Combined radiation acoustics and ultrasound imaging for real-time guidance in radiotherapy

结合辐射声学和超声成像，用于放射治疗的实时指导

• 批准号: 10245972
• 负责人: Issam M. El Naqa
• 金额: $ 49.48万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-05 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10245972
• 关键词: 3-Dimensional; 3D ultrasound; Abdomen; Acoustics; Affect; Anatomy; Animals; Area; Calibration; Cancer Patient; Caring; Cesarean section; Characteristics; Clinic; Clinical; Clinical Research; Clinical Treatment; Deposition; Detection; Diagnostic Imaging; Dose; Effectiveness; Elements; Exposure to; Feedback; Financial compensation; Gel; Generations; Goals; Image; Investigation; Ionizing radiation; Lasers; Lead; Linear Accelerator Radiotherapy Systems; Liver; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of abdomen; Malignant neoplasm of gastrointestinal tract; Malignant neoplasm of liver; Malignant neoplasm of pancreas; Measurement; Measures; Medical Imaging; Methods; Modeling; Monitor; Morphologic artifacts; Motion; Normal tissue morphology; Oncology; Online Systems; Optics; Organ; Oryctolagus cuniculus; Outcome; Pancreas; Patients; Pattern; Performance; Physiological; Pilot Projects; Pre-Clinical Model; Process; Property; Radiation; Radiation Dose Unit; Radiation Oncology; Radiation Physics; Radiation therapy; Reporting; Resolution; Roentgen Rays; Safety; Shapes; Signal Transduction; System; Technology; Testing; Three-Dimensional Imaging; Time; Tissues; Toxic effect; Transducers; Translations; Treatment outcome; Ultrasonography; Uncertainty; Variant; X-Ray Computed Tomography; absorption; acoustic imaging; anatomic imaging; base; cancer site; cancer type; cost; cost effective; detector; dosimetry; effective therapy; image guided; improved; in vivo; novel; optimal treatments; phantom model; photoacoustic imaging; radiation delivery; real-time images; respiratory; response; side effect; systems research; tomography; treatment planning; tumor; tumor eradication

Radiotherapy can be a highly effective treatment for many types of cancers. A major impediment to achieving its full curative promise is the current delivery process, where typically the originally planned tumor area is exposed to a fixed pattern of ionizing radiation over time irrespective of target deformations, organ motion, or function. To avoid misses, geometric uncertainties in this feedforward process are dealt with by increasing the planning margin around the tumor, but of necessity result in unnecessary exposure of uninvolved tissue which can lead to debilitating toxicities. We hypothesize that the unwanted radiation dose to normal tissues could be significantly reduced by using a feedback system that would “know” the shape and location of the tumor as well as the location and intensity of the irradiated dose during delivery. This framework would require the unique ability to simultaneously image the absorbed dose and the targeted tumor anatomy during radiation delivery, which is not possible with currently existing technologies. A known phenomenon in radiation physics is the generation of acoustic waves due to thermal expansion of a substance following the absorption of penetrating radiation. Detection of this radiation induced acoustic signal from clinical treatment beams has been recently demonstrated but has not been clinically realized. That signal exists “for free” in real time as a consequence of the treatment beam. The signal can be measured with ultrasound detectors and processed to reveal the location and intensity of the deposited energy/dose. Furthermore, ultrasound technologies have also long been established for medical imaging and monitoring of tumor size, shape and location, without introducing ionizing radiation. Therefore, we propose to combine measurements of radiation acoustics and ultrasound imaging in an integrated system using advanced matrix array probes to determine in real-time the volumetric delivered radiation dose with respect to that day’s tumor shape and location, and ultimately to optimize tumor targeting via online feedback. The system will be optimized in phantoms and preclinical models. Then, its feasibility and versatility will be tested for treatment of tumors in the liver and the pancreas, two aggressive cancer sites where misplaced dose due to deformation and physiological motion not only compromises tumor eradication but also affects vital functions in the patient and subsequent treatment outcomes. Impact statement: We aim to implement new, safe, simple, cost effective technology and methods for online guidance of radiotherapy delivery that can provide simultaneous tumor tracking and dose compensation capabilities. These technologies will be evaluated in a pilot clinical study of liver and pancreatic cancers to demonstrate feasibility and potentials for translation. If successful, this feedback technology will have a significant impact on personalizing radiotherapy delivery and achieving optimal treatment outcomes.

放射治疗可能是许多类型的癌症的高效治疗方法。实现自己的主要障碍 充分的治疗诺言是当前的交货过程，通常是最初计划的肿瘤区域 无论目标变形，器官运动或功能如何，随着时间的推移电离辐射的固定模式。到 避免错过，通过增加计划来解决此馈送过程中的几何不确定性 肿瘤周围的边缘，但必要的结果是不必要的未涉及组织的暴露 我们假设不需要的辐射剂量可以显着明显 通过使用将“知道”肿瘤的形状和位置以及位置的反馈系统降低 和辐照剂量的强度。这个框架将需要独特的能力才能 同样，在放射线递送过程中，吸收剂量和靶向肿瘤解剖结构 当前现有技术可能。 辐射物理学中的已知现象是由于热膨胀而产生的声波 透明辐射抽象后的受试者。检测该辐射引起的声学信号 最近已经证明了从临床治疗梁中，但尚未在临床上实现。那个信号 由于治疗梁，实时“免费”存在。信号可以用 超声探测器并加工以揭示沉积能量/剂量的位置和强度。 此外，长期以来已经建立了超声技术，用于医学成像和监测 肿瘤的大小，形状和位置，而无需引入电离辐射。 因此，我们建议将辐射声学和超声成像的测量 使用高级矩阵阵列问题进行集成系统，以实时确定交付的体积 相对于当天的肿瘤形状和位置的辐射剂量，并最终通过 在线反馈。该系统将在幻影和临床前模型中进行优化。然后，它的可行性和 多功能性将测试用于治疗肝脏和胰腺中的肿瘤，这是两个侵略性癌症部位 由于变形和身体运动而导致的剂量放错位置不仅会损害消除肿瘤，而且还会损害 影响患者的重要功能以及随后的治疗结果。 影响声明：我们旨在实施新的，安全，简单，成本效益的技术和在线方法 可以提供同时提供肿瘤跟踪和剂量补偿的放射治疗的指导 功能。这些技术将在肝脏和胰腺癌的试点临床研究中进行评估 证明可行性和翻译潜力。如果成功，此反馈技术将有一个 对个性化放射疗法提供的重大影响并实现最佳治疗结果。