Shift detection discrepancy between ExacTrac Dynamic system and cone‐beam computed tomography

Chow, Vivian U. Y.; Cheung, Maggie; Kan, Monica W.K.; Chan, Anthony Tak Cheung

doi:10.1002/acm2.13567

Cited by 9 publications

(15 citation statements)

References 28 publications

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“…A similar study with both cranial and pelvis phantoms was performed by Chow et al. to investigate the positional differences detected by EXTD X‐ray and CBCT (Varian) imaging, and comparable results were reported (deviations <0.6 mm and <0.6°) 26 …”

Section: Discussionsupporting

confidence: 58%

“…to investigate the positional differences detected by EXTD X‐ray and CBCT (Varian) imaging, and comparable results were reported (deviations <0.6 mm and <0.6°). 26 …”

Section: Discussionmentioning

confidence: 99%

“…15 Chow et al investigated the performance of the EXTD system compared to CBCT with a phantom study. 26 Our study aimed to provide additional information about the geometric accuracy of EXTD and its workflow in a clinical environment. The investigation of the performance of the EXTD system and its IGRT components, such as the spatial drift of the optical/thermal system was investigated.…”

Section: Introductionmentioning

confidence: 99%

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ExacTrac Dynamic workflow evaluation: Combined surface optical/thermal imaging and X‐ray positioning

Mendes

Reiner

Huang

et al. 2022

J Applied Clin Med Phys

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In modern radiotherapy (RT), especially for stereotactic radiotherapy or stereotactic radiosurgery treatments, image guidance is essential. Recently, the ExacTrac Dynamic (EXTD) system, a new combined surface-guided RT and image-guided RT (IGRT) system for patient positioning, monitoring, and tumor targeting, was introduced in clinical practice. The purpose of this study was to provide more information about the geometric accuracy of EXTD and its workflow in a clinical environment. The surface optical/thermal-and the stereoscopic X-ray imaging positioning systems of EXTD was evaluated and compared to cone-beam computed tomography (CBCT). Additionally, the congruence with the radiation isocenter was tested. A Winston Lutz test was executed several times over 1 year, and repeated end-to-end positioning tests were performed. The magnitude of the displacements between all systems, CBCT, stereoscopic X-ray,optical-surface imaging,and MV portal imaging was within the submillimeter range, suggesting that the image guidance provided by EXTD is accurate at any couch angle. Additionally, results from the evaluation of 14 patients with intracranial tumors treated with open-face masks are reported,and limited differences with a maximum of 0.02 mm between optical/thermal-and stereoscopic X-ray imaging were found. As the optical/thermal positioning system showed a comparable accuracy to other IGRT systems, and due to its constant monitoring capability, it can be an efficient tool for detecting intra-fractional motion and for real-time tracking of the surface position during RT.

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Section: Discussionsupporting

confidence: 58%

“…to investigate the positional differences detected by EXTD X‐ray and CBCT (Varian) imaging, and comparable results were reported (deviations <0.6 mm and <0.6°). 26 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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ExacTrac Dynamic workflow evaluation: Combined surface optical/thermal imaging and X‐ray positioning

Mendes

Reiner

Huang

et al. 2022

J Applied Clin Med Phys

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“…Elements eliminated one of the remaining advantages of frame-based SRS, that is, the integrated diagnosis of both CBCTA and limited frames of 2D-DSA, and would become a tailwind for the further implementation of frameless SRS [15,19]. One of the remaining issues concerning frameless SRS has been an intra-fractional patient movement within a thermoplastic mask, for which more frequent detection and correction of head motion during treatment can be performed owing to the recent advent of bony and surface image-guidance systems (e.g., ExacTrac Dynamic® [Brainlab AG], which utilizes continuous monitoring by a thermal camera and/or frequent and timely kV image acquisition during irradiation) [20].…”

Section: Discussionmentioning

confidence: 99%

Frameless Co-Registration of Biplane 2D Digital Subtraction Angiography Whole Frames and 3D Rotational Angiography-Based Cone-Beam Computed Tomography Angiogram on Dedicated Software for Stereotactic Radiosurgery of Cranial Vascular Malformations

