Three-dimensional surface scanning for accurate patient positioning and monitoring during breast cancer radiotherapy

Gaisberger, Christoph; Steininger, Philipp; Mitterlechner, B.; Huber, Stefan; Weichenberger, H.; Sedlmayer, Felix; Deutschmann, H.

doi:10.1007/s00066-013-0358-6

Cited by 30 publications

(26 citation statements)

References 29 publications

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“…Intrafraction motion is mainly due to breathing movements but also to relaxation of the patient during the session 38. It was confirmed by our own experience with surface‐based repositioning system.…”

Section: Discussionsupporting

confidence: 62%

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Tyran

Tallet

Resbeut

et al. 2018

J Applied Clin Med Phys

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PurposeThis study evaluates the benefit of a virtual bolus method for volumetric modulated arc therapy (VMAT) plan optimization to compensate breast modifications that may occur during breast treatment.MethodsTen files were replanned with VMAT giving 50 Gy to the breast and 47 Gy to the nodes within 25 fractions. The planning process used a virtual bolus for the first optimization, then the monitors units were reoptimized without bolus, after fixing the segments shapes. Structures and treatment planning were exported on a second scanner (CT) performed during treatment as a consequence to modifications in patient's anatomy. The comparative end‐point was clinical target volume's coverage. The first analysis compared the VMAT plans made using the virtual bolus method (VB‐VMAT) to the plans without using it (NoVB‐VMAT) on the first simulation CT. Then, the same analysis was performed on the second CT. Finally, the level of degradation of target volume coverage between the two CT using VB‐VMAT was compared to results using a standard technique of forward‐planned multisegment technique (Tan‐IMRT).ResultsUsing a virtual bolus for VMAT does not degrade dosimetric results on the first CT. No significant result in favor of the NoVB‐VMAT plans was noted. The VB‐VMAT method led to significant better dose distribution on a second CT with modified anatomies compared to NoVB‐VMAT. The clinical target volume's coverage by 95% (V95%) of the prescribed dose was 98.9% [96.1–99.6] on the second CT for VB‐VMAT compared to 92.6% [85.2–97.7] for NoVB‐VMAT (P = 0.0002). The degradation of the target volume coverage for VB‐VMAT is not worse than for Tan‐IMRT: the median differential of V95% between the two CT was 0.9% for VMAT and 0.7% for Tan‐IMRT (P = 1).ConclusionThis study confirms the safety and benefit of using a virtual bolus during the VMAT planning process to compensate potential breast shape modifications.

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Section: Discussionsupporting

confidence: 62%

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Tyran

Tallet

Resbeut

et al. 2018

J Applied Clin Med Phys

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“…A combination of EMT with surface imaging could improve the registration and also be sensitive to potential non‐rigid inter‐fractional changes of the patient's anatomy, for example, changes in breast posture. Various surface imaging systems are available mainly for patient positioning in external beam radiation therapy 33, 34, 35. CT‐extracted surfaces could be used as a reference such that daily measured patient surfaces in combination with, for example, IR‐reflective fiducials on the EMT‐fiducial sensors would allow a registration of EMT and CT‐surface on a daily level.…”

Section: Discussionmentioning

confidence: 99%

Electromagnetic tracking (EMT) technology for improved treatment quality assurance in interstitial brachytherapy

