Evaluation of the Geometric Accuracy of Anatomic Landmarks as Surrogates for Intrapulmonary Tumors in Image-guided Radiotherapy

Li, Hongsheng; Kong, Lingling; Zhang, Jian; Li, Baosheng; Chen, Jinhu; Zhu, Jian; Liu, Tonghai; Yin, Yong

doi:10.7314/apjcp.2012.13.5.2393

Cited by 6 publications

(10 citation statements)

References 21 publications

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“…The results showed that using different landmarks for clipbox resulted in similar results in the automatic dual registrations of 4D CBCT images, which are different from the published study of 3D CBCT, 9 where using different landmarks led to different registration precisions for peripheral and central lung tumours, e.g. using spine as a landmark for clipbox caused larger errors in 3D CBCT image registration of central tumours.…”

Section: Resultscontrasting

confidence: 53%

“…using spine as a landmark for clipbox caused larger errors in 3D CBCT image registration of central tumours. 9 In our study, Cases 3 and 4 are of central lung tumours, and the others are of peripheral lung tumours. In Cases 3 and 4, no significant differences were observed among automatic dual-image registrations using different landmarks including spine for clipboxes.…”

Section: Resultsmentioning

confidence: 99%

“…There have been studies [7][8][9] to compare the precision of automatic image registrations using different landmarks for clipbox in radiation treatment of lung cancer, and it has been reported that using different landmarks for clipbox in automatic image registrations led to different precisions. These studies, [7][8][9] however, were based on three-dimensional (3D) CBCT. Recently, four-dimensional (4D) CBCT became available in clinics.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Elekta 4D cone beam CT-based automatic image registration for radiation treatment of lung cancer

Li¹,

Harrison²,

Yu³

et al. 2015

BJR

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Objective: The study was aimed to evaluate the precision of Elekta four-dimensional (4D) cone beam CT (CBCT)-based automatic dual-image registrations using different landmarks for clipbox for radiation treatment of lung cancer. Methods: 30 4D CBCT scans from 15 patients were studied. 4D CBCT images were registered with reference CT images using dual-image registration: a clipbox registration and a mask registration. The image registrations performed in clinic using a physician-defined clipbox, were reviewed by physicians, and were taken as the standard. Studies were conducted to evaluate the automatic dual registrations using three kinds of landmarks for clipbox: spine, spine plus internal target volume (ITV) and lung (including as much of the lung as possible). Translational table shifts calculated from the automatic registrations were compared with those of the standard. Results: The mean of the table shift differences in the lateral direction were 0.03, 0.03 and 0.03 cm, for clipboxes based on spine, spine plus ITV and lung, respectively. The mean of the shift differences in the longitudinal direction were 0.08, 0.08 and 0.08 cm, respectively. The mean of the shift differences in the vertical direction were 0.03, 0.03 and 0.03 cm, respectively. Conclusion: The automatic registrations using three different landmarks for clipbox showed similar results. One can use any of the three landmarks in 4D CBCT dualimage registration. Advance in knowledge: The study provides knowledge and recommendations for application of Elekta 4D CBCT image registration in radiation therapy of lung cancer.

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Section: Resultscontrasting

confidence: 53%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of Elekta 4D cone beam CT-based automatic image registration for radiation treatment of lung cancer

Li¹,

Harrison²,

Yu³

et al. 2015

BJR

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“…Akciğer olgularında kV-kV ve kV CBCT görüntülemeler arasında istatiksel anlamlı farklılık daha önce yapılan çalışmalarla uyumludur. [27,28] Borst R. ve ark.nın [8] yaptıkları çalışma da akciğer hastaları için 2B ve 3B IGRT tekniklerinden CBCT ve MV portal gö-rüntülemeleri karşılaştırdıklarında CBCT sonuçla-rının daha büyük olduğunu, 3B CBCT görüntüle-menin akciğer olgularının tedavisinde daha doğru bir yöntem olduğu sonucuna varılmıştır.…”

Section: Discussionunclassified

“…Bu sonuç ile marjin değerini artır-mak yerine haftada iki kez değil günlük kV-kV gö-rüntüleme ile bu kaymanın minimuma indirilmesi hedeflendi. Bu çalışmada da daha önce yapılan ça-lışmalarda olduğu gibi kV ve CBCT esaslı düzelt-meler birbirine yakın çıksa da [28][29][30][31] tedavi bölgesi-ne verilecek yeterli setup marjı IGRT yöntemine, düzeltme protokollerine ve hasta immobilizasyon sisteminin kalitesine bağlıdır. Akciğer hastalarının sonuçlarına göre hesaplanan gerekli set-up marjı kV-kV görüntülemede z yönünde 11.5 mm bulunurken bu değer klinikte kullandığımız 8 mm setup marjının kV-kV görüntüleme kullanıldığında yeterli olmadığını göstermektedir.…”

Section: Discussionunclassified

Definition of the set-up error using 2D radiographic images and 3D computed tomography and dosimetric effect of set-up errors for head and neck/lung radiotherapy patients

