Myocardial infarction is one of the proven cardiotoxic effects caused by incidental irradiation of the heart in patients with breast and lung cancer treated with radiotherapy (Darby et al 2013, van den Bogaard et al 2017, Bradley et al 2015). A clear dose-effect relationship was observed: the higher the dose of the incidental radiation to the heart, the higher the likelihood of a cardiovascular complication, such as a heart attack (Darby et al 2013, Wang et al 2017).
These cardiotoxic effects can already occur within a few years after the irradiation. The likelihood of these effects is even higher if there are synergistic cardiac risk factors present such as smoking and hypertension (Darby et al 2013).
With the introduction of advanced therapies (such as for example targeted therapies, like Nivolumab) the survival of lung cancer patients is steadily increasing (Brahmer et al 2015). It can be expected that, with an increased survival, lung cancer patients with incidental radiation dose to the heart will be more at risk time to develop radiation induced cardiac toxicity. This could negatively impact on the quality of life and even their survival (Wang et al 2017). One of the possible causes for this 'misdosage' is heart movement. The (magnitude) of the movement of the heart is caused by different factors. Two essential factors are the pumping action and respiration. The magnitude of the motion of the heart can be as large as 13 mm, measured on cone beam CT-scans taken during the treatment (Liu et al).
In lung radiotherapy treatment planning a computed tomography in 4 dimensions (4D-CT) is typically used to outline the movement of the lung tumour. However, the (magnitude of) movement of the heart can also be captured using the same imaging technology.
From these 4D-CT images a realistic volume for the heart (referred to as PRV, planned organ at risk volume) can be created. This PRV of the heart will allow to create a radiotherapy plan delivering a lower radiation dose to the healthy tissues. This will reduce the likelihood of cardiotoxicity and therefore potentially increase quality of life and survival rates.
In this research proposal, we aim to develop an automated segmentation technique to create an individualised PRV for the heart, based on data from international clinical partners.
Skills and experience
The scope of this project would be suited to Honours, Masters or PhD students. Ideally you will have a background in medical physics, biomedical/biomechanical engineering/radiation therapy/medical imaging or similar.
You will join an internationally recognised team of researchers in the area of radiation therapy and medical image processing.
You will gain exposure to the clinical and research environments and build their experience in designing and developing complex research projects.
You may be able to apply for a research scholarship in our annual scholarship round.
Contact the supervisor for more information.