Kellermeier

Herbolzheimer

Kreppner

et al. 2017

J Applied Clin Med Phys

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Electromagnetic Tracking (EMT) is a novel technique for error detection and quality assurance (QA) in interstitial high dose rate brachytherapy (HDR‐iBT). The purpose of this study is to provide a concept for data acquisition developed as part of a clinical evaluation study on the use of EMT during interstitial treatment of breast cancer patients. The stability, accuracy, and precision of EMT‐determined dwell positions were quantified. Dwell position reconstruction based on EMT was investigated on CT table, HDR table and PDR bed to examine the influence on precision and accuracy in a typical clinical workflow. All investigations were performed using a precise PMMA phantom. The track of catheters inserted in that phantom was measured by manually inserting a 5 degree of freedom (DoF) sensor while recording the position of three 6DoF fiducial sensors on the phantom surface to correct motion influences. From the corrected data, dwell positions were reconstructed along the catheter's track. The accuracy of the EMT‐determined dwell positions was quantified by the residual distances to reference dwell positions after using a rigid registration. Precision and accuracy were investigated for different phantom‐table and sensor‐field generator (FG) distances. The measured precision of the EMT‐determined dwell positions was ≤ 0.28 mm (95th percentile). Stability tests showed a drift of 0.03 mm in the first 20 min of use. Sudden shaking of the FG or (large) metallic objects close to the FG degrade the precision. The accuracy with respect to the reference dwell positions was on all clinical tables < 1 mm at 200 mm FG distance and 120 mm phantom‐table distance. Phantom measurements showed that EMT‐determined localization of dwell positions in HDR‐iBT is stable, precise, and sufficiently accurate for clinical assessment. The presented method may be viable for clinical applications in HDR‐iBT, like implant definition, error detection or quantification of uncertainties. Further clinical investigations are needed.

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“…Recent patient studies showed similar accuracy errors in OSI patient setup, suggesting the OSI should be carefully used because of the relatively large interfraction variability. [13][14][15][16] According to the study of Betgen et al, 13 interfraction systematic and random errors are 2.0-5.0 mm and 0.9-2.2 mm for translation and between 0.08…”

Section: Discussionmentioning

confidence: 99%

“…Recent research on the OSI accuracy using patients can be found in Refs. [13][14][15][16], which argue OSI may reduce CBCT scan frequency for patient setup where tumor location is fixed relative to the surface although interfraction error is relatively large. Here, we evaluate the accuracy of surface registration by comparing registration results with that of a conventional volumetric registration method for 26 head-and-neck cases based on simulation experiments.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of surface registration compared to conventional volumetric registration in patient positioning for head‐and‐neck radiotherapy: A simulation study using patient data

Kim

et al. 2014

Medical Physics

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Purpose: 3D optical surface imaging has been applied to patient positioning in radiation therapy (RT). The optical patient positioning system is advantageous over conventional method using conebeam computed tomography (CBCT) in that it is radiation free, frameless, and is capable of real-time monitoring. While the conventional radiographic method uses volumetric registration, the optical system uses surface matching for patient alignment. The relative accuracy of these two methods has not yet been sufficiently investigated. This study aims to investigate the theoretical accuracy of the surface registration based on a simulation study using patient data. Methods: This study compares the relative accuracy of surface and volumetric registration in head-and-neck RT. The authors examined 26 patient data sets, each consisting of planning CT data acquired before treatment and patient setup CBCT data acquired at the time of treatment. As input data of surface registration, patient's skin surfaces were created by contouring patient skin from planning CT and treatment CBCT. Surface registration was performed using the iterative closest points algorithm by point-plane closest, which minimizes the normal distance between source points and target surfaces. Six degrees of freedom (three translations and three rotations) were used in both surface and volumetric registrations and the results were compared. The accuracy of each method was estimated by digital phantom tests. Results: Based on the results of 26 patients, the authors found that the average and maximum root-mean-square translation deviation between the surface and volumetric registrations were 2.7 and 5.2 mm, respectively. The residual error of the surface registration was calculated to have an average of 0.9 mm and a maximum of 1.7 mm. Conclusions: Surface registration may lead to results different from those of the conventional volumetric registration. Only limited accuracy can be achieved for patient positioning with an approach based solely on surface information. C

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Three-dimensional surface scanning for accurate patient positioning and monitoring during breast cancer radiotherapy

Abstract: Optical surface scanning is a simple, fast and reproducible method for breast cancer patient alignment. Particularly for more sophisticated irradiation techniques, it helps to improve accuracy in patient positioning during radiotherapy without the exposure to additional ionizing radiation.

Cited by 30 publications

References 29 publications

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Electromagnetic tracking (EMT) technology for improved treatment quality assurance in interstitial brachytherapy

Accuracy of surface registration compared to conventional volumetric registration in patient positioning for head‐and‐neck radiotherapy: A simulation study using patient data

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