Project Details
Projekt
Motion management and response prediction for real-time adaptive MRI-guided RT in liver and rectal cancer
Applicants
Dr. Cihan Gani; Professor Dr.-Ing. Thomas Küstner
Subject Area
Nuclear Medicine, Radiotherapy, Radiobiology
Medical Physics, Biomedical Technology
Medical Physics, Biomedical Technology
Term
since 2024
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 531653937
Online adaptive MR-guided radiotherapy has great potential in the abdominal region due to the optimal soft tissue contrast, but the large positional variability of tumors and organs at risk in this body region between sessions and within a session (due to respiration, peristaltic and patient movement) presents a challenge. In the first funding phase, new therapeutic concepts for liver and rectal tumors were established by addressing some challenges, and over 50 patients were treated and evaluated within a prospective clinical protocol. Building on these results, the following objectives are pursued in the requested extension: An upcoming update of the MR-Linac will enable high-dose irradiation in a selectable breathing phase, potentially leading to further therapy optimization by reducing the irradiated volumes. In the first work package, the new technology will be scientifically evaluated with respect to feasibility, treatment duration, and dosimetry compared to the previous treatment strategy in a cohort expanded by 20 patients. Additionally, it will be investigated whether patients with reduced liver function can be treated with higher radiation doses using the new treatment method and functional imaging. The second work package deals with the tracking of anatomical structures. The self-supervised tracking method, developed and investigated in the first project phase, will be extended to intra- and inter-session tracking. The generalizability of the lesion and organ tracking towards different anatomical areas (liver and rectum) and imaging sequences is investigated. Thereby automating the very time-consuming part of manual segmentation of the target structures and organs at risk in the context of online adaptive radiotherapy. While early rectal carcinomas were mainly examined as the basis for the dose escalation work in the first project phase, locally advanced tumors will now be the subject of investigation in the third work package of the extension phase. Since these tumors are generally not suitable for dose escalation of the entire tumor due to their size, it will be investigated whether subareas can be identified in these tumors using diffusion-weighted and perfusion imaging that are potentially radioresistant and should be treated with higher radiation doses.
DFG Programme
Research Grants
