The objective of this Program is to investigate image-guided radiotherapy technology to enable safe delivery of more aggressive dose regimens through a combination of biological imaging for improved target delineation and implementation of an integrated and clinically practical system of image-guided adaptive radiation therapy (IGART). IGART uses daily onboard imaging, including 3D CT, coupled with online 3D/4D IMRT adaptive replanning to dramatically reduce treated tissue volumes while simultaneously reducing the uncertainty of dose delivery to extended primary and regional tumor targets. This will allow us to more precisely target dose-per-fraction escalation only to regions known to harbor primary tumor and nodal metastases while reducing early and late sequelae by normal tissue avoidance. We propose to develop IGART initially for three patient populations: locally advanced malignancies of the cervix, prostate, and lung, where the literature supports improved outcomes by dose escalation to both primary and regional disease targets. Novel deformable image registration and reconstruction methods developed in Project 1 will allow mapping of targets delineated on biological imaging studies onto daily treatment CT studies and tracking of trajectories of tissue voxels through a course of IGART therapy. Project 2 will characterize and minimize dose-calculation errors on deforming anatomies;and develop probabilistic IMRT planning tools for optimally managing residual errors. Project 3 will conduct clinical studies of cervical and prostate cancer patients to quantify patient setup and tissue deformation uncertainties and to optimize strategies for estimating the daily anatomy, performing adaptive replanning, and to integrate brachytherapy and IMRT into the IGART process. Project 4 will utilize clinical studies to develop and investigate a 4D IGART system to account for quasiperiodic intrafraction breathing motion variations along with interfraction anatomic changes. In support of the projects, Core A will develop a novel layered image management and software development infrastructure and a QA paradigm for addressing the unique error pathways and logistical constraints posed by online IGART while Core B will provide administrative, biostatistical, and biomodeling support.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Program Projects (P01)
Project #
5P01CA116602-04
Application #
7806517
Study Section
Special Emphasis Panel (ZCA1-GRB-P (O4))
Program Officer
Deye, James
Project Start
2007-04-15
Project End
2012-03-31
Budget Start
2010-05-17
Budget End
2011-03-31
Support Year
4
Fiscal Year
2010
Total Cost
$2,098,555
Indirect Cost
Name
Virginia Commonwealth University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Shieh, Chun-Chien; Caillet, Vincent; Dunbar, Michelle et al. (2017) A Bayesian approach for three-dimensional markerless tumor tracking using kV imaging during lung radiotherapy. Phys Med Biol 62:3065-3080
Jan, Nuzhat; Hugo, Geoffrey D; Mukhopadhyay, Nitai et al. (2015) Respiratory motion variability of primary tumors and lymph nodes during radiotherapy of locally advanced non-small-cell lung cancers. Radiat Oncol 10:133
Shieh, Chun-Chien; Keall, Paul J; Kuncic, Zdenka et al. (2015) Markerless tumor tracking using short kilovoltage imaging arcs for lung image-guided radiotherapy. Phys Med Biol 60:9437-54
Shieh, Chun-Chien; Kipritidis, John; O'Brien, Ricky T et al. (2015) Improving thoracic four-dimensional cone-beam CT reconstruction with anatomical-adaptive image regularization (AAIR). Phys Med Biol 60:841-68
Kipritidis, John; Hugo, Geoffrey; Weiss, Elisabeth et al. (2015) Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging. Med Phys 42:1255-67
Xu, Huijun; Gordon, J James; Siebers, Jeffrey V (2015) Coverage-based treatment planning to accommodate delineation uncertainties in prostate cancer treatment. Med Phys 42:5435-43
Watkins, W Tyler; Moore, Joseph A; Gordon, James et al. (2014) Multiple anatomy optimization of accumulated dose. Med Phys 41:111705
Xu, Huijun; Vile, Douglas J; Sharma, Manju et al. (2014) Coverage-based treatment planning to accommodate deformable organ variations in prostate cancer treatment. Med Phys 41:101705
Shieh, Chun-Chien; Kipritidis, John; O'Brien, Ricky T et al. (2014) Image quality in thoracic 4D cone-beam CT: a sensitivity analysis of respiratory signal, binning method, reconstruction algorithm, and projection angular spacing. Med Phys 41:041912
Jan, Nuzhat; Balik, Salim; Hugo, Geoffrey D et al. (2014) Interfraction displacement of primary tumor and involved lymph nodes relative to anatomic landmarks in image guided radiation therapy of locally advanced lung cancer. Int J Radiat Oncol Biol Phys 88:210-5

Showing the most recent 10 out of 71 publications