Clipless MR-eye guided planning and follow-up for proton therapy of Uveal Melanoma

Principle Investigators:  Jan Willem Beenakker (LUMC), Emine Kilic (Erasmus MC), Coen Rasch (HollandPTC)

PhD students: Lisa Klaassen (LUMC), Bas van der Burgh (TU Delft),  Mike Wu (Erasmus MC), Martijn Hol (HollandPTC)



Proton therapy is next to brachytherapy, stereotactic photon irradiation and enucleation a major treatment option for local treatment of uveal melanoma. Since Jan. 2020 proton therapy is possible in The Netherlands at HollandPTC. Current state of the art, as is duplicated from existing centers, is however not up to standard compared to other anatomical sites. In particular this holds for target delineation, intra-operative clip placement, treatment planning and follow-up image interpretation. This unavoidably leads to suboptimal irradiation. It is the aim of this project to bring proton treatment for uveal melanoma up to standards comparable to other treatment sites, by building upon the developments of Protons4vision. First, to develop a fixation setup with gazing angle guidance for MRI and Eye Treatment Room to replace the invasive intra-operative clip placement. Second, to use the information of the 3D MR-images to enable a more accurate tumour and eye model with the current version of the treatment planning system. Third to develop biological MR sequences and blood serum biomarkers for more accurate follow-up beyond spatial dimensions alone. We further aim to explore methods to use these biomarkers to further tailor the treatment to the tumors’ genetic make-up.  At the end of the project clipless photon irradiation with 3D treatment planning and follow-up will be possible for eye tumors.