Automated Object Contouring Methods & Software for Thoracic Radiotherapy Planning

DESCRIPTION provided by applicant In nearly million new cancer cases are estimated to occur in the US where nearly two thirds will have treatment by radiation therapy In current clinical practice organ contour delineation on medical images is still performed with low levels of automation due to lack of highly automated commercial contouring software This deteriorates therapy planning due to several reasons Manual contouring is error prone subject to intra and inter observer variations labor intensive and results in suboptimal throughput In modern conformal radiation techniques like intensity modulated radiotherapy and proton beam radiation therapy PBRT anatomic changes taking place during a week course of serial treatment are not accounted for due to manual labor involved in re contouring Such changes can significantly affect the total dose delivered to the tumor and normal surrounding organs and are particularly important when treating thoracic malignancies that are often highly radiosensitive Given the above gaps and the fact that there are over radiation therapy centers in the US there is a strong commercial opportunity for reducing the total dose to normal critical structures and delivering highly precise radiotherapy to tumors that
can lead to improved patient outcomes throughput and cost saving The overall aim of this project therefore is to develop a methodology and a software prototype for clinical use to routinely define at a high level of automation and improved accuracy anatomical organ contours on CT and PET CT images and to evaluate the clinical utility of the software in thoracic radiation therapy The specific aims of this small business effort are fold Aim To develop a highly automated method and software prototype to delineate all major thoracic organs on An automatic anatomy recognition methodology will be developed by adapting the highly successful fuzzy anatomy modeling technology developed at Penn to existing image and contour data from lung cancer patients Patients will be divided into four groups by gender and age and modeling will be done for each group Aim outcome will be a prototype software technically validated to have a mean false positive and false negative volume fractions at or below or Dice coefficient at or above and boundary distance within one voxel as compared to reference segmentations The expected human time needed in contouring will be minutes or less per study Aim To perform a preliminary assessment of the utility of the proposed software for optimized radiation therapy planning in patients with thoracic malignancies treated with PBRT Image and contour data of an additional patients who have received proton treatment for thoracic malignancy and have undergone weekly CT studies in their routine clinical care will be studied and the accuracy and efficiency of AAR software will b evaluated Expected Aim outcome will be similar to that described in Aim but for the above patient cohort undergoing serial treatment diagnostic CT images and low dose CT of PET CT acquisitions

PUBLIC HEALTH RELEVANCE In M new cancer cases are estimated to occur in the US where nearly two thirds will have treatment that may involve radiation therapy In current clinical practice organ contour delineation on medical images by using commercial radiotherapy planning systems is still performed with low levels of automation due to lack of highly automated contouring software This deteriorates therapy planning efficiency throughput and accuracy This project aims to develop a methodology and a software prototype for clinical use to routinely define at a high level of automation and improved accuracy anatomical organ contours on CT and PET CT images and to evaluate the clinical utility of the software in thoracic radiation therapy There is a strong commercial opportunity for such a software which can impart considerable impact on current practice of radiotherapy planning