THE PROBLEM

Due to a patient’s breathing, lung tumours are constantly moving. Current radiotherapy treatments allow for this movement by treating with a large radiation beam, to try and ensure they cover the entire tumour. This means that healthy tissue often gets hit with radiation and can sometimes even miss the tumour. For lung cancer patients, sparing as much healthy tissue as possible is extremely important. With an already reduced lung capacity, toxicity and complications such as pneumonia can be life threatening. In an effort to keep track of the tumour, a patient may have ‘markers’ surgically implanted around the tumour. This shows the tumour’s location during imaging, but this is an invasive and expensive option.

OUR SOLUTION

In a world first, we’re developing software that tracks lung cancer tumours without any need for implanted markers. To achieve this, we’re using an x-ray device combined with our advanced algorithms. This solution requires no invasive surgery, and it allows the tumour to be accurately targeted. The collateral damage to healthy lung tissue is minimized, thus improving the outcomes for lung cancer patients.

“Potential to improve treatment effectiveness by up to 8% and reduce radiation dose to organs-at-risk by up to 56%”

-Mechalakos et al., Radiotherapy and Oncology (2004)
-Caillet et al., Radiotherapy and Oncology (2017)

CURRENT STATUS

  • Two publications in high impact journal (Physics in Medicine and Biology)
  • Retrospective validation on 13 patient cases
  • Total of $700k funding from NHMRC and Cancer Institute NSW

INTELLECTUAL PROPERTY

  • No. PCT/AU2016/000086 Method and system for in situ targeting of objects
  • Australian Provisional Patent No. 2016904747 Method for 3D tracking using 2D imaging
  • Both patents licensed to Nano-X Pty Ltd

CLINICAL TRIALS

Preparing for a multi-centre phase I feasibility trial recruiting 30 patients:

MAGIK – Markerless Image Guidance using Intrafraction Kilovoltage X-ray Imaging: Phase I Interventional Study of Lung Cancer Radiotherapy

FUTURE STEPS

  • Clinical implementation
  • Real-time volumetric visualisation – 3D Fluoroscopy
  • Extension to liver cancer

RESEARCH OPPORTUNITIES

To find out more about this project including research opportunities, contact Marco Müller

PUBLICATIONS

Shieh, C., Caillet, V., Dunbar, M., Keall, P., Booth, J., Hardcastle, N., Haddad, C., Eade, T., Feain, I. (2017). A Bayesian approach for three-dimensional markerless tumor tracking using kV imaging during lung radiotherapy. Physics in Medicine and Biology, 62(8), 3065-3080. [More Information]

Shieh, C., Keall, P., Kuncic, Z., Huang, C., Feain, I. (2015). Markerless tumor tracking using short kilovoltage imaging arcs for lung image-guided radiotherapy. Physics in Medicine and Biology, 60(24), 9437-9454. [More Information]

Rottman, J., Keall, P., Berbeco, R. (2013). Markerless EPID image guided dynamic multi-leaf collimator tracking for lung tumors. Physics in Medicine and Biology, 58(12), 4195-4204. [More Information]