On July 7, 2022 RefleXion Medical, a therapeutic oncology company pioneering the use of biology-guided radiotherapy (BgRT)* for all stages of cancer, reported a non-exclusive, worldwide licensing agreement with Mirada Medical (Press release, RefleXion Medical, JUL 7, 2022, View Source [SID1234616549]). The agreement allows for the integration of Mirada’s RegEngine image registration algorithms into the RefleXion X1 treatment planning software. The algorithms align patient anatomy between different imaging modalities or between radiotherapy treatments.
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"Day-of-treatment modifications, called adaptive radiotherapy, are critical for responding to changes in patient anatomy that occur as a result of cancer treatment, and to lowering toxicity to improve outcomes," said Thorsten Melcher, Ph.D., chief business officer at RefleXion. "In challenging patients, such as those with metastatic disease where more than one tumor may be treated, adaptation requires robust tools such as Mirada’s sophisticated RegEngine software, so that clinicians can quickly assess patient anatomy and, in the future their biology, to implement changes to the treatment plan.
"Mirada’s extensive industry experience and development expertise were key factors in our decision to pursue this agreement," continued Melcher.
Image registration is a complex series of algorithms that align the images of a patient’s anatomy taken at different points in time and using different imaging modalities. For radiation oncology, where millimeters matter in order to preserve healthy tissue, registration of the tumor target to be treated, as well as nearby anatomy to avoid, is critical. Precise targeting may also result in lowering toxicity, thereby improving outcomes for patients.
BgRT is designed to one day overcome the technical limitations of existing radiotherapy approaches by using a PET radiotracer to create a unified motion management solution for one or multiple tumors. As the PET tracer binds to tumor cells, it produces emissions that signal the cancer’s location. BgRT uses this real-time biological information to deliver a tracked radiation dose to the cancer. Integrating RegEngine into BgRT will allow clinicians to rapidly adapt the daily treatment plan by precisely registering images and image components crucial for treatment planning and dose calculation.
A difficult challenge occurs when the frames of reference of the images are similar, but the patient’s anatomy has changed from biological processes, such as breathing or digestion, or changes in position during the imaging procedures. To assist clinicians in accounting for these changes, RegEngine "warps" or "deforms" the images pixel by pixel, a process called deformable image registration.
"Our relationship with RefleXion is another example of our ability to work with cutting edge oncology companies," said Jon DeVries, CEO at Mirada. "RefleXion’s biology-guided radiotherapy has the potential to offer a new treatment option for patients with all stages of cancer, and we are excited and proud to have RegEngine selected as a key component of the treatment planning process in this exciting novel technology."