout a course of radiotherapy for a representative patient cohort, develop strategies to mitigate the effect of the variations, and, thereby, minimize their clinical impact whilst rigorously accounting for the residual uncertainties. To achieve the goal the specific aimsare: (1) To conduct a clinical imaging study to quantify the magnitude and distribution of inter- and intrafraction anatomic variations, including the temporal stability of the tumor/respiration signal correlation. (2) To improve the acquisition and reconstruction of 4D CT images by (a) advancing the 4D CT data collection process and (b) evaluating 4D CT image reconstruction using different respiratory inputs, in addition to quantifying the uncertainty of deformable image-registration algorithms, a core tool for 4D IGART. (3) To develop and investigate the efficacy of inter- and intrafraction probabilistic-based 4D IGART strategies for clinical application and to perform simulation studies to determine the dosimetric and biological improvement gains from the 4D IGART system. The culmination of the project is the clinical implementation of 4D IGART safety and efficacy studies.

最近的临床数据表明，这两种常规的剂量肿瘤响应关系明确 分馏和降量的非细胞肺癌放射疗法；几项大型研究证实了 肺，食道，心脏和支气管的剂量毒性关系。但是，肺肿瘤随着 呼吸，关于骨骼解剖学的变化位置，每天都在 放疗过程中的体积。这些解剖变化阻碍了准确的成像，计划 并提供胸部放射疗法，因此阻碍了我们最大化治疗窗口的能力 在局部控制/生存和治疗引起的并发症之间。 呼吸门控，呼吸良好放射疗法和四维放射疗法的发展 但是，说明了一些呼吸运动问题，但是这些技术引入了其他 尚未解决的问题。例如，4D CT采集中的呼吸不规则性 过程表现为图像伪像，随后作为整个整个系统错误 治疗课程。解剖运动与用作呼吸信号之间的时间变化 由于代理和 解剖运动依赖于位置，而解剖学和替代运动因周期到周期而异 日复一日。 该项目的总体目标是在整个过程中系统地量化解剖变化 用于代表性患者队列的放疗，制定策略来减轻变化的影响， 而且，，在严格地考虑残留不确定性的同时，将其临床影响最小化。到 实现特定目标的目标： （1）进行临床成像研究，以量化间和间 肢体内解剖学变异，包括肿瘤/呼吸信号相关的时间稳定性。 （2）通过（a）推进4D CT数据来改善4D CT图像的采集和重建 收集过程和（b）使用不同的呼吸输入评估4D CT图像重建 除了量化可变形图像注册算法的不确定性，这是一种核心工具 4d Igart。 （3）开发和研究基于概率的4D IGART的效果 临床应用的策略并进行仿真研究以确定剂量计和生物学 4D IGART系统的改进收益。 该项目的高潮是4D IGART安全性和功效研究的临床实施。