Cone-Beam Computed Tomographic Image Guidance for Lung Cancer Radiation Therapy

Bissonnette, Jean‐Pierre; Purdie, Thomas G.; Higgins, J.; Li, Winnie; Bezjak, Andrea

doi:10.1016/j.ijrobp.2008.08.059

Cited by 154 publications

(110 citation statements)

References 30 publications

(35 reference statements)

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“…Image‐guidance systems are now commonly used to minimize setup uncertainties 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 and have provided highly effective for quantifying patient setup errors and correcting target localization 20 , 21 A reduction in setup uncertainties would allow for a reduction in treatment margins, leading to dose escalation and an improvement in local control at the tumor site 22 , 23 , 24 , 25 , 26 …”

Section: Introductionmentioning

confidence: 99%

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Baek

Kim

et al. 2014

J Applied Clin Med Phys

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The aim of this study was assess the patient setup errors for various tumor sites based on clinical data from a sufficient number of treatments with volumetric‐modulated arc therapy (VMAT) using daily pretreatment CBCT imaging guidance. In addition, we calculated and compared the planning target volume (PTV) margins for all disease sites based on an analysis of specific systematic and random errors in our institution. All patients underwent pretreatment kV‐CBCT imaging. The various tumor sites were divided into four categories; 21 brain (438 fractions), 35 head‐and‐neck tumors (H&N, 933 fractions), 19 thorax and abdomen tumors (T&A, 313 fractions), and 17 prostate cancer tumors (546 fractions). Overall distributions of setup corrections in all directions, frequencies of 3D vector lengths, institution‐specific setup error, and PTV margins were analyzed. The longitudinal distribution for the T&A site represented an asymmetric offset in the negative direction. Rotational distributions were comparable for all treatment sites, and the prostate site had the narrowest distribution of ≤±2∘. The cumulative frequencies of 3D vector length of ≥ 7 mm were rare for brain lesions and H&N, but more common for T&A and prostate lesions at 25.6% and 12.1%, respectively. The overall mean error for all treatment sites were within ±1 mm and ±0.1∘, with the exception of the T&A site, which had overall mean error of 2 mm in the negative longitudinal direction. The largest magnitude of systematic error and random error for the brain lesions and H&N was 1.4 mm in the translational directions, and 3.3 mm for T&A and prostate lesions. The PTV margins required in this analysis are ≤ 4 mm for the brain lesions and H&N in all translational directions, but ranged from 4 to 10 mm for T&A and prostate lesions. Analysis of each institution's specific setup errors using daily CBCT is essential for determining PTV margins and reducing setup uncertainties, because setup errors vary according to each immobilization system and patient.PACS number: 87.55.km

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Section: Introductionmentioning

confidence: 99%

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Baek

Kim

et al. 2014

J Applied Clin Med Phys

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“…A reduction of margins in RT would allow a reduction of the quantity and dose at the OAR, resulting in a reduction of side effects, which would allow an increase in the dose prescribed. 8,12,14,27,28 In Table 4, our findings are compared to other authors' for the same region. The Hawkins et al 20 study compared planar MV images instead of kV images, being our reference for planar images (bony structures).…”

Section: Ctv-ptv Margin According To Image Modalitymentioning

confidence: 88%

“…Those studies show that there are variations in terms of the observed setup error. 7,[19][20][21] Although the planar kV images are quicker to acquire and to observe apart from offering a lower dose to the patient, 8,11,12 the advantages of using a 3D verification image are the possibility of observing soft tissues with good contrast, like the tumour or the oesophagus, and providing a more accurate match of the area being treated. 5,10,19 …”

Section: Assessment Of Differences Between Planar Kv and Cbctmentioning

confidence: 99%

“…There are several differences between both techniques: with CBCT, it becomes possible to observe soft tissues [4][5][6][7][8][9] (including the oesophagus, the tumour and the OAR). The kV images are quicker to acquire and with lower exposure to the patient but they have low contrast for soft tissues, [8][9][10][11][12][13] the objective of this study is to evaluate if there are significant differences in terms of setup errors observed between the two techniques in this particular tumour location.…”

Section: Introductionmentioning

confidence: 99%

“…The kV images are quicker to acquire and with lower exposure to the patient but they have low contrast for soft tissues, [8][9][10][11][12][13] the objective of this study is to evaluate if there are significant differences in terms of setup errors observed between the two techniques in this particular tumour location.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of planar kV vs. CBCT in evaluation of setup errors in oesophagus carcinoma radiotherapy

Martins

Couto

Barbosa

2016

Reports of Practical Oncology & Radiotherapy

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A new CT reconstruction technique using adaptive deformation recovery and intensity correction (ADRIC)

Zhang

Iyengar

et al. 2017

Med. Phys.

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Purpose Sequential same-patient CT images may involve deformation-induced and non-deformation-induced voxel intensity changes. An adaptive deformation recovery and intensity correction (ADRIC) technique was developed to improve the CT reconstruction accuracy, and to separate deformation from non-deformation-induced voxel intensity changes between sequential CT images. Materials and Methods ADRIC views the new CT volume as a deformation of a prior high-quality CT volume, but with additional non-deformation-induced voxel intensity changes. ADRIC first applies the 2D-3D deformation technique to recover the deformation field between the prior CT volume and the new, to-be-reconstructed CT volume. Using the deformation-recovered new CT volume, ADRIC further corrects the non-deformation-induced voxel intensity changes with an updated algebraic reconstruction technique (‘ART-dTV’). The resulting intensity-corrected new CT volume is subsequently fed back into the 2D-3D deformation process to further correct the residual deformation errors, which forms an iterative loop. By ADRIC, the deformation field and the non-deformation voxel intensity corrections are optimized separately and alternately to reconstruct the final CT. CT myocardial perfusion imaging scenarios were employed to evaluate the efficacy of ADRIC, using both simulated data of the extended-cardiac-torso (XCAT) digital phantom and experimentally acquired porcine data. The reconstruction accuracy of the ADRIC technique was compared to the technique using ART-dTV alone, and to the technique using 2D-3D deformation alone. The relative error metric and the universal quality index metric are calculated between the images for quantitative analysis. The relative error is defined as the square root of the sum of squared voxel intensity differences between the reconstructed volume and the ‘ground-truth’ volume, normalized by the square root of the sum of squared ‘ground-truth’ voxel intensities. In addition to the XCAT and porcine studies, a physical lung phantom measurement study was also conducted. Water-filled balloons with various shapes/volumes and concentrations of iodinated contrasts were put inside the phantom to simulate both deformations and non-deformation-induced intensity changes for ADRIC reconstruction. The ADRIC-solved deformations and intensity changes from limited-view projections were compared to those of the ‘gold-standard’ volumes reconstructed from fully-sampled projections. Results For the XCAT simulation study, the relative errors of the reconstructed CT volume by the 2D-3D deformation technique, the ART-dTV technique and the ADRIC technique were 14.64%, 19.21% and 11.90% respectively, by using 20 projections for reconstruction. Using 60 projections for reconstruction reduced the relative errors to 12.33%, 11.04% and 7.92% for the three techniques, respectively. For the porcine study, the corresponding results were 13.61%, 8.78%, 6.80% by using 20 projections; and 12.14%, 6.91% and 5.29% by using 60 projections. The ADRIC technique also dem...

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Cone-Beam Computed Tomographic Image Guidance for Lung Cancer Radiation Therapy

Cited by 154 publications

References 30 publications

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Use of planar kV vs. CBCT in evaluation of setup errors in oesophagus carcinoma radiotherapy

A new CT reconstruction technique using adaptive deformation recovery and intensity correction (ADRIC)

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