SBIR-STTR Award

Seed implantation brachytherapy for prostate cancer has been projected to grow by 18-fold in the ten years since 1995, to become the preferred treatment option in 2005. The major obstacle to achieving uniformly high standard and cost-effective care in this procedure is the lack of robust and optimized treatment planning and real-time dosimetric guidance. The specific aim and long term objective of this proposed project are autonomous treatment planning and interventional treatment guidance, respectively. The core technologies include a genetic algorithm engine which designs the optimal seed implant for each patient, a decision- theoretic steering agent which ensures that the clinical objectives and tradeoffs are thoroughly explored in 10(2) second time scale, and a sensitivity analysis module which simulates and reduces the likelihood of real-time surgical deviations from the optimized plan. The maturity of web-based computing technology has enabled integration of these intelligent modules to create a synergy for immersive treatment optimization in both telemedical and intra-operative settings. The proposed planning and guidance system will be developed and integrated on the platform of these technologies. The system is targeted to eliminate redundant and error-prone steps, to streamline the clinician- machine interface, and to provide stepwise feedforward optimization.Proposed Commercial Application:The immediate commercial application will focus on the autonomous Internet or intranet based treatment planning and the real-time interventional intra-operative treatment guidance for prostate seed implantation. The scope of application may extend to radiation treatment planning in general for the telemedical network-based system. The real- time interventional systems have strong potential in the treatment of restenosis and in the setting of cath-lab.

Thesaurus Terms:
Internet, computer assisted medical decision making, computer program /software, computer system design /evaluation, neoplasm /cancer radionuclide therapy, prostate neoplasm, radionuclide implant computer simulation, interactive multimedia, patient care planning, radiation dosage, telemedicine, ultrasonography bioengineering /biomedical engineering, medical implant scienceNATIONAL CANCER INSTITUTE

The major goal of this Phase II effort is to develop an adaptive optimization and dosimetric guidance system for prostate seed implant brachytherapy, to be deployed in the operating room for real-time treatment planning and postimplant dosimetry. The specific aims are (a) to implement accelerated genetic algorithm optimization, (b) to develop automated image segmentation and region recognition tools, and (c) to deliver real-time dosimetric verification and optimized guidance. Seed implant brachytherapy is now widely recognized as a major treatment modality for localized prostate cancer. However, conventional techniques involve three disjoined steps -pre-planning, implantation and postimplant dosimetry -all separated by 1-4 weeks. An uncertainty chain is propogated in these steps, such that any under-dosage is only discovered after the completion of treatment. For this reason, prostate brachytherapy is currently very operator-dependent. This project aims to deliver intelligent technologies in optimization and image processing to enable intraoperative planning and verification of the entire treatment in one step. By providing a what-you-see-is-what-you- get environment, clinician-users will have complete confidence of adequate dosimetry for every implant before leaving the operating room. Societal value is to be achieved through cost savings per patient and reduced local failures and/or morbidities. PROPOSED COMMERCIAL APPLICATION PIPER will be marketed as a standalone computer treatment planning system for intraoperative dose optimization and surgical guidance in prostate seed implant brachytherapy. The target users are radiation oncologists, urologists, medical physicists, dosimetrists, and radiologists.

Thesaurus Terms:
computer assisted medical decision making, computer program /software, computer system design /evaluation, imaging /visualization, neoplasm /cancer radionuclide therapy, patient care planning, prostate neoplasm, radionuclide implant image processing, radiation dosage bioimaging /biomedical imaging, medical implant science