Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor

Shirato, Hiroki; Shimizu, Satoru; Kitamura, Kei; Nishioka, Takeshi; Kagei, Kenji; Hashimoto, S; Aoyama, Hidefumi; Kunieda, Tatsuya; Shinohara, Nobuo; Dosaka‐Akita, Hirotoshi; Miyasaka, Kazuo

doi:10.1016/s0360-3016(00)00625-8

Cited by 415 publications

(254 citation statements)

References 10 publications

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“…( 3 ) In a continuing effort to reduce invasiveness, interventional radiological implantation of round gold markers facilitating the use of real‐time stereoscopic fluoroscopy in automated image‐guided respiratory‐gated radiation therapy was later developed in Japan. ( 4 , 5 ) These principles were soon after applied to a commercial system in the form of dynamic tumor tracking using automated detection and trajectory modeling of implanted gold markers (CyberKnife, Accuray, Inc., Sunnyvale, CA). The CyberKnife uses periodic stereoscopic X‐ray imaging in combination with continuous optical imaging of light‐emitting diode markers placed on the external body surface to facilitate tracking of lesions.…”

Section: Introductionmentioning

confidence: 99%

Migration of implanted markers for image‐guided lung tumor stereotactic ablative radiotherapy

Hong

Eclov

et al. 2013

J Applied Clin Med Phys

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The purpose of this study was to quantify postimplantation migration of percutaneously implanted cylindrical gold seeds (“seeds”) and platinum endovascular embolization coils (“coils”) for tumor tracking in pulmonary stereotactic ablative radiotherapy (SABR). We retrospectively analyzed the migration of markers in 32 consecutive patients with computed tomography scans postimplantation and at simulation. We implanted 147 markers (59 seeds, 88 coils) in or around 34 pulmonary tumors over 32 procedures, with one lesion implanted twice. Marker coordinates were rigidly aligned by minimizing fiducial registration error (FRE), the root mean square of the differences in marker locations for each tumor between scans. To also evaluate whether single markers were responsible for most migration, we aligned with and without the outlier causing the largest FRE increase per tumor. We applied the resultant transformation to all markers. We evaluated migration of individual markers and FRE of each group. Median scan interval was 8 days. Median individual marker migration was 1.28 mm (interquartile range [IQR] 0.78−2.63 mm). Median lesion FRE was 1.56 mm (IQR 0.92−2.95 mm). Outlier identification yielded 1.03 mm median migration (IQR 0.52−2.21 mm) and 1.97 mm median FRE (IQR 1.44−4.32 mm). Outliers caused a mean and median shift in the centroid of 1.22 and 0.80 mm (95th percentile 2.52 mm). Seeds and coils had no statistically significant difference. Univariate analysis suggested no correlation of migration with the number of markers, contact with the chest wall, or time elapsed. Marker migration between implantation and simulation is limited and unlikely to cause geometric miss during tracking.PACS number: 87.57.N‐; 87.57.nm; 87.53.Ly

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Section: Introductionmentioning

confidence: 99%

Migration of implanted markers for image‐guided lung tumor stereotactic ablative radiotherapy

Hong

Eclov

et al. 2013

J Applied Clin Med Phys

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“…If the EPID images are acquired using respiration gating, the set-up margin can be substantially reduced, especially if the GTV can be seen on the images, which is a possibility with the ever-increasing improvement in EPID hardware and software. Furthermore, gating can be based on internal markers embedded in the tumour rather than an external respiration signal, 13,16,17,30 and thus the positional uncertainties can be substantially reduced.…”

Section: Introductionmentioning

confidence: 99%

Potential radiotherapy improvements with respiratory gating

Keall

Kini

Vedam

et al. 2002

Australas. Phys. Eng. Sci. Med.

148

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Gating is a relatively new and potentially useful therapeutic addition to external beam radiotherapy applied to regions affected by intra-fraction motion. The impact was of gating on treatment margins, image artifacts, and volume and positional accuracy was investigated by CT imaging of sinusoidally moving spheres. The motion of the spheres simulates target motion. During the CT imaging of dynamically moving spheres, gating reproduced the static volume to within 1%, whereas errors of over 20% were observed where gating was not used. Using a theoretical analysis of margins, gating alone or in combination with an electronic portal imaging device may allow a 2-11 mm reduction in the CTV to PTV margin, and thus less healthy tissue need be irradiated. Gating may allow a reduction of treatment margins, an improvement in image quality, and an improvement in positional and volumetric accuracy of the gross tumor volume.

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“…However, radiation dose must be lower than the case of the irradiation without internal margin, because the irradiated area also covers normal tissues surrounding the target volume. On the other hand, a gating technique can give a high radiation dose to the lung tumor [6,7]. This is on-and-off irradiation to static region as shown in Figure 2.…”

Section: Introductionmentioning

confidence: 99%

“…The first technique for tumor localization has been achieved by using an X-ray fluoroscopic imaging system such as real-time tumor tracking system [7]. The second technique of beam-positioning systems can be realized by using dynamic multi-leaf collimator, robotic couch, robotic manipulator, and so on.…”

Section: Introductionmentioning

confidence: 99%

“…Figure 5 shows an example of time series of respiratory motion of lung tumor. The time series of tumor motion was observed as a location of the golden fiducial marker implanted into around the tumor, by using a kV X-ray fluoroscopic imaging system known as RTRT system, with sampling frequency 30 Hz, at Hokkaido University Hospital, Sapporo, Japan [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Respiratory Motion Prediction Based on Time-Variant Seasonal Autoregressive Model for Real-Time Image-Guided Radiotherapy

Ichiji¹,

Homma²,

Sakai³

et al. 2013

Frontiers in Radiation Oncology

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Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor

Cited by 415 publications

References 10 publications

Migration of implanted markers for image‐guided lung tumor stereotactic ablative radiotherapy

Migration of implanted markers for image‐guided lung tumor stereotactic ablative radiotherapy

Potential radiotherapy improvements with respiratory gating

A Respiratory Motion Prediction Based on Time-Variant Seasonal Autoregressive Model for Real-Time Image-Guided Radiotherapy

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