The clinical motivation of this research project is to improve accuracy of the treatment planning while providing a standardized procedure for the therapy of ocular tumours. For both radiotherapy and proton beam treatments planning, CT represents the standard modality for tumour volume delineation, despite some inherent limitations. The target volume is usually defined in a CT scan which is very useful in providing information on physical density for dose calculation and morphological volumetric information but with a low sensitivity in assessing the tumour viability, margins and his proximity to critical structures. In order to perfectly delineate the primary tumour and to optimize doses administered to normal tissues, it is necessary for patients to undergo a multimodal imaging and in addition in the case of proton beam therapy to integrate alphanumeric measurements revealing the tumour shape and its spatial position.
Through an automatic segmentation of gross tumour volume (GTV) in the 3D US and simultaneous registration with the CT, MR and fundus photography, the time-consuming and rather inaccurate manual volume definition in such therapies can be shortened and the volume definition would become more reproducible and comparable. This in turn would overcome the intrinsic problem of inter- and intra-user variability, thus making these tumour treatments amenable for standardization. Moreover increased planning accuracy will also lead to less conservative treatment plans.
We are convinced that such multi-modal framework will enable us to build a comprehensive patient specific model of the pathologic eye that can be used to establish the treatment plan. Fitting the different image modalities into one parametric model will provide both the segmented tumour border in each modality and the registration between the individual image modalities.
Main investigators This work is investigated by Dr. M. Bach Cuadra and C. Ciller (CIBM-CHUV).
Collaborators This work is funded by the Swiss Cancer League (PI: M. Bach Cuadra, Co-PI: Prof. Jens Kowal (ARTORG, Uni Bern), Alessia Pica, MD (Radiation Oncology Department, Inselspital Bern), and Prof. Francis Munier (Hôpital ophtalmique Jules-Gonin, Lausanne), and in collaboration with Philippe Maeder (Radiology Department, CHUV).