基于亚肝段功能单元保护优化的肝癌个体化放疗研究

项目名称： 基于亚肝段功能单元保护优化的肝癌个体化放疗研究

项目编号： No.81472811

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 尹勇

作者单位： 山东省医学科学院

项目金额： 72万元

中文摘要： 放射性肝损伤（RILI）已成为原发性肝癌（HCC）精确放疗首要考虑的限制因素。课题组在研基金实施中发现HCC放疗后RILI发生比例较低的患者可有非均匀的肝脏再生，说明准确预测RILI发生与有效代偿可减少其危害。准确识别肝硬化程度与分布，尽量保护有再生能力肝脏细胞和区域，对肝脏功能储备评估、再生能力保护、放疗方案优化和疗效提高有重大意义。本项目提出了一种基于亚肝段功能单元保护优化HCC个体化放疗的方法，即按肝脏管道系统融合多模态图像（CT与MRI）实现亚肝段划分、编码，再用MRI弥散加权成像（DWI）分析亚肝段差异性硬化程度以评估其功能储备情况；通过形变配准技术匹配亚肝段放射剂量与肝硬化程度对应关系，经随访建立肝脏局域再生/放射损伤与亚肝段放射剂量、硬化程度的关系，依此制定有针对性保护无或轻度肝硬化区域的HCC患者个体优化放疗方案，为进一步提高放疗安全性和疗效提供科学依据与创新方法。

中文关键词： C09_肝和肝内胆管肿瘤；放射治疗；放射性损伤；亚肝段功能单元；形变配准

英文摘要： Radiation-induced liver injury (RILI) has become the primary critical factor for the precise radiotherapy of hepatocellular carcinoma. In the investigation of the prior National Natural Science Foundation of China(NSFC) program, we found that the patients with lower proportion of RILI may experience non-uniform liver regeneration. This important finding proved that accurate prediction and effective compensation of the RILI may reduce risk and damage. It is significant to evaluate liver biology function, protect live regenerative capacity, optimize radiotherapy plans and improve the clinical outcome by identifying the extent and distribution of liver cirrhosis, protecting the regenerative capacity of liver cells. This project aims to design a novel method for personalized radiotherapy based on liver subsegment function protection. Our research group will evaluate location reserved hepatic functional through analysing hepatic cirrhosis differences by MRI diffusion weighted-images（DWI）for liver subsegment function unit(s). And the liver subsegment could be firstly segmented on multi-modal anatomical images of CT and MRI.Deformable image registration techniques will be used to correspond the liver subsegment hepatic cirrhosis and irradiation dose, and the established correspondence will play an important role in effective protection of the liver subsegment with none or mild cirrhosis. The personalized radiotherapy approach guided by protecting the live subsegment function unit could provide the foundation and strategy to improve the patient safty and clinical outcome.

英文关键词： hepatocellular carcinoma;radiotherapy;radiation-induced injury;liver subsegment function unit;deformable registration