Precision breast radiotherapy with the soft robot and supine CT

使用软体机器人和仰卧位 CT 进行精准乳腺放射治疗

• 批准号: 10827341
• 负责人: Lihua Jin
• 金额: $ 43.08万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10827341
• 关键词: Acute; Affect; Air; Algorithms; Anatomy; Biological; Biomechanics; Biomedical Engineering; Breast; Breast Cancer Patient; Cancer Control; Cardiac; Chest wall structure; Chronic; Climacteric; Clinical; Clinical Research; Clinical Sciences; Conformal Radiotherapy; Dedications; Development; Devices; Dose; Engineering; Force of Gravity; Gait; Geometry; Goals; Heart; Height; Image; Immobilization; Individual; Infrastructure; Lead; Life; Lifting; Lung; Machine Learning; Mechanics; Membrane; Methods; Morphology; Motion; Nodal; Optics; Organ; Outcome; Patient observation; Patients; Performance; Physics; Play; Positioning Attribute; Posture; Prone Position; Property; Quality of life; Radiation Dose Unit; Radiation therapy; Radiology Specialty; Reproducibility; Research Project Grants; Resolution; Rest; Robot; Robotics; Roentgen Rays; Secure; Shapes; Structure; Supination; Supine Position; Surface; Systems Integration; Techniques; Testing; Thinness; Toxic effect; United States National Institutes of Health; Validation; X-Ray Computed Tomography; X-Ray Therapy; breast imaging; cone-beam computed tomography; cost; curative treatments; deep neural network; disorder control; effectiveness evaluation; experience; flexibility; image guided; image guided radiation therapy; improved; individual patient; malignant breast neoplasm; novel; novel strategies; patient tolerability; prevent; prototype; reconstruction; research and development; respiratory; side effect; skeletal; success; tumor; volunteer

Project Summary/Abstract Radiotherapy is essential to achieve durable disease control for breast cancer patients. However, despite several decades of research and development in imaging and radiotherapy techniques, breast radiotherapy remains crude due to the lack of viable methods to accurately isolate, immobilize, localize and target the breast. Subsequently, the success of tumor control is at the cost of both acute and chronic toxicities that adversely affect the patients’ quality of life and potentially introduce life-threatening complications decades after the curative treatment. The challenge in providing accurate breast imaging and therapy is due to the unique biomechanical properties of the breast, which is an external organ with no internal skeletal support. As a result, its shape varies substantially with the patient's posture. In the supine position, which is the most stable and common position for radiotherapy, the breast rests on the chest wall, resulting in its close proximity to the chest wall, lung, heart, and other vital organs, which creates an undesirable geometry for radiotherapy. Yet, existing devices for supine breast setup not only provide poor support and immobilization but also adversely interfere with imaging and therapy X-rays. Patients treated in the prone position experience new problems, including the lower setup reproducibility, increased cardiac dose due to heart descending, the difficulty to tolerate, and incompatibility with nodal treatment. To attain the desirable prone breast geometry and avoid drawbacks associated with this posture, a more effective method to lift the breast from the chest wall and to image the breast in the supine position is urgently needed for precision image-guided breast radiotherapy. To achieve the first goal, a pneumatically powered multi-gait soft robot, BreastBot, will be developed and optimized to support and immobilize the breast in the supine position. The BreastBot will be fabricated in several generic form factors to minimize the cost but personalized for each breast via an individualized actuation sequence. The feasibility of BreastBot has been demonstrated using single gait prototypes on volunteers and phantoms. To achieve the second goal, which is to image the BreastBot immobilized breast for image-guided radiotherapy, avoid imaging dose to the patient's body, and achieve a higher image quality, a novel supine ceiling-mounted breast CT will be developed. The following four aims are proposed for image-guided supine breast radiotherapy. Aim 1: Optimization of a breast setup soft robot (BreastBot) for supine breast setup. Aim 2: Development of a ceiling-mounted CBCT for breast image- guided radiation therapy. Aim 3: Specific Aim 3: End-to-end integration, validation, and observational patient study.

项目概要/摘要 放射治疗对于乳腺癌患者实现持久的疾病控制至关重要，尽管存在一些问题。 经过数十年影像和放射治疗技术的研究和发展，乳腺放射治疗仍然 由于缺乏准确隔离、固定、定位和瞄准乳房的可行方法，该方法还很粗糙。 随后，肿瘤控制的成功是以急性和慢性毒性为代价的，这些毒性对人体产生不利影响。 患者的生活质量，并可能在治疗几十年后引入危及生命的并发症 提供准确的乳腺成像和治疗的挑战是由于独特的生物力学。 乳房是一个没有内部骨骼支撑的外部器官，因此其形状各不相同。 基本上与患者的姿势有关，仰卧位是最稳定、最常见的姿势。 放射治疗时，乳房靠在胸壁上，导致其紧邻胸壁、肺、心脏和 然而，现有的仰卧位装置会产生不适合放射治疗的几何形状。 乳房设置不仅提供较差的支撑和固定，而且还会对成像和成像产生不利干扰。 俯卧位治疗的患者会遇到新的问题，包括较低的设置。 重复性、由于心脏下降而增加的心脏剂量、难以耐受以及与 为了获得理想的俯卧乳房几何形状并避免与这种姿势相关的缺点， 将乳房从胸壁抬起并以仰卧位对乳房进行成像的更有效方法是 迫切需要进行精确图像引导乳腺放射治疗，以实现第一个目标，即气动。 将开发和优化动力多步态软机器人 BreastBot，以支撑和固定乳房 仰卧位的 BreastBot 将采用多种通用外形尺寸来制造，以最大限度地降低成本，但 通过个性化的驱动序列对每个乳房进行个性化。BreastBot 的可行性已得到验证。 使用在志愿者和模型上演示的单一步态原型来实现第二个目标。 对 BreastBot 固定乳房进行图像引导放射治疗，避免对患者身体造成成像剂量， 为了获得更高的图像质量，将开发一种新型仰卧吊顶式乳腺CT。 图像引导仰卧乳腺放射治疗提出了四个目标：目标 1：优化乳房设置软体。 用于仰卧乳房设置的机器人 (BreastBot) 目标 2：开发用于乳房成像的吊顶式 CBCT。 目标 3：具体目标 3：端到端整合、验证和观察患者。 学习。