Ceylan¹

2015

TJ Oncol

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OBJeCTIVesIn this study, the comparison of the set-up accuracy using twodimensional kilo voltage (kV-kV) imaging and three-dimensional cone beam CT (CBCT) in head and neck/lung radiotherapy patients was done. MeTHOds404 images of all 8 head and neck and 9 lung patients studied to find 2D and 3D set-up errors. CTV to PTV margins were obtained using calculated set-up errors. The plans of the selected head and neck and lung patients were calculated to investigate dosimetric effect of the set-up errors. ResuLTskV-kV and CBCT detected average set-up errors for head and neck patients were less than 2 mm. kV-kV and CBCT detected average set-up errors for lung patients were less than 7 mm. While there was a statistically differences (p<0.05) for lung patients, no statistically differences was found for head and neck cases as compared kV-kV and CBCT image data sets. The calculated margin using CBCT image data sets was found bigger than the calculated margin using kV-kV image data sets. The adequate and clinically accepted margins were calculated for both IGRT approach. The neglible dosimetric effects were observed for both data sets. CONCLusIONWe conclude that the 2D radiographic image of head and neck radiotherapy patient reduces positioning errors. While 3D registration of CBCT and planning CT of head and neck cases adds little improvement comparing with 2D images, 3D CBCT images of lung radiotherapy patients provided more accurate information of the set-up errors.Key words: Set-up; CBCT; kV-kV. AMAÇBu çalışmada baş-boyun ve akciğer hastalarının iki boyutlu kVkV ve üç boyutlu kV CBCT ile belirlenen set-up hataları karşı-laştırıldı. GeReÇ Ve yÖNTeMÇalışmada sekiz baş-boyun, dokuz akciğer hastasının IGRT sü-reçlerinde elde edilen 404 kV-kV ve CBCT görüntüleri incelendi. İki boyutta ve üç boyutta belirlenen set-up farklılıkları tespit edildi. Bu farklar kullanılarak PTV marjlarının yeterliliği araştırıldı. Set-up farklılıklarının doz dağılımına etkisine bakıldı. BuLGuLARBaş-boyun hastaları için ortalama x, y, z yönündeki sapmalar kv-kV ve CBCT görüntülemelerde sırasıyla ≤2 mm ve akciğer hastalarında her iki görüntüleme için <7 mm bulundu. Her hasta gurubu için kV-kV ve CBCT görüntüleme teknikleri karşılaştı-rıldığında baş-boyun hastalarında anlamlı farklılık bulunmadı. Akciğer hastalarında anlamlı farklılık (p<0.05) tespit edildi. Sapmalara göre PTV çin gereken marj her iki tedavi bölgesi için kVkV kullanıldığında CBCT için hesaplanan marj değerinden daha fazla bulundu. Bu marj değerleri klinik marj değerlerinin içinde bulunduğundan CTV hacimlerini kapsanmasında dozimetrik etkinin göz ardı edilebileceği görüldü. sONuÇÇalışmada baş-boyun hastalarında haftada iki kez kV-kV görün-tülemenin pozisyon hatalarını azaltacağı gösterilmiştir. Akciğer olgularında set-up hatalarını minimuma indirmek için CBCT ile hastalarının tedavi pozisyonlandırılmasının daha doğru yapılabi-lirken baş-boyun olgularında kV-kV görüntülemenin yeterli olduğu, CBCT ile planlama CT'sinin 3D eşlemesinin anlamlı fayda sağlamadığı gösterilmiştir.Anahtar söz...

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Feasibility of integrating a multi-camera optical tracking system in intra-operative electron radiation therapy scenarios

García-Vázquez¹,

Marinetto²,

Santos-Miranda³

et al. 2013

Phys. Med. Biol.

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Intra-operative electron radiation therapy (IOERT) combines surgery and ionizing radiation applied directly to an exposed unresected tumour mass or to a post-resection tumour bed. The radiation is collimated and conducted by a specific applicator docked to the linear accelerator. The dose distribution in tissues to be irradiated and in organs at risk can be planned through a pre-operative computed tomography (CT) study. However, surgical retraction of structures and resection of a tumour affecting normal tissues significantly modify the patient's geometry. Therefore, the treatment parameters (applicator dimension, pose (position and orientation), bevel angle, and beam energy) may require the original IOERT treatment plan to be modified depending on the actual surgical scenario. We propose the use of a multi-camera optical tracking system to reliably record the actual pose of the IOERT applicator in relation to the patient's anatomy in an environment prone to occlusion problems. This information can be integrated in the radio-surgical treatment planning system in order to generate a real-time accurate description of the IOERT scenario. We assessed the accuracy of the applicator pose by performing a phantom-based study that resembled three real clinical IOERT scenarios. The error obtained (2 mm) was below the acceptance threshold for external radiotherapy practice, thus encouraging future implementation of this approach in real clinical IOERT scenarios.

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Evaluation of the Geometric Accuracy of Anatomic Landmarks as Surrogates for Intrapulmonary Tumors in Image-guided Radiotherapy

Cited by 6 publications

References 21 publications

Evaluation of Elekta 4D cone beam CT-based automatic image registration for radiation treatment of lung cancer

Evaluation of Elekta 4D cone beam CT-based automatic image registration for radiation treatment of lung cancer

Definition of the set-up error using 2D radiographic images and 3D computed tomography and dosimetric effect of set-up errors for head and neck/lung radiotherapy patients

Feasibility of integrating a multi-camera optical tracking system in intra-operative electron radiation therapy scenarios

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