Clinical Radiation Physics Service

临床放射物理服务

基本信息

批准号：
10926700
负责人：
Robert Miller
金额：
$ 38.76万
依托单位：
DIVISION OF CLINICAL SCIENCES - NCI
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10926700
关键词：
3D Print Acceleration Anatomy Anesthesia procedures Body Surface Brachytherapy Calcium Calibration Cephalic Clinical Clinical Protocols Clinical Research Collimator Communication Consultations Dedications Detection Diameter Directories Dose Rate Elements Environment Equipment Facility Designs Farm Fractionation Freedom Functional Imaging Guidelines Image Immobilization Implant Interruption Iodine Lateral Maintenance Measurement Methodology Mission Monitor Motion Motor Needles Optics Patients Periodicals Physics Plant Leaves Positioning Attribute Process Prostate Protocols documentation Radiation Radiation Oncology Radiation Physics Radiation Tolerance Radiation therapy Radiosurgery Research Project Grants Scanning Schedule Security Series Services Source Speed Surface System Testing Thinness Time Tracer Transducers United States National Institutes of Health Vertebral column Water Width X-Ray Computed Tomography cancer imaging clinical implementation clinically relevant data centers fabrication flexibility image reconstruction imaging capabilities improved in vivo interstitial prostate radiotherapy quality assurance radio frequency treatment planning ultrasound virtual

项目摘要

We have a series of initiatives utilizing our High Dose-Rate Remote Afterloader (HDR) using a small, high intensity 192Ir source for interstitial and intercavitary brachytherapy. The department now has two state-of-the-art Varian TrueBeam STX accelerators which are equipped with 120 leaf high definition multi-leaf collimators with leaf widths as thin as 2.5 mm. This renders them capable of performing frameless stereotactic radiosurgery (SRS), although a set of circular collimators with diameters ranging from 4mm to 25mm and an SRS planning module are included in the acquisition. The patient couches also provide for 6 Degrees-of-Freedom (6DOF) to greatly improve positional accuracy by permitting corrections for pitch, roll and yaw, in addition to the traditional longitudinal, lateral and vertical position adjustments. The treatment delivery parameters of these two accelerators are matched to within 0.5%, thus providing true redundancy, assuring that patients can continue to receive their treatments according to their fractionation schedule. These machines include the Edge Extracranial SABR Package that will permit them to deliver frameless stereotactic body radiation therapy (SBRT) using advanced motion management based on radiofrequency local positioning using implanted fiducial transponders and infrared cameras. The revised Edge package includes a Calypso radiofrequency positioning system, utilizing implantable fiducial transducers and real-time tracking capability. The real-time optical tracking utilizes an upgraded Optical Surface Monitoring System (VisionRT) system to monitor the body surface and to interrupt the treatment if the surface distorts (due to motion) and the clinical implementation of a prostate radiotherapy protocol using Calypso RF transponders to monitor prostate position and correspondingly gate the treatment delivery. ROB has acquired a new Elekta Flexitron 40 channel High-Dose-Rate (HDR) remote brachytherapy afterloader to replace its previous unit. Additionally, ROB has acquired a new B-K ultrasound unit, which has vastly improved imaging capabilities relative to the previous unit. We have acquired a couch-mounted stepper-stabilizer to improve needle insertion methodology and are working on adapting a motorized scanning system for the probe to speed image acquisition. ROB has a dedicated brachytherapy suite (B2-3643). This room is now clinically operational and has proved to provide greater flexibility in the layout of operative and support equipment, which is reflected in reduced patient time under anesthesia. ROB has installed a replacement CT Simulator. While similar overall to the existing unit, the new system has substantially more powerful processing power to accelerate image reconstruction. It also utilizes dual energy, sequential CT scans, which can be post processed to enhance the detection of Iodine, Calcium or other detectable elements utilized as bio-tracers for the functional imaging of tumors. ROB has completed its transition to ARIA-RO version 16. This now utilizes the NIH Active Directory system, which improves security, and utilizes a virtual server environment to enhance operational reliability. Finally, ROB has shifted to a new IT backbone, streamlining communication between the Eclipse workstations and TrueBeam accelerators at the Bethesda campus and the virtual server farm located at the NCI Shady Grove Data center. This provides for stable communications. ROB has also upgraded its Machine Shop to conform with current electrical standards as well as permitting the installation of more advanced fabrication equipment, such as a 3-D printer and a water jet cutter, in order to better support clinical research projects.

我们采取了一系列举措，利用我们的高剂量率远程后装器 (HDR)，使用小型高强度 192Ir 源进行间质和腔内近距离放射治疗。该部门现拥有两台最先进的瓦里安TrueBeam STX加速器，配备120叶高清多叶准直器，叶宽薄至2.5毫米。这使得它们能够执行无框架立体定向放射外科 (SRS)，尽管此次采购中还包括一组直径范围为 4 毫米至 25 毫米的圆形准直器和一个 SRS 规划模块。除了传统的纵向、横向和垂直位置调整之外，患者床还提供 6 个自由度 (6DOF)，通过允许校正俯仰、滚动和偏航来大大提高位置精度。这两个加速器的治疗传递参数匹配在 0.5% 以内，从而提供真正的冗余，确保患者可以根据分次时间表继续接受治疗。这些机器包括 Edge Extracranial SABR 套件，允许他们使用基于射频局部定位的先进运动管理（使用植入的基准应答器和红外摄像机）来提供无框架立体定向身体放射治疗（SBRT）。修订后的 Edge 套件包括 Calypso 射频定位系统，利用植入式基准传感器和实时跟踪功能。实时光学跟踪利用升级的光学表面监测系统 (VisionRT) 系统来监测身体表面，并在表面变形（由于运动）时中断治疗，并使用 Calypso RF 转发器来临床实施前列腺放射治疗方案监测前列腺位置并相应地控制治疗实施。 ROB 购买了一台新型 Elekta Flexitron 40 通道高剂量率 (HDR) 远程近距离放射治疗后装机来取代其之前的设备。此外，ROB 还购买了一台新的 B-K 超声设备，与之前的设备相比，该设备的成像能力大大提高。我们已经购买了一个安装在沙发上的步进稳定器来改进针插入方法，并正在努力采用探头的电动扫描系统来加速图像采集。 ROB 拥有专用的近距离放射治疗套件 (B2-3643)。该房间现已投入临床使用，并已证明在手术和支持设备的布局方面提供了更大的灵活性，这体现在减少了患者的麻醉时间。 ROB 已安装替换 CT 模拟器。虽然总体上与现有设备相似，但新系统具有更强大的处理能力来加速图像重建。它还利用双能量连续 CT 扫描，可进行后处理以增强对碘、钙或其他可检测元素的检测，这些元素可用作肿瘤功能成像的生物示踪剂。 ROB 已完成向 ARIA-RO 版本 16 的过渡。它现在利用 NIH Active Directory 系统来提高安全性，并利用虚拟服务器环境来增强操作可靠性。最后，ROB 已转向新的 IT 主干网，简化了 Bethesda 园区的 Eclipse 工作站和 TrueBeam 加速器以及位于 NCI Shady Grove 数据中心的虚拟服务器场之间的通信。这提供了稳定的通信。 ROB 还升级了其机械车间，以符合当前的电气标准，并允许安装更先进的制造设备，例如 3D 打印机和水射流切割机，以便更好地支持临床研究项目。