Adaptive Partial-Boost Stereotactic Radiation Therapy for Muscle-Invasive Carcinoma of the Urinary Bladder

Thariat, Juliette; Aluwini, Shafak; Housset, Martin

doi:10.1007/978-3-642-11495-3_17

Cited by 2 publications

(2 citation statements)

References 56 publications

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“…The problem of digestive and peristaltic activity, in particular, can be alleviated by adjusting the patient’s diet prior to the intervention [ 16 ] or by the administration of drugs such as butylscopolamine and/or glucagon acting as digestive motility inhibitors [ 17 , 18 ]. Long term drifts originating from other physiological sources such as bladder filling are usually addressed by the use of Foley catheters [ 19 , 20 ]. Finally, spontaneous motion due to, for example, muscle spasms is fast and infrequent, making it difficult to predict and to compensate for.…”

Section: Introductionmentioning

confidence: 99%

A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen

Zachiu¹,

Senneville

Dmitriev³

et al. 2017

J Ther Ultrasound

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BackgroundDuring lengthy magnetic resonance-guided high intensity focused ultrasound (MRg-HIFU) thermal ablations in abdominal organs, the therapeutic work-flow is frequently hampered by various types of physiological motion occurring at different time-scales. If left un-addressed this can lead to an incomplete therapy and/or to tissue damage of organs-at-risk. While previous studies focus on correction schemes for displacements occurring at a particular time-scale within the work-flow of an MRg-HIFU therapy, in the current work we propose a motion correction strategy encompassing the entire work-flow.MethodsThe proposed motion compensation framework consists of several linked components, each being adapted to motion occurring at a particular time-scale. While respiration was addressed through a fast correction scheme, long term organ drifts were compensated using a strategy operating on time-scales of several minutes. The framework relies on a periodic examination of the treated area via MR scans which are then registered to a reference scan acquired at the beginning of the therapy. The resulting displacements were used for both on-the-fly re-optimization of the interventional plan and to ensure the spatial fidelity between the different steps of the therapeutic work-flow. The approach was validated in three complementary studies: an experiment conducted on a phantom undergoing a known motion pattern, a study performed on the abdomen of 10 healthy volunteers and during 3 in-vivo MRg-HIFU ablations on porcine liver.ResultsResults have shown that, during lengthy MRg-HIFU thermal therapies, the human liver and kidney can manifest displacements that exceed acceptable therapeutic margins. Also, it was demonstrated that the proposed framework is capable of providing motion estimates with sub-voxel precision and accuracy. Finally, the 3 successful animal studies demonstrate the compatibility of the proposed approach with the work-flow of an MRg-HIFU intervention under clinical conditions.ConclusionsIn the current study we proposed an image-based motion compensation framework dedicated to MRg-HIFU thermal ablations in the abdomen, providing the possibility to re-optimize the therapy plan on-the-fly with the patient on the interventional table. Moreover, we have demonstrated that even under clinical conditions, the proposed approach is fully capable of continuously ensuring the spatial fidelity between the different phases of the therapeutic work-flow.

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Section: Introductionmentioning

confidence: 99%

A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen

Zachiu¹,

Senneville

Dmitriev³

et al. 2017

J Ther Ultrasound

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show abstract

“…Shifts in the lower abdomen due to bladder filling can be reduced, for example, by the use of Foley catheters. 20,21 • Finally, spontaneous motion is a difficult problem-it occurs infrequently and on a very short time scale. It is particularly problematic for long interventions, which require the patient to remain in an uncomfortable position.…”

Section: Introductionmentioning

confidence: 99%

A framework for the correction of slow physiological drifts during MR-guided HIFU therapies: Proof of concept

et al. 2015

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This study proposes a motion correction strategy for displacements resulting from slowly varying physiological motion that might occur during a MR-guided HIFU intervention. The authors have shown that such drifts can lead to a misalignment between interventional planning, energy delivery, and therapeutic validation. The presented volunteer study and in vivo experiment demonstrate both the relevance of the problem for HIFU therapies and the compatibility of the proposed motion compensation framework with the workflow of a HIFU intervention under clinical conditions.

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Adaptive Partial-Boost Stereotactic Radiation Therapy for Muscle-Invasive Carcinoma of the Urinary Bladder

Cited by 2 publications

References 56 publications

A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen

A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen

A framework for the correction of slow physiological drifts during MR-guided HIFU therapies: Proof of concept

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