Suitability of markerless EPID tracking for tumor position verification in gated radiotherapy

Serpa, Marco; Baier, Kurt; Cremers, F.; Gückenberger, Matthias; Meyer, Juergen

doi:10.1118/1.4863597

Cited by 20 publications

(23 citation statements)

References 47 publications

(87 reference statements)

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“…If a tumor happens to be temporarily out of the planned position, the dosimetric differences may be exacerbated compared to treatment using longer beam on times. 6 The feasibility of markerless lung tumor tracking in 2D has been reported by a number of groups using the MV treatment beam [7][8][9][10][11][12] or kV imaging systems. [13][14][15] Using EPID movie-based tumor tracking, Richter et al 7 showed in 40 patients treated using static beams that the difference between automatic and manual tracking was a maximum of 2 mm for 98.3% in the X-direction and 89.4% in the Y -direction.…”

Section: Introductionmentioning

confidence: 99%

Markerless tracking of small lung tumors for stereotactic radiotherapy

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Markerless tracking of small lung tumors for stereotactic radiotherapy

et al. 2015

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“…Several markerless lung tumor tracking methods have been proposed using MV electronic portal imaging devices (EPID) (Richter et al , 2010; Rottmann et al , 2013; Bryant et al , 2014; Serpa et al , 2014) or kV imaging systems (Hugo et al , 2010; Lewis et al , 2010; Gendrin et al , 2012; Yang et al , 2012; van Sornsen de Koste et al , 2015). MV EPID based methods are limited by the treatment field size and poor contrast.…”

Section: Introductionmentioning

confidence: 99%

Markerless tumor tracking using short kilovoltage imaging arcs for lung image-guided radiotherapy

et al. 2015

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The ability to monitor tumor motion without implanted markers is clinically advantageous for lung image-guided radiotherapy (IGRT). Existing markerless tracking methods often suffer from overlapping structures and low visibility of tumors on kV projection images. We introduce the short arc tumor tracking (SATT) method to overcome these issues. The proposed method utilizes multiple kV projection images selected from a nine-degree imaging arc to improve tumor localization, and respiratory-correlated 4D cone-beam CT (CBCT) prior knowledge to minimize the effects of overlapping anatomies. The 3D tumor position is solved as an optimization problem with prior knowledge incorporated via regularization. We retrospectively validated SATT on 11 clinical scans from four patients with central tumors. These patients represent challenging scenarios for markerless tumor tracking due to the inferior adjacent contrast. The 3D trajectories of implanted fiducial markers were used as the ground truth for tracking accuracy evaluation. In all cases, the tumors were successfully tracked at all gantry angles. Compared to standard pre-treatment CBCT guidance alone, trajectory errors were significantly smaller with tracking in all cases, and the improvements were the most prominent in the superior-inferior (SI) direction. The mean 3D tracking error ranged from 2.2–9.9 mm, which was 0.4–2.6 mm smaller compared to pre-treatment CBCT. In conclusion, we were able to directly track tumors with inferior visibility on kV projection images using SATT. Tumor localization accuracies are significantly better with tracking compared to the current standard of care of lung IGRT. Future work involves the prospective evaluation and clinical implementation of SATT.

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“…Due to low MV contrast, also detection of (moving) fiducial gold markers with a diameter smaller than 0.08 cm was problematic. 10 Based on a series of studies dealing with fiducial marker and marker-less detection during EPID fluoroscopy, [11][12][13][14] it can be concluded that most clinical applications of EPID fluoroscopy are conducted with frame rates between 2 and 12.8 Hz. For tumors with a velocity component of up to 4.0 cm/s [with a maximum velocity of 9.6 cm/s (Ref.…”

Section: Introductionmentioning

confidence: 99%

Fiducial marker and marker‐less soft‐tissue detection using fast MV fluoroscopy on a new generation EPID: Investigating the influence of pulsing artifacts and artifact suppression techniques

et al. 2014

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In general, marker contrast decreased in function of higher frame rates, which was detrimental for marker detection success. In this work, Visicoils with a thickness of 0.075 cm were showing best results for a 15 Hz frame rate, while non-MV compatible 0.05 cm Visicoil markers were not visible on the new EPID with improved sensitivity compared to EPID models based on a Kodak Lanex Fast scintillator. No noticeable influence of pulsing artifacts on the detection of a 0.075 cm Visicoil was observed, while a synchronized readout provided most reliable detection of a marker-less soft-tissue structure.

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Suitability of markerless EPID tracking for tumor position verification in gated radiotherapy

Cited by 20 publications

References 47 publications

Markerless tracking of small lung tumors for stereotactic radiotherapy

Markerless tracking of small lung tumors for stereotactic radiotherapy

Markerless tumor tracking using short kilovoltage imaging arcs for lung image-guided radiotherapy

Fiducial marker and marker‐less soft‐tissue detection using fast MV fluoroscopy on a new generation EPID: Investigating the influence of pulsing artifacts and artifact suppression techniques

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