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）：前列腺癌影响六分之一的男性，并且仍然是男性癌症相关死亡的第二大原因。永久性间质近距离放射治疗，即在前列腺中永久性放置放射性粒子，广泛用于治疗前列腺癌。尽管最近机器人手术的兴起（据报道泌尿道发病率增加）影响了近距离放射治疗和传统手术，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，具有潜在的优异的长期效果。近距离放射治疗的成功取决于充分照射前列腺，同时避免对周围器官（最重要的是尿道和直肠）过度辐射。尽管近距离放射治疗技术的改进改善了结果，但当代报告记录了近距离放射治疗实践的相当大的变化，从而导致了次优的结果和毒性。造成这些不良结果的一个公认的主要原因是缺乏实时图像指导来可视化术中源放置和剂量，因为它是由于种子定位错误和前列腺水肿的发生而发生的。拟议的工作是在智能平台上开发多模态图像引导，具有实时、精确、 在近距离放射治疗过程中对源位置和目标剂量测定进行定量评估，从而使医生能够持续校正源位置变化并自适应地实现最佳植入，从而降低毒性并改善癌症控制。 拟议的工作是开发、设计和评估基于集成光声和经直肠超声图像引导以及先进图像处理软件的实时成像系统，该系统将对种子位置和剂量测定进行实时、精确和定量评估在近距离放射治疗过程中，同时观察前列腺解剖结构。所提出的系统将集成当前近距离放射治疗实践中已常规使用的成像和规划工具，并包含低成本激光源。实时成像将使医生能够持续纠正源位置错误，并在不中断现有手术工作流程的情况下自适应地实现最佳植入，从而降低毒性并改善癌症控制。 该研究计划将实现三个目标：1）研究前列腺和金属种子的光学特性，2）开发集成光声和经直肠超声成像系统，3）在组织中进行系统集成、测试和验证。模仿幻影、离体俯卧和有限的体内动物研究。所提出的集成系统将是同类中第一个能够对近距离放射治疗植入物进行实时成像并同时可视化前列腺解剖结构的系统。