Tutorial on Image-Guided Adaptive Radiation Therapy

Date and time

1 October 2006, 9 a.m.-4:30 p.m.

Venue

IT University of Copenhagen, Auditorium 4

Description

Radiation therapy (RT) is used in the management of over 50% of patients suffering from cancer. In the past 5 years, there has been a revolution in our capacity to precisely and accurately direct the radiation fields employed in treatment delivery. This is referred to as image-guided radiation therapy, in which, novel hybrid devices have been developed with imaging systems embedded in the treatment unit for the sole purpose of directing therapy. In parallel, remarkable developments in the field of three-dimensional imaging (PET, SPECT, MR) now offer unprecedented opportunity for non-invasive assessment of the characteristics of the disease and normal processes. These two developments create a unique opportunity to alter the paradigm of cancer treatment from a step-wise, linear approach to one in which the therapy is individualized and adapted, in a real-time fashion to the target and normal structure characteristics as they respond to the ongoing therapy.

Adaptive radiation therapy offers adaptive treatments for increased probability of tumor control under reduced or equivalent toxicity. Such adaptions can be based upon biological changes in target signatures (changes in metabolism, hypoxia, perfusion, replication) or simple alterations in the geometric placement/shape of the target and normal structures as the treatment is delivered.

The exploration of this new and exciting domain requires the re-tooling of radiation therapy in a way that has not been seen before. This tutorial will introduce the field of cancer treatment and radiation therapy; highlight state-of-the-art research in image-guided and adaptive RT; biological Image-based assessment of of tumor; image processing and analysis methodology in the context of image-guided adaptive radiotherapy; and outline current and future challenges and opportunities.

Expected outcome for tutorial participants

Introduction to cancer management and radiation therapy (RT); clinical and technical aspects of radiation therapy and treatment planning; use of imaging modalities (CT, MRI, functional CT, functional MRI, cone-beam volumetric X-ray, NM); concepts of image-guided RT using integrated treatment-imaging systems (CBCT and MRI); concepts of adaptive RT; concepts of image-based functional tumor characterization; image processing and analysis technology and applications of segmentation, deformable registration, and kinetic analysis of functional and molecular imaging.

Programme

Speaker Information

Kristy graduated from the University of Michigan, Ann Arbor, Michigan with a BSE in Nuclear Engineering and Radiological Sciences in 1999 and completed her PhD in the same department in 2003. In 2003 she joined the faculty of University of Toronto, where she is currently an Assistant Professor in the Department of Radiation Oncology. Dr. Brock's research interests include deformable modeling of physiological motion, for high precision image-guided radiotherapy and accurate dose accumulation, and treatment response, for accurate assessment of novel treatment techniques and correlation of applied treatment and normal tissue and tumor response. Currently, her major interest is in developing a biomechanical-based deformable modeling algorithm, Morfeus, to facilitate classification, targeting, and monitoring of tumor and normal tissue.

Dr. Duncan received the BSEE degree from Lafayette College, Easton, PA in 1973, the MS degree in Engineering from UCLA in 1975 and the Ph.D. degree in Electrical Engineering from the University of Southern California, in 1982. In 1983, he joined the faculty of Yale University, where he currently is a Professor of Diagnostic Radiology and Electrical Engineering; is the Vice-Chair of Bioimaging Sciences Research and the Director of the Image Processing and Analysis Group within Diagnostic Radiology; and is the Chair of Yale's Program in Biomedical Engineering. His research and teaching efforts have been in the areas of image processing, computer vision and medical imaging. His current specific research interests include the segmentation of deformable objects from both 2D and 3D data, the tracking of non-rigid object motion from 2D and 3D data, the use of geometrical and physical models to constrain the recovery of information from images and the integration of processing modules in vision systems, all with a special interest in using these approaches for medical image analysis.

Michael is a Senior Scientist at the Philips Research Laboratories. He received his Diploma in Electrical Engineering (with honors) in 1996 and his PhD in Electrical Engineering (with highest honors) in 2000 from the University of Erlangen-Nürnberg. He was with the Department of Neurosurgery Erlangen-Nürnberg in 1996, the Surgical Planning Laboratory, Brigham and Women's Hospital in 1997, and the Philips Research Laboratories Germany in 2000. For the last 10 years he has worked on image processing and analysis for clinical applications in the area of image-guided surgery, cardiac analysis, and radiation therapy treatment planning. He is currently the leading scientist for radiotherapy-related image processing, and a clinical scientist at the Princess Margaret Hospital in Toronto.

Cynthia Ménard received her M.D. degree from the University of Calgary in 1996, and completed her residency in Radiation Oncology at the University of Alberta, Edmonton, in 2001. She worked as a research fellow in the Radiation Oncology Branch of the National Cancer Institute (NCI) until 2003, where she was subsequently appointed Staff Clinician and Head of the Radiation Oncology Molecular Imaging Section. In this role, she pursued translational research in the development, validation, and clinical application of novel MR imaging techniques to radiotherapy. She is now a Clinician Scientist in the Radiation Medicine Program at Princess Margaret Hospital, Toronto, and is the co-director of the Gamma Knife Center and the MRI-Simulator Research Program.

Uulke van der Heide graduated in Experimental Physics, with specialization Molecular Biophysics at the University of Utrecht in 1989. He worked on the molecular mechanism of motor proteins and received a PhD in 1993 from the University of Utrecht. The work was continued at the department of Physiology in Utrecht and then at the Department of Physiology of the University of Pennsylvania, PA. In 1999 he started to work at the radiotherapy department of the University Medical Center in Utrecht, since 2003 as a medical physicist. His work now focuses on MRI-guided radiotherapy.

Dr. Knisely completed degree requirements in East Asian Language and Literature (Chinese) and Molecular Biophysics & Biochemistry at Yale University in 1982. He then attended the University of Pennsylvania School of Medicine and graduated in 1986. Subsequently, he completed an Internal Medicine residency at Michael Reese Hospital in Chicago in 1989, and then a Radiation Oncology residency at the University of Toronto in 1992. He has been at Yale since that time, where he is currently an Associate Professor of Therapeutic Radiology and a member of the Yale Cancer Center. He is the Principal Investigator for the Yale Cancer Center in the Radiation Therapy Oncology Group, is the Senior Radiation Oncologist at the Yale-New Haven Gamma Knife Center, and focuses his intellectual and clinical efforts on improving outcomes for radiation therapy cancer treatments by improving the accuracy of treatment design and delivery.