Ultrasound Monitoring of Abdominal Soft Tissue
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Liver Cancer, Cancer, Cancer, Cancer, Cancer, Pancreatic Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - 100 |
| Updated: | 11/9/2018 |
| Start Date: | May 2015 |
| End Date: | May 2021 |
Ultrasound System For Non-Invasive, Real-Time Monitoring of Abdominal Soft Tissue
This research study is being done to collect data and analyze the motion of soft tissue in
the abdomen (liver, pancreas, stomach and intestines) of people who have pancreatic and liver
cancer as well as healthy volunteers.
During the study researchers will look at the movement of organs in the abdomen that
naturally occurs with breathing and with a bowel movement.
This study will examine the differences between abdominal soft tissue motion in healthy
volunteers and in cancer patients with the goal of developing a better way to manage and
minimize the abdominal soft tissue motion. Accurate location of the tumor is very important
in treatment delivery and reduction of toxicity.
the abdomen (liver, pancreas, stomach and intestines) of people who have pancreatic and liver
cancer as well as healthy volunteers.
During the study researchers will look at the movement of organs in the abdomen that
naturally occurs with breathing and with a bowel movement.
This study will examine the differences between abdominal soft tissue motion in healthy
volunteers and in cancer patients with the goal of developing a better way to manage and
minimize the abdominal soft tissue motion. Accurate location of the tumor is very important
in treatment delivery and reduction of toxicity.
Within the last decade, Linac based stereotactic body radiation therapy (SBRT) has been shown
to be an effective treatment option for pancreas1, 2 and liver3, 4 tumors. SBRT delivers high
doses of radiation therapy to the tumor over only 1-5 treatments. Because of the spatial
precision of SBRT, it is feasible to administer a high radiation dose in only a few
treatments. By minimizing the amount of radiation to surrounding healthy tissue, it is
possible to decrease the rate of toxicity/complication and increase the radiation dose to
cancerous tissue, thereby allowing better local control.
SBRT of the abdomen has been limited by the movement of intra-abdominal organs that naturally
occurs with respiration and bowel movement. Organ motion occurs both intra- and
inter-fractionally. While intra-fractional motion is a result of respiration, peristalsis and
cardiac motion, the magnitude of inter-fractional target motion is dependent of daily
variations in organ filling, weight change, tumor growth and radiation induced changes of
tissue. Tumor movement may lead to tumor displacement and suboptimal dose delivery. Accurate
localization of the target is very important to improve treatment delivery accuracy and
reduce toxicity of the treatment. To evaluate tumor motion due to breathing motion, a 4-D CT
simulation scan is performed. If the tumor moves more than 3 mm during a breathing cycle,
breathing motion management is employed using Active Breathing Control (ABC) technique. ABC
requires the patient to hold his/her breath within the proper tidal volume while treatment is
delivered, while free breathing may be resumed between periods of treatment. This technique
limits the delivery of RT to specific phases of the respiratory cycle so as to minimize the
influence of breathing on the delineated tumor.
Despite significant progress made in ABC technique, tumor and organ motion could only be
minimized and not eliminated completely with this technique. Assessing patient specific
tumor/organ motion (both intra- and interfractional) throughout the course of SBRT treatment
offers the possibility of ensuring delivery of the prescribed target dose while
simultaneously minimizing normal tissue damage. In order to monitor the abdominal soft tissue
motion, the Department of Radiation Oncology has developed a 4D ultrasound technique based on
an ultrasound probe holder and a continuous motion monitoring software. The 4D ultrasound
image is acquired by using a motorized 3D ultrasound probe and image continuously. 4D
ultrasound is a new non-ionizing and non-invasive imaging technique that continuously
monitors the tumor motion during the radiation treatment in real time.
to be an effective treatment option for pancreas1, 2 and liver3, 4 tumors. SBRT delivers high
doses of radiation therapy to the tumor over only 1-5 treatments. Because of the spatial
precision of SBRT, it is feasible to administer a high radiation dose in only a few
treatments. By minimizing the amount of radiation to surrounding healthy tissue, it is
possible to decrease the rate of toxicity/complication and increase the radiation dose to
cancerous tissue, thereby allowing better local control.
SBRT of the abdomen has been limited by the movement of intra-abdominal organs that naturally
occurs with respiration and bowel movement. Organ motion occurs both intra- and
inter-fractionally. While intra-fractional motion is a result of respiration, peristalsis and
cardiac motion, the magnitude of inter-fractional target motion is dependent of daily
variations in organ filling, weight change, tumor growth and radiation induced changes of
tissue. Tumor movement may lead to tumor displacement and suboptimal dose delivery. Accurate
localization of the target is very important to improve treatment delivery accuracy and
reduce toxicity of the treatment. To evaluate tumor motion due to breathing motion, a 4-D CT
simulation scan is performed. If the tumor moves more than 3 mm during a breathing cycle,
breathing motion management is employed using Active Breathing Control (ABC) technique. ABC
requires the patient to hold his/her breath within the proper tidal volume while treatment is
delivered, while free breathing may be resumed between periods of treatment. This technique
limits the delivery of RT to specific phases of the respiratory cycle so as to minimize the
influence of breathing on the delineated tumor.
Despite significant progress made in ABC technique, tumor and organ motion could only be
minimized and not eliminated completely with this technique. Assessing patient specific
tumor/organ motion (both intra- and interfractional) throughout the course of SBRT treatment
offers the possibility of ensuring delivery of the prescribed target dose while
simultaneously minimizing normal tissue damage. In order to monitor the abdominal soft tissue
motion, the Department of Radiation Oncology has developed a 4D ultrasound technique based on
an ultrasound probe holder and a continuous motion monitoring software. The 4D ultrasound
image is acquired by using a motorized 3D ultrasound probe and image continuously. 4D
ultrasound is a new non-ionizing and non-invasive imaging technique that continuously
monitors the tumor motion during the radiation treatment in real time.
Inclusion Criteria:
- Arm 1: Healthy adult (age >18 years)
- Arm 2: Pancreatic cancer patients (age >18 years) currently receive SBRT treatment at
JHU
- Arm 3: Hepatic cancer patients (age >18 years) currently receive SBRT treatment at JHU
Exclusion Criteria:
- Children (age < 18 years) are excluded.
We found this trial at
1
site
Baltimore, Maryland 21231
Phone: 410-502-3823
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