MIGRATES: Multi-centre deployment of preclinical multi-modal imaging-guided radiotherapy

Current problem Small animal radiotherapy (RT) research is the weak link in translating exciting, new radiation discovery research into patient benefit. This is because pre-clinical RT does not currently mirror cutting-edge image-guided adapted used for clinical RT.

This leads to inconsistent preclinical results that fail to provide a strong foundation for new clinical RT and RT-drug trials.

For example, computed tomography imaging used in preclinical RT planning and image-guidance does not enable accurate delineation and targeting of tumours located in soft tissues due to low image contrast.

Novel technology Our network-wide collaboration aims to bridge this gap with the Multi-modal Imaging-Guided Radiotherapy for small Animals with a Technological and Extensible System (MIGRATES) project.

We will develop and deploy an end-to-end user-friendly framework for multi-modal co-registration using a system-agnostic cradle for accurate physical co-registration of preclinical imaging modalities.

This will be combined with accurate and easy-to-use co-registration software to enable preclinical magnetic resonance- and biology-guided RT and maintenance of body homeostasis through monitoring and thermoregulation.

MIGRATES will provide a unique system to overcome the limitations of computed tomographic guidance and allow optimisation of clinically-relevant RT plans to better target tumours and spare healthy tissues in mouse models.

Project plan Our multi-centre inter-disciplinary collaboration has developed through the RadNet Molecular Imaging & RT Working Group that has representation and support from all RadNet Centres.

We aim to optimise and implement our multi-modal imaging and RT bed system in Cambridge by harnessing physics expertise and support from the world-class Cavendish Laboratory.

We will then “migrate” the pipeline to other RadNet Centres, providing support to install/adapt the system to the local environment.

Three work packages (WP) will be completed within 12 months: WP1: Design and Manufacturing (Cambridge); WP2: Implementation and Testing In Vivo (Cambridge); WP3: Roll-out to other RadNet Centres (Glasgow and Leeds).

The robust installation protocol developed will facilitate implementation at the remaining RadNet Centres with minimal cost.

Potential impact and patient benefit MIGRATES will provide the ability to mirror highest quality clinical RT practice by ensuring highly targeted, reproducible image-guided pre-clinical RT.

It will facilitate collaborative, high-quality and harmonised preclinical RT and RT-drug trials and enable cross-validation of quantitative MR and PET imaging biomarkers to guide adaptive RT and to measure RT response/resistance.

MIGRATES will form a robust link between discovery radiation science and clinical trials and provide a firm foundation for world-class CRUK RadNet research with translation into patient benefit.