Personalized dosimetry for liver cancer radioembolization using fluid dynamics simulation

使用流体动力学模拟进行肝癌放射栓塞的个性化剂量测定

基本信息

批准号：
9899967
负责人：
Emilie Roncali
金额：
$ 16.71万
依托单位：
UNIVERSITY OF CALIFORNIA AT DAVIS
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9899967
关键词：
3-Dimensional 90Y Address Affect Albumins Algorithms Anatomy Angiography Biomedical Engineering Blood Vessels Blood flow Cancer Etiology Cancer Patient Caring Catheters Cause of Death Cessation of life Classification Clinical Collaborations Convolution Kernel Custom Data Data Set Development Disseminated Malignant Neoplasm Distal Doppler Ultrasound Dose Family suidae Future Goals Hepatic Hepatic artery Human Image Incidence Individual Injections Lesion Liquid substance Liver Liver neoplasms Malignant neoplasm of liver Measures Methods Microspheres Modeling Monte Carlo Method Organ Organism Outcome Patient Care Patient imaging Patient-Focused Outcomes Patients Physicians Physics Precision therapeutics Primary Neoplasm Radiation therapy Radioactive Radioembolization Radioisotopes Radiology Specialty Radionuclide therapy Recurrence Reporting Resolution Risk Statistical Data Interpretation Structure Techniques Three-Dimensional Image Time Toxic effect Tracer Translations Treatment Efficacy Trees Unresectable Validation Variant Work base cancer type clinical implementation computerized tools convolutional neural network deep learning design dosage dosimetry hemodynamics improved innovation internal radiation morphometry multidisciplinary neglect novel novel strategies patient population personalized medicine prevent research clinical testing simulation standard of care tool treatment planning tumor

项目摘要

Project Summary/ Abstract Liver cancer is one of the leading causes of cancer deaths with rising incidence in the U.S and worldwide. Yttrium-90 microspheres radioembolization, or Selective Internal Radiation Therapy (SIRT), is a treatment in which a catheter inserted in the patient's hepatic artery delivers radioactive 90Y microspheres to the liver. It is increasingly utilized to treat patients with unresectable liver tumors in second or third line, but some of its potential to improve overall survival is still untapped. The major obstacle in making SIRT more efficient is the treatment planning. It consists in selecting the 90Y activity to inject based on the estimated dose to the tumor and organs-at-risk. The problem is that the dose calculation is highly unreliable and does not include important parameters, such as well-known non-uniformities or the injection point. As a result, physicians often choose very conservative dosage to limit toxicity at the expense of the tumor(s) dose, which drastically reduces SIRT efficacy. The objective of this project is to develop accurate patient-specific dosimetry for SIRT planning. We propose a novel method combining computational fluid dynamics (CFD) to simulate the 90Y microsphere 3D distribution and 90Y physics modeling to predict the absorbed dose. The central and novel approach is to carry out the CFD simulations for each patient's hepatic arterial tree to achieve high accuracy and precision, because anatomical features determining the microsphere distribution present wide variations across the patient population and prohibit the use of generic models. This novel CFD-based dosimetry will be the first comprehensive tool to integrate (1) the hepatic arterial tree extracted from the patient's standard-of-care angiogram, (2) CFD simulation in this hepatic arterial tree to predict and optimize the microsphere distribution, (3) calculation of the absorbed dose with 90Y physics modeling. Our long-term goal is developing a tool that can be integrated in clinical workflow to optimize the quantity and injection point of 90Y microspheres during SIRT planning. To this end, we will pursue two specific aims. (1) We will develop the CFD model and dose calculation using a pig model for validation; (2) we will develop a deep learning approach to simultaneously segment the hepatic artery from the standard-of-care patient angiograms and conduct a morphometric study of the obtained hepatic arterial trees to identify the principal parameters affecting the model. If successful, this project will generate a reliable, patient-specific dosimetry for SIRT providing a comprehensive calculation of the absorbed dose in individual lesions as well as in the healthy liver. This will enable high precision treatment planning to better treat the tumors with a “dose-painting” approach and ultimately improve long-term patient outcome.

项目摘要/摘要肝癌是癌症死亡的主要原因之一，在美国和世界各地的发病率上升。 YTTrium-90微球放射栓塞或选择性内部放射疗法（SIRT）是一种特征导管将其插入患者的肝动脉deliovers放射性90年微球到肝脏。越来越多地用于治疗第二或第三行中无法切除的肝肿瘤的患者，但其中一些提高整体生存的潜力仍未开发。治疗计划。和危险的器官。重要的参数，例如众所周知的非均匀性或注射点。通常选择非常非常保守的剂量以将tomit tomit限制为肿瘤剂量的费用降低了SIRT功效。该项目的目的是为我们提出的SIRT计划开发精确的患者特定剂量法一种结合计算流体动力学（CFD）的新方法来模拟90y微球3D 分布和90年的物理模型预测吸收剂量。为每位患者的肝脏人工树进行CFD模拟，以实现高精度和精确度，因为确定微球分布的解剖学特征遍布您患者人群并禁止使用这种新型CFD的剂量。整合（1）从患者护理标准中提取的肝动脉树的综合工具 Angiagne，（2）CFD模拟在此肝脏人工树中，以预测和优化微球分布，（3）用90年物理建模的吸收剂量计算。可以集成在临床工作流程中，以优化90y微球的数量和注入点 SIRT计划。使用猪模型进行val瓣计算；段来自护理标准患者血管造影研究的肝动脉研究在获得的肝动脉树中，以识别影响模型的主要参数。如果成功，该项目将产生一个可靠的，特定于患者的剂量计堡全面计算单个病变和健康肝脏中吸收剂量的计算。以“剂量绘制”方法和最终改善了长TTM患者的结果。