Four‐dimensional cone‐beam computed tomography and digital tomosynthesis reconstructions using respiratory signals extracted from transcutaneously inserted metal markers for liver SBRT

Park, Justin C.; Park, Sung Ho; Kim, Jong Hoon; Yoon, Sang Min; Kim, Su Ssan; Kim, Jin Sung; Liu, Zhaowei; Watkins, Tyler; Song, William Y.

doi:10.1118/1.3544369

Cited by 42 publications

(44 citation statements)

References 46 publications

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“…Compared with other image methods, CBCT scans can provide volumetric information of lung tumor directly and do not need insertion of metal fiducial markers, which is invasive to the human body (22) . Daily CBCT‐guided radiotherapy allows for assessment of change in volume or position of lung tumors, which further facilitates the formulation of adaptive treatment planning.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of interfractional variation of the centroid position and volume of internal target volume during stereotactic body radiotherapy of lung cancer using cone‐beam computed tomography

Sun

Cheng

et al. 2016

J Applied Clin Med Phys

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The purpose of this study was to determine interfractional variation of the centroid position and volume of internal target volume (ITV) during stereotactic body radiation therapy (SBRT) of lung cancer. From January 2014 to August 2014, a total of 32 patients with 37 primary or metastatic lung tumors were enrolled in our study. All patients received SBRT treatment in 4–5 fractions to a median dose of 48 Gy. Both 3D CT and 4D CT scans were used for radiotherapy treatment planning. 3D CBCT was acquired prior to treatment delivery to verify patient positioning. A total of 163 3D CBCT images were available for evaluation. 3D CBCT scans acquired for verification were registered with simulation CT scans. The ITVs were contoured on all verification 3D CBCT scans and compared to the initial gross target volume (GTV) or ITV in treatment planning system. GTV was based on 3D CT while ITV was based on both 3D CT and 4D CT. To assess the interfractional variation of ITV centroid position, we used vertebrae body adjacent to the tumor as reference point when performing the registration procedure. To eliminate the effect of time on tumor volume between simulation CT scan and the first fraction, the interfractional variation of ITV was evaluated from the first fraction to the last fraction. The overall 3D vector shift was 4.4±2.5 mm (range: 0.4−13.8 mm). The interfractional variation of ITV centroid position in superior‐inferior, anterior‐posterior, and left‐right directions were −0.7±2.7 mm, −1.4±3.4 mm, and −0.5±2.2 mm, respectively. No significant difference was observed between three directions (p=0.147). Large interfractional variations (≥5 mm) were observed in 12 fractions (9.3%) in superior‐inferior direction, 24 fractions (18.6%) in anterior‐posterior direction, and 5 fractions (3.9%) in left‐right direction. No time trend of tumor volume change measured in 3D CBCT was detected during four fractions (p=0.074). A significant (p=0.010) time trend was detected when evaluating the time trend of ITV change during 5 fractions and diameter was found to be significantly correlated with the ITV change (p=0.000). ITV did not show significant regression during SBRT treatment, but interfractional variation in the ITV centroid position was observed, especially in anterior‐posterior direction. An isotropic margin of 7 mm around ITV might be necessary for adequate coverage of interfractional variation of ITV centroid position, but only in case no soft tissue‐based setup is performed during SBRT treatment.PACS number(s): 87.55.dk

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Section: Discussionmentioning

confidence: 99%

“…Traditionally, the margin of PTV should take respiration motion and setup error into consideration for lung tumors (22) . However, respiratory pattern may differ considerably due to the change of patients’ psychological state or to the concomitant disease.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of interfractional variation of the centroid position and volume of internal target volume during stereotactic body radiotherapy of lung cancer using cone‐beam computed tomography

Sun

Cheng

et al. 2016

J Applied Clin Med Phys

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“…Emerging hypo-fractionated treatment regimens such as lung stereotactic body radiation therapy [4–6] deliver a much higher radiation dose per fraction, which further necessitates accurate tumor localization. 4D on-board imaging techniques such as 4D cone-beam CT (CBCT) [7–10] and 4D digital tomosynthesis (DTS) [11–14] have found wider clinical interest recently to improve the localization accuracy of moving tumors. Compared with 3D imaging techniques, the 4D capacity of these techniques enables the trajectory of moving tumors to be captured, which can lead to better alignment of the target volume.…”

Section: Introductionmentioning

confidence: 99%

Preliminary clinical evaluation of a 4D-CBCT estimation technique using prior information and limited-angle projections

