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Minimally Invasive Therapy for Tumours 3D Ultra-sound guided

Objective

Research and development of a new medical "Integrated Brachytherapy System", will have great advantages for users and patients. The system decreases waiting time and treatment time, and results in a treatment with minimally invasive consequences. The system combines new techniques in advanced medical imaging and uses a virtual world for preparing a treatment. In the virtual world the guiding of catheters can be simulated. Guiding of catheters can be done in the real world using 3D Ultrasound images, which can be combined with other modalities. The programme will also result in a system for placing radioactive sources in a calculated way.

Objectives:
By targeting the development of an integrated brachytherapy system, the project proposal addresses the following needs:
* It enables the treatment of a significantly increased number of patients, while at the same time offering higher accuracy
* Its operation is cost effective
* It speeds up the realisation of a worldwide acknowledged cancer treatment method by applying innovative technologies to clinical trials
* It allows brachytherapy to be performed intra-operatively and be made less operator-dependent and more reproducible
* It launches multinational clinical trials and facilitates technology and know-how transfer on an international level
* It produces spin-offs that will introduce innovative technologies in several application areas.

Work description:
Create a dual usage brachytherapy system employing seeds (LDR) or catheters (HDR) using 3D-ultrasound images rather than computer tomography (CT) scans.

The system includes the following main components:
* Establishing inexpensive, accurate and easy-to-use LDR (seeds) systems as an alternative to the established HDR procedure for prostrate treatment.

Due to the simplicity of LDR, it will significantly boost the number of customers for brachytherapy systems worldwide
* New LDR implanting equipment innovating the "seeds" design and making the implantation of LDR "seeds" simpler, safer and inexpensive. Patient modelling system based mainly on 3D-ultrasound either than on CT scans. 3D-ultrasound (U/S) is much cheaper, widely available and an uncomplicated procedure as compared with CT
* Inverse planning system using the segmented anatomy as stated above derived from 3D-U/S, CT, or from a combination of the two (fusion), calculating the minimum number and the optimal position of seeds or catheters to deliver the desired dose on the specified area. An innovative method and an anatomy based 3D-dosage optimisation will solve the inverse problem starting from the desired irradiation pattern and delivering number and location of implants. A navigation system based on templates or magnetic tracker information which will for the first time give doctors the possibility of seeing the result of their actions in real-time and will enable them to position implants accurately in the positions defined by the pre-planning.

This will increase the effectiveness of the treatment and enable accurate records to be kept
* Anatomy Based Optimisation based on genetic algorithms and fine-tuning the dose delivery to compensate differences between ideal and real implant position
* Telemedicine features allowing the on-line communication of experts. Unlike previous "teleradiology-motivated" approaches, our approach will enable co-operation during the planning phase as well during the interventional application of treatment
* Ultrasound beam formed by employing technology originally developed for defence purposes (sonar) to significantly increase the quality of ultrasound U/S images.

Milestones:
The project results in the following implementations:
* Advanced Beam Former can be modified to support high quality imaging in totally different application areas, such as cardiology, obstetrics/gynaecology etc
* 3D-Ultrasound and CT Registration can become a stand-alone tool with application possibilities in other medical areas such as cardiology
* Needle Navigation System either based on magnetic trackers or on image tracking employing U/S or in a combination of both can be used also for guiding biopsy needles, endoscopes and other surgical instruments
* Dosage Optimisation System can be possibly employed also with other irradiation methods, e.g., external beams
* Seed sorter gives the possibility to arrange radioactive sources in a calculated way.

Funding Scheme

DEM - Demonstration contracts

Coordinator

NUCLETRON BV
Address
Waardgelder 1
3905 TH Veenendaal
Netherlands

Participants (10)

B-K MEDICAL A/S
Denmark
Address
Mileparken 32-34
2730 Herlev
DEFENCE AND CIVIL INSTITUTE OF ENVIRONMENTAL MEDICINE
Canada
Address
1133 Sheppart Avenue West
M3M 3B9 Toronto
ESAOTE S.P.A.
Italy
Address
Via Ruffino Aliora 32
15033 Casale Monferrato
FRAUNHOFER GESELLSCHAFT ZUR FOERDERUNG DER ANGEWANDTEN FORSCHUNG E.V.
Germany
Address
Hansastrasse 27C
80686 Muenchen
J.P. ROBARTS RESEARCH INSTITUTE
Canada
Address
100 Perth Drive
N6A 5K8 London, Ontario
LIFE IMAGING SYSTEM
Canada
Address
195 Dufferin Avenue - Suite 300
London, Ontario
LONDON HEALTH SCIENCES CENTRE
Canada
Address
339 Windermere Road
N6A 5A5 London, Ontario
MEDCOM GESELLSCHAFT FUER MEDIZINISCHE BILDVERARBEITUNG MBH
Germany
Address
Rundeturmstrasse 6
64283 Darmstadt
NTEC MEDIA GMBH - ADVANCED DIGITAL MOTION PICTURE SOLUTIONS
Germany
Address
August-bebel-strasse 26-53, Medienhaus
14482 Potsdam
STAEDTISCHE KLINIKEN OFFENBACH
Germany
Address
Starkenburgring 66
63069 Offenbach