Radiomics or computer - extracted texture features have been shown to achieve superior performance than multiparametric MRI (mpMRI) signal intensities alone in targeting prostate cancer (PCa) lesions. Radiomics along with deformable co-registration tools can be used to develop a framework to generate targeted focal radiotherapy treatment plans.
The Rad-TRaP framework comprises three distinct modules. Firstly, a module for radiomics based detection of PCa lesions on mpMRI via a feature enabled machine learning classifier. The second module comprises a multi-modal deformable co-registration scheme to map tissue, organ, and delineated target volumes from MRI onto CT. Finally, the third module involves generation of a radiomics based dose plan on MRI for brachytherapy and on CT for EBRT using the target delineations transferred from the MRI to the CT.
用来自两个不同单位的23个病人的回顾性队列对Rad-TRaP框架进行评估。第一个单位的11个病人用来训练放射组学的分类器，然后用来对第二个单位的12位病人进行肿瘤检测。对于训练机器学习分类器真正的癌症规划是通过有经验的放射肿瘤学家通过多功能参数MRI（mpMRI）、活检部位的知识以及放射科的报告中得来的。检测到的肿瘤区域用来对用mpMRI的近距治疗提供方案，从MRI到CT产生的肿瘤区域对EBRT产生相应的处理。对于每一个BRET和近距疗法都会有3个剂量的方法，整个腺体均匀是目前临床的标准，基于表面的放射组学和基于表面提升放射组学的整个腺体。对比传统的疗法发现有目标的局部治疗在剂量对于OARs中会有一个显著的下降，并且可以确保处方药剂量送到了病灶。[Formula: see text]跟[Formula: see text]相比，对OARs只增加了边缘性的剂量。类似的趋势在EBRT案例中被观察到。
Rad-TRaP framework was evaluated using a retrospective cohort of 23 patient studies from two different institutions. 11 patients from the first institution were used to train a radiomics classifier, which was used to detect tumor regions in 12 patients from the second institution. The ground truth cancer delineations for training the machine learning classifier were made by an experienced radiation oncologist using mpMRI, knowledge of biopsy location and radiology reports. The detected tumor regions were used to generate treatment plans for brachytherapy using mpMRI, and tumor regions mapped from MRI to CT to generate corresponding treatment plans for EBRT. For each of EBRT and brachytherapy, 3 dose plans were generated - whole gland homogeneous ([Formula: see text]) which is the current clinical standard, radiomics based focal ([Formula: see text]), and whole gland with a radiomics based focal boost ([Formula: see text]). Comparison of [Formula: see text] against conventional [Formula: see text] revealed that targeted focal brachytherapy would result in a marked reduction in dosage to the OARs while ensuring that the prescribed dose is delivered to the lesions. [Formula: see text] resulted in only a marginal increase in dosage to the OARs compared to [Formula: see text]. A similar trend was observed in case of EBRT with [Formula: see text] and [Formula: see text] compared to [Formula: see text].
A radiotherapy planning framework to generate targeted focal treatment plans has been presented. The focal treatmentplans generated using the framework showed reduction in dosage to the organs at risk and a boosted dose delivered to the cancerous lesions.