Ohtakara¹,

Izumi²,

Tanahashi³

et al. 2022

Cureus

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Purpose: Given its high spatial resolution and vasculature selectivity, the cone-beam computed tomography (CT) angiography (CBCTA) image acquired by selective 3D rotational angiography (3DRA) is the most suitable 3D image for the target definition of stereotactic radiosurgery (SRS) for intracranial arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs). Furthermore, the relatively low temporal resolution of 3DRA-based CBCTA can be complemented by the stereotactic co-registration of orthogonally paired 2D dynamic digital subtraction angiography (2D-DSA). The integration of 2D-DSA, which is usually limited to one or a few frames for each projection, into CBCTA and/or planning CT can be achieved only by catheter-directed angiography on the day of SRS via a dedicated image localizer under rigid frame fixation to the skull, which imposes substantial burdens on patients. This study aimed to demonstrate a novel, convenient, and significantly less invasive method for the frameless co-registration of biplane 2D-DSA whole frames and CBCTA on commercially available dedicated software, namely, Brainlab ® Elements (Brainlab AG, Munich, Germany), and present its prerequisite for successful image fusion.Technical Report: Elements have afforded the following functionality: A 3D vasculature image is automatically extracted as a floating image from any 3D image series containing vascular details and then subsequently co-registered manually and automatically to a selected frame pair of 2D-DSA with a sixdegree-of-freedom rigid registration. As a preclinical feasibility study, two anonymous image datasets from patients harboring cerebral AVM and transverse-sigmoid (TS) DAVF were used to verify the accuracy and practicality of Elements for the frameless co-registration of 2D/3D vascular images, particularly on the assumption of clinical workflow for the target delineation of SRS planning. The use of ordinary unsubtracted CBCTA resulted in the insufficient extraction of abutting vessels or vessels that are in close proximity to bony structures, particularly in the case of TS-DAVF, where the fistulous pouch and the affected venous sinuses were adjacent to the cranial bone. By contrast, the amount and selectivity of vasculatures and the accuracy of subsequent image fusion were significantly improved from the subtracted CBCTA. The integration of CBCTA into dynamic 2D-DSA allowed the simultaneous review of both image information by sharing any concerning point and 2D or 3D structures under a common 3D coordinate.Conclusions: Elements enable the clinically useful frameless co-registration of biplane 2D-DSA whole frames into CBCTA, for which the routine acquisition of both subtracted and unsubtracted CBCTA axial images for ordinary diagnostic purposes is an indispensable prerequisite for successful image fusion and further widespread application. This frameless integration of the 2D/3D angiogram would dramatically enhance both the frame-based and frameless SRS workflow and circumstances by allowing users to forward SRS p...

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“…This system uses a conventional x-ray imaging system with two x-ray tubes mounted on the floor and two flat panel detectors mounted on the ceiling of the treatment room, and surface imaging is performed with optical and thermal cameras mounted on the ceiling, which detect visible surface images of the patient and infrared waves radiated from the body, respectively. Thermal images of the patients might reduce the registration sliding effects for surface imaging and improve position accuracy [80]. if high quality images are obtained before each radiation therapy treatment session, the target can be matched with the planning images, rather than the bone, facilitating a more accurate treatment process.…”

Section: ) Usmentioning

confidence: 99%

Image Guided Radiation Therapy

Hwang

Min

Kim

et al. 2022

Progress in Medical Physics

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Over the past decades, radiation therapy combined with imaging modalities that ensure optimal image guidance has revolutionized cancer treatment. The two major purposes of using imaging modalities in radiotherapy are to clearly delineate the target prior to treatment and set up the patient during radiation delivery. Image guidance secures target position prior to and during the treatment. High quality images provide an accurate definition of the treatment target and the possibility to reduce the treatment margin of the target volume, further lowering radiation toxicity and improving the quality of life of cancer patients. In this review, the various types of image guidance modalities used in radiation therapy are distinguished into ionized (kilovoltage and megavoltage image) and nonionized imaging (magnetic resonance image, ultrasound, surface imaging, and radiofrequency). The functional aspects, advantages, and limitation of imaging using these modalities are described as a subsection of each category. This review only focuses on the technological viewpoint of these modalities and any clinical aspects are omitted. Image guidance is essential, and its importance is rapidly increasing in modern radiotherapy. The most important aspect of using image guidance in clinical settings is to monitor the performance of image quality, which must be checked during the periodic quality assurance process.

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Shift detection discrepancy between ExacTrac Dynamic system and cone‐beam computed tomography

Cited by 9 publications

References 28 publications

ExacTrac Dynamic workflow evaluation: Combined surface optical/thermal imaging and X‐ray positioning

ExacTrac Dynamic workflow evaluation: Combined surface optical/thermal imaging and X‐ray positioning

Frameless Co-Registration of Biplane 2D Digital Subtraction Angiography Whole Frames and 3D Rotational Angiography-Based Cone-Beam Computed Tomography Angiogram on Dedicated Software for Stereotactic Radiosurgery of Cranial Vascular Malformations

Image Guided Radiation Therapy

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