Hadron Therapy and Grids Issues and Requirements Ken

Hadron Therapy and Grids: Issues and Requirements Ken Peach (Particle Therapy Cancer Research Institute, Oxford) EGI Technical Forum Amsterdam, September 16 th 2010 on behalf of The ENLIGHT Network of EU projects http: //enlight. web. cern. ch

Outline • Cancer – statistics and challenges • ENLIGHT – research and development • Cancer informatics – what is needed? – (how) can Grids help? – issues? • Summary Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 2

Cancer Statistics and challenges

Cancer Statistics • About one third of us will have cancer • About two thirds of cancers are in people over 65 Source CRUK Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 4

Cancer - Information • Cancer is a terrible condition but there have been great advances in therapy “ Radiotherapy remains a mainstay in the treatment of cancer. Comparison of the contribution towards cure by the major cancer treatment modalities shows that of those cured, 49% are cured by surgery, 40% by radiotherapy and 11% by chemotherapy”. RCR document BFCO(03)3, (2003). • Radiotherapy is a very important weapon in the battle against cancer Thanks to Roger Dale Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 5

Photons, Protons and Carbon Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 6

X-rays compared with protons X-rays IMRT IMPT • IMRT • IMPT Intensity Modulated Radio. Therapy Intensity Modulated Proton Therapy Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 7

CPT is very effective 1. 503 proton matched with 1591 X-ray patients. 6. 4% of proton patients had a second malignancy 12. 8% of X-ray patients had a second malignancy [ Median follow-up 7. 7 years (proton) and 6. 1 years (X-ray) Median age at treatment 56 (proton) and 59 (X-ray) ] (C. S. Chung et al, International Journal of Radiation Oncology*Biology*Physics , 72/1, Supplement 1 doi: 10. 1016/j. ijrobp. 2008. 06. 785 ) 2. Chordoma Dose Response Spinal cord tolerance 65 Gy in 39 fractions Only protons/light ions can deliver the required 90 Gy for good local control (D. Schulz- Ertner et al. Int J Radiat Oncol Biol Phys. 2007 Jun 1; 68(2): 449 -57) Thanks to Raj Jena Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 8

CPT worldwide In Physics Laboratories In hospitals Courtesy Janet Sisterson, MGH Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 9

ENLIGHT Coordinated by CERN Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 10

ENLIGHT FP 7 Projects Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 11

Cancer Informatics – what is needed? – (how) can Grids help? – issues?

Cancer Informatics what is needed? • Cancer is very common – lung, breast, skin … … but … many rare tumours • “rare” tumours make up 20% of all cancers • tens or fewer each year in each country • naturally distributed and multidisciplinary • Cancer treatment is sophisticated – many options, many variables • Maximise tumour control • Minimise normal tissue toxicity and long-term complications Secondary tumours, organ function impairment Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 13

PARTNER GRID Test Bed • Classes of use: – Clinical • Patient referral (few centres, cross-border…) • Treatment options (search for similar cases with treatment outcomes) – Research • Access to statistical data – Treatment and outcomes – Training • Treatment planning, research methodologies • Example: Rare Tumour Data. Base Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 14

Cancer Informatics (how) can Grids help? Hadron therapy I Sharing Platform i nformation Daniel Abler Faustin Laurentiu Roman Vassiliki Kanellopoulos [PARTNER] • In order to allow rapid accumulation of evidence in trials, standard informatics systems are required so that data from different centres can be readily combined. This same system would underpin patient services, such as transnational referral. Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 15

Cancer Informatics – issues? 1. Authentication – – Patient data Confidentiality Legal considerations Ethical considerations • Username/password & certificate not enough 2. Authorisation – – – Anonymity (research) Full record (clinical) Need to account for “Role” [ Actor] • Different authorisation according access – – As doctor As researcher Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 16

Cancer Informatics – issues (cont) 3. Data Ownership, Access, Integrity & Use – These data have a specific “owner” • • – – The patient If part of a clinical trial, the research team Undesirable to make common real DB Undesirable to make local copy • Once copied, owner risks losing control – − } Note: does not apply to (a) Backup (b) Archiving (c) Cloning for security/integrity/availability Data volumes can be large • 10’s GB per patient with images (CT, MRI, PET, TP…) Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 17

Examples: multi-modal imaging CT PET-CT high-resolution lower-resolution fuses two structural information functional information co-registered images (same coordinate system) Fusion helps identify position and extent of tumour Imaging in different places/at different times complicated Thanks to Dan Warren Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 Topkan et. al. , J Exp Clin Cancer Res. 2008; 27(1): 18 41.

Further comments Confidentiality, Anonymity & Trust – Clinical • [Confidentiality ] Confidentiality must be guaranteed – Note: the doctor, radiologist, medical physicist… can only access a patient record for a patient in their care – Research • [Anonymity] Anonymity must be guaranteed – Where is anonymisation performed? » Can only be at source – Hospital policies [Trust] • Many hospital IT policies are very restrictive – With good reason … the internet is a security risk Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 19

Common issues with other VOs • • Platform/infrastructure independence Middleware independence – Together “interoperability” • • • Security and sustainability (Virtual) database definition & management Metadata, ontology & semantics Workflow Curation Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 20

Data • Treatment Planning & Verification is computationally intense BUT Cancer informatics is about Data! – Agreed data formats – Open data standards – Ergonomic GUIs – Service reliability – Data integrity – Data completeness Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 21

What do IBM think? http: //www. youtube. com/watch? v=AEh 6 LStx. Y-I Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 Thanks to Faust Roman 22

ENLIGHT: a multidisciplinary collaboration platform • ENLIGHT: – 300 persons, 20 countries ENLIGHT • The aim is to: – – – – communicate share data ULICE ENVISION collaborate and network train and educate PARTNER improve and optimise refer and treat patients research and improve real time imaging & quality assurance • 4 funded projects: 3 ongoing Thanks to Manjit Dosanjh Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 23

ENLIGHT addresses these issues Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 24

Summary • Hadron Therapy and Grids Common requirements with other applications Specific issues concerned with patient data • • • Confidentiality Security Authentication Authorisation Anonymisation Health system IT managers – Cautious • Clinicians – Prefer the tried and trusted – what I know works Ken Peach, EGI Technical Meeting, Amsterdam, 16/9/2010 25