The development of advanced imaging and dosimetry for permanent breast seed implant radiation therapy

永久性乳房粒子植入放射治疗的先进成像和剂量测定的发展

• 批准号: RGPIN-2021-02623
• 负责人: Hilts, Michelle
• 金额: $ 2.99万
• 依托单位: University of British Columbia
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2021
• 资助国家: 加拿大
• 起止时间: 2021-01-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=742113
• 关键词: development; advanced; imaging; dosimetry; permanent; development; advanced; imaging; dosimetry; permanent

An estimated 27,000 Canadian women will be diagnosed with breast cancer in 2020. The treatment, surgery followed by 3.5 to 7 weeks of daily radiation therapy (RT), presents a significant burden to both our health care system and our patients. In fact, patients in remote communities may not complete their RT due to challenges in undertaking treatment far from home. Permanent breast seed implant (PBSI) is a novel, effective, breast RT that is undertaken in a single day, thereby significantly reducing the healthcare burden. My research program is focused on developing novel imaging and dosimetry tools and techniques to help enable PBSI across Canada. PBSI is administered by implanting radioactive seeds into the breast under two-dimensional ultrasound (2DUS) imaging guidance. While effective, PBSI is technically challenging and my research group has pioneered the development of technology and dose analysis tools to increase the precision and robustness of PBSI. We were the first to quantify the uncertainty in implant delivery and to discover that US clarity impacts implant accuracy. We have developed methodologies for accurately recording skin dose (a risk for treatment toxicity) and target doses post-operatively. In collaboration with Robarts Imaging we have developed a non-clinical prototype 3DUS scanner for PBSI. Here we build on this work to address primary bottlenecks in PBSI imaging, precision, individualized targeting, and quantitative post-implant dosimetry. The aims of this proposal are: Aim 1: 3DUS based PBSI: Long-term: To develop a fully 3DUS-based PBSI technique. Five-year: To develop and verify 3DUS technology for PBSI target delineation and implant guidance, thereby enabling improved treatment accuracy over existing protocols. Aim 2: Individualized targeting: Long-term: To develop methodology for personalized, precision, PBSI. Five-year: To model uncertainties in implant delivery and establish individualized margins for PBSI targeting, thereby enabling high precision, individualized targeting of PBSI treatments. Aim 3: Accurate post-implant dosimetry: Long-term: To develop quantitative dosimetry systems for accurate dose-outcome analysis. Five-year: To model the dosimetric impacts of seed movement, skin delineation, and breast shielding on skin dose, and to experimentally determine the impact of breast position on treatment dose. The result will be improved accuracy of post-implant dose analysis over current methodologies.  This work will establish a technical framework to enable precise, image-guided, individualized, adaptive PBSI and ultimately support my long-term research goal to ensure the availability of single day breast cancer radiation treatment across Canada. My work will also positively impact Canada's future by training a diverse group of 5 HQP to be medical physics leaders in academia, hospitals, or industry. As a mentor for young women, my HQP training will help address the gender imbalance in our field.

估计有27,000名加拿大妇女将在2020年被诊断出患有乳腺癌。治疗，手术，然后是3.5至7周的每日放射治疗（RT），对我们的医疗保健系统和患者均大量烧伤。实际上，由于远离家园的治疗方面的挑战，偏远社区的患者可能无法完成RT。永久性乳腺种子植入物（PBSI）是一种新型，有效的乳房RT，在一天内进行，从而大大减少了医疗保健伯恩。我的研究计划的重点是开发新颖的成像和剂量计的工具和技术，以帮助在整个加拿大启用PBSI。 PBSI是通过在二维超声（2DUS）成像指导下植入放射性种子在乳房中施用的。尽管有效，PBSI在技术上具有挑战性，而我的研究小组率先开发了技术和剂量分析工具，以提高PBSI的精度和鲁棒性。我们是第一个量化植入物交付中不确定性的人，并发现我们的清晰度影响植入物的准确性。我们已经开发了准确记录皮肤剂量（治疗毒性的风险）和靶剂量后的方法。与Robarts成像合作，我们为PBSI开发了一个非临床原型3DUS扫描仪。在这里，我们以这项工作为基础，以解决PBSI成像，精度，个性化靶向和定量植入物剂量测定法中的主要瓶颈。该提案的目的是：AIM 1：3DUS PBSI：长期：开发完全基于3DUS的PBSI技术。五年：用于开发和验证PBSI目标描述和植入物指导的3DU技术，从而使治疗准确性比现有方案提高了准确性。目标2：个性化目标：长期：为个性化，精度，PBSI开发方法。五年：在植入物输送中建模不确定性并为PBSI靶向建立个性化边缘，从而实现了PBSI治疗的高精度，个性化的靶向。目标3：准确的植入后剂量法：长期：开发定量剂量测定系统以进行准确的剂量结果分析。五年：为种子运动，皮肤描绘和乳房屏蔽对皮肤剂量的剂量影响，并通过实验确定乳腺位置对治疗剂量的影响。结果将提高植入后剂量分析的准确性，而不是当前方法。这项工作将建立一个技术框架，以实现精确，图像引导，个性化的自适应PBSI，并最终支持我的长期研究目标，以确保加拿大整个加拿大的乳腺癌辐射治疗可用。我的工作还将通过培训5 HQP的潜水员小组成为学术界，医院或工业的医学物理领导者，从而对加拿大的未来产生积极影响。作为年轻女性的心理，我的HQP培训将有助于解决我们领域的性别失衡。