You

Yin

Pan

et al. 2015

Radiotherapy and Oncology

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Background and Purpose A new technique has been previously reported to estimate high-quality 4D-CBCT using prior information and limited-angle projections. This study is to investigate its clinical feasibility through both phantom and patient studies. Materials and Methods The new technique used to estimate 4D-CBCT is called MMFD-NCC. It is based on the previously reported motion-modeling and free-form deformation (MMFD) method, with the introduction of normalized-cross-correlation (NCC) as a new similarity metric. The clinical feasibility of this technique was evaluated by assessing the accuracy of estimated anatomical structures in comparison to those in the ‘ground-truth’ reference 4D-CBCT, using data obtained from a physical phantom and three lung cancer patients. Both volume percentage error (VPE) and center-of-mass error (COME) of the estimated tumor volume were used as the evaluation metrics. Results The average VPE/COME of the tumor in the prior image was 257.1%/10.1 mm for the phantom study and 55.6%/3.8 mm for the patient study. Using only orthogonal-view 30° projections, the MMFD-NCC has reduced the corresponding values to 7.7% /1.2 mm and 9.6%/1.1 mm, respectively. Conclusions The MMFD-NCC technique is able to estimate 4D-CBCT images with geometrical accuracy of the tumor within 10% VPE and 2 mm COME, which can be used to improve the localization accuracy of radiotherapy.

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“…Recently DTS is introduced to 4D verification of target location due to respiration motion 11 , 12 and patient setup in several treatment sites including breast, lung, and liver were investigated 13 , 14 . As more DTS datasets are required in 4D and the other clinical treatment sites, the reconstruction efficiency of DTS become more important.…”

Section: Introductionmentioning

confidence: 99%

A software tool of digital tomosynthesis application for patient positioning in radiotherapy

Yan

Dai

2016

J Applied Clin Med Phys

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Digital Tomosynthesis (DTS) is an image modality in reconstructing tomographic images from two‐dimensional kV projections covering a narrow scan angles. Comparing with conventional cone‐beam CT (CBCT), it requires less time and radiation dose in data acquisition. It is feasible to apply this technique in patient positioning in radiotherapy. To facilitate its clinical application, a software tool was developed and the reconstruction processes were accelerated by graphic processing unit (GPU). Two reconstruction and two registration processes are required for DTS application which is different from conventional CBCT application which requires one image reconstruction process and one image registration process. The reconstruction stage consists of productions of two types of DTS. One type of DTS is reconstructed from cone‐beam (CB) projections covering a narrow scan angle and is named onboard DTS (ODTS), which represents the real patient position in treatment room. Another type of DTS is reconstructed from digitally reconstructed radiography (DRR) and is named reference DTS (RDTS), which represents the ideal patient position in treatment room. Prior to the reconstruction of RDTS, The DRRs are reconstructed from planning CT using the same acquisition setting of CB projections. The registration stage consists of two matching processes between ODTS and RDTS. The target shift in lateral and longitudinal axes are obtained from the matching between ODTS and RDTS in coronal view, while the target shift in longitudinal and vertical axes are obtained from the matching between ODTS and RDTS in sagittal view. In this software, both DRR and DTS reconstruction algorithms were implemented on GPU environments for acceleration purpose. The comprehensive evaluation of this software tool was performed including geometric accuracy, image quality, registration accuracy, and reconstruction efficiency. The average correlation coefficient between DRR/DTS generated by GPU‐based algorithm and CPU‐based algorithm is 0.99. Based on the measurements of cube phantom on DTS, the geometric errors are within 0.5 mm in three axes. For both cube phantom and pelvic phantom, the registration errors are within 0.5 mm in three axes. Compared with reconstruction performance of CPU‐based algorithms, the performances of DRR and DTS reconstructions are improved by a factor of 15 to 20. A GPU‐based software tool was developed for DTS application for patient positioning of radiotherapy. The geometric and registration accuracy met the clinical requirement in patient setup of radiotherapy. The high performance of DRR and DTS reconstruction algorithms was achieved by the GPU‐based computation environments. It is a useful software tool for researcher and clinician in evaluating DTS application in patient positioning of radiotherapy.PACS number(s): 87.57.nf

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Four‐dimensional cone‐beam computed tomography and digital tomosynthesis reconstructions using respiratory signals extracted from transcutaneously inserted metal markers for liver SBRT

Cited by 42 publications

References 46 publications

Evaluation of interfractional variation of the centroid position and volume of internal target volume during stereotactic body radiotherapy of lung cancer using cone‐beam computed tomography

Evaluation of interfractional variation of the centroid position and volume of internal target volume during stereotactic body radiotherapy of lung cancer using cone‐beam computed tomography

Preliminary clinical evaluation of a 4D-CBCT estimation technique using prior information and limited-angle projections

A software tool of digital tomosynthesis application for patient positioning in radiotherapy

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