Integrated Photoacoustic Ultrasound Real-time Imaging for Brachytherapy Treatment

用于近距离放射治疗的集成光声超声实时成像

• 批准号: 8593128
• 负责人: Emad M Boctor
• 金额: $ 17.74万
• 依托单位: ACOUSTIC MEDSYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-12 至 2014-08-11
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8593128
• 关键词: Acoustics; Address; Adverse effects; Affect; Air; Anatomy; Animals; Area; Biological; Brachytherapy; Brachytherapy Seeds; Cancer Control; Cancer Etiology; Clinical; Computer software; Conventional Surgery; Coupled; Deposition; Development; Diagnosis; Dose; Drug Delivery Systems; Edema; Employee Strikes; Evaluation; External Beam Radiation Therapy; Fiber; Fiber Optics; Future; Gel; Goals; Grant; Hearing; Image; Imagery; Implant; Integrated Delivery Systems; Ionizing radiation; Lasers; Lead; Lightning; Location; Malignant Neoplasms; Malignant neoplasm of prostate; Maps; Measures; Mechanics; Metals; Methods; Modification; Monitor; Morbidity - disease rate; Nature; Needles; Operating Rooms; Operative Surgical Procedures; Optics; Organ; Outcome; Patients; Phase; Physicians; Physiologic pulse; Pilot Projects; Population; Positioning Attribute; Prevalence; Procedures; Property; Prostate; Prostatic; Quantitative Evaluations; Radiation; Radioactive; Radioactive Seed Implantation; Rectum; Report (document); Reporting; Research; Risk; Robotics; Safety; Seed Implantation; Seeds; Signal Transduction; Source; System; Systems Integration; Techniques; Testing; Time; Tissues; Toxic effect; Transrectal Ultrasound; Tube; Ultrasonography; United States; Urethra; Validation; Work; absorption; base; cancer recurrence; computerized tools; cost; design; dosimetry; drug synthesis; experience; image processing; imaging modality; imaging probe; improved; in vivo; interstitial; men; minimally invasive; molecular imaging; mortality; novel; operation; optical fiber; photoacoustic imaging; programs; public health relevance; reconstruction; soft tissue; sound; success; three-dimensional modeling; tool; treatment planning; uptake; urinary

DESCRIPTION (provided by applicant): Prostate cancer affects one in every six men and remains the second leading cause of cancer related mortality in men. Permanent interstitial brachytherapy, the permanent placement of radioactive seeds in the prostate, is widely used in the treatment of prostate cancer. Despite the recent uptake in robotic surgery (with reported increased urinary morbidity) which has impacted both brachytherapy and conventional surgery, brachytherapy remains a widely used treatment. In the historical perspective, brachytherapy has been a definitive treatment option with potentially excellent long term results. The success of brachytherapy depends on adequately irradiating the prostate while avoiding excessive radiation to surrounding organs, most importantly the urethra and rectum. Despite improved outcomes from modifications in brachytherapy technique, contemporary reports document considerable variability in brachytherapy practice, with resultant suboptimal outcomes and toxicity. A recognized major contributor to these poor outcomes is the lack of real- time image guidance to visualize source placement and dose intra-operatively as it evolves due to seed positioning errors and the onset of prostatic edema. The proposed work is the development of a multi-modal image-guidance build in an intelligent platform with capability for real-time, precise, and quantitative evaluation of source position and target dosimetry during the course of a brachytherapy procedure, thereby allowing the physician to continuously correct for source position alterations and adaptively achieve an optimal implant, resulting in both reduced toxicity and improved cancer control. The proposed work is the development, design and evaluation of a real-time imaging system based on integrated photo-acoustic and transrectal ultrasound image guidance and advanced image processing software that will produce real-time, precise, and quantitative evaluation of seed positions and dosimetry during the brachytherapy procedure and visualize prostate anatomy simultaneously. The proposed system will integrate imaging and planning tools that are already routinely used in current brachytherapy practice with an inclusion of low cost laser source. The real-time imaging will enable the physician to continuously correct for source position errors and adaptively achieve an optimal implant without disruption of existing surgical workflow, resulting in both reduced toxicity and improved cancer control. The research plan will be carried out in three aims: 1) study the optical properties of both prostate and metallic seed, 2) develop integrated photo-acoustic and transrectal ultrasound imaging system, and 3) perform system integration, testing and validation in tissue-mimicking phantoms, ex vivo prostrates and a limited in vivo animal study. The proposed integrated system will be first of its kind to have the capability of real-time imaging of brachytherapy implant and simultaneously visualizing prostate anatomy.

描述（由申请人提供）：前列腺癌会影响每六名男性中的一个，并且仍然是男性癌症相关死亡率的第二大主要原因。永久性间质近距离放射治疗（放射性种子在前列腺中的永久放置）被广泛用于治疗前列腺癌。尽管最近对机器人手术的摄入量（据报道泌尿发病率增加），从而影响了近距离放射治疗和常规手术，但近距离放射治疗仍然是一种广泛使用的治疗方法。从历史的角度来看，近距离放射治疗一直是一种明确的治疗选择，具有可能出色的长期结果。近距离放射治疗的成功取决于充分辐照前列腺，同时避免过度辐射到周围的器官，最重要的是尿道和直肠。尽管近距离放射治疗技术的修饰得到了改善，但当代报告证明了近距离放射治疗实践的差异很大，导致了次优的结果和毒性。公认的对这些不良结果的主要贡献者是缺乏实时图像指导，无法在源源内观察和剂量在术中，随着种子定位误差和前列腺水肿的发作而发展。拟议的工作是在智能平台上开发多模式图像指导构建的，具有实时，精确的能力 在近距离放射治疗过程中对源位置和靶标的剂量法的定量评估，从而使医生能够不断纠正源位置改变并适应实现最佳植入物，从而降低了毒性和改善癌症的控制。 拟议的工作是基于集成的照片声音和跨直直直直径超声图像指导和先进的图像处理软件的实时成像系统的开发，设计和评估，该软件将在腕止疗法过程中对种子位置和剂量测定进行实时，精确和定量评估，并同时可视化前列腺解剖学。所提出的系统将集成成像和计划工具，这些工具已在当前的近距离放射治疗实践中常规使用，其中包括低成本激光源。实时成像将使医生能够连续纠正源位置误差并自适应地实现最佳植入物而不会破坏现有手术工作流程，从而导致毒性降低和改善的癌症控制。 研究计划将以三个目的进行：1）研究前列腺和金属种子的光学特性，2）发展集成的光声和外端超声超声成像系统，3）进行系统模拟幻象的系统集成，测试和验证，Ex VIV Prestrates和Vivo In Vivo In Vivo Inter Animal Animal Animal Animal。拟议的综合系统将首先具有近距离放射治疗植入物的实时成像并同时可视化前列腺解剖结构的能力。