Cone-beam-CT guided radiation therapy: A model for on-line application

Mark Oldham, Daniel Létourneau, Lindsay Watt, Geoffrey Hugo, Di Yan, David Lockman, Leonard H. Kim, Peter Y. Chen, Alvaro Martinez, John Wong

Research output: Contribution to journalArticle

Abstract

Background and Purpose: This paper presents efficient and generalized processes for the clinical application of on-line X-ray volumetric cone-beam CT imaging (XVI) to improve the accuracy of patient set-up in radiation therapy. XVI image-guided therapy is illustrated by application to two contrasting sites, intra-cranial radiosurgery and prostate radiation therapy, with very different characteristics regarding organ motion, treatment precision, and imaging conditions. Patients and methods: On-line set-up errors are determined in a two-step process. First the XVI data is registered to the planning data by matching the machine-isocenter with the planning-isocenter, respectively. The machine isocenter is defined in the XVI data during the reconstruction. The planning-isocenter is defined during the planning process in the planning CT data. Set-up errors are then determined from a second registration to remove residual displacements. The accuracy of the entire procedure for on-line set-up error correction was investigated in precision radiosurgery phantom studies. Results: The phantom studies showed that sub-pixel size set-up errors (down to 0.5 mm) can be correctly determined and implemented in the radiosurgery environment. XVI is demonstrated to provide quality skull detail enabling precise skull based on-line alignment in radiosurgery. A 'local XVI' technique was found to give encouraging soft-tissue detail in the high-scatter pelvic environment, enabling on-line soft-tissue based set-up for prostate treatment. The two-step process for determination of set-up errors was found to be efficient and effective when implemented with a dedicated six panel interface enabling simultaneous visualization on the XVI and planning CT data sets. Conclusions: XVI has potential to significantly improve the accuracy of radiation treatments. Present image quality is highly encouraging and can enable bony and soft-tissue patient set-up error determination and correction. As with all image guided treatment techniques the development of efficient procedures to utilize on-line data are of paramount importance.

Original languageEnglish (US)
JournalRadiotherapy and Oncology
Volume75
Issue number3
DOIs
StatePublished - Jun 2005
Externally publishedYes

Fingerprint

Cone-Beam Computed Tomography
Radiosurgery
Radiotherapy
Skull
Prostate
Therapeutics
X-Rays
Radiation

Keywords

  • Cone-beam CT
  • IGRT
  • Image-guided therapy
  • On-line imaging

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Urology

Cite this

Cone-beam-CT guided radiation therapy : A model for on-line application. / Oldham, Mark; Létourneau, Daniel; Watt, Lindsay; Hugo, Geoffrey; Yan, Di; Lockman, David; Kim, Leonard H.; Chen, Peter Y.; Martinez, Alvaro; Wong, John.

In: Radiotherapy and Oncology, Vol. 75, No. 3, 06.2005.

Research output: Contribution to journalArticle

Oldham, M, Létourneau, D, Watt, L, Hugo, G, Yan, D, Lockman, D, Kim, LH, Chen, PY, Martinez, A & Wong, J 2005, 'Cone-beam-CT guided radiation therapy: A model for on-line application', Radiotherapy and Oncology, vol. 75, no. 3. https://doi.org/10.1016/j.radonc.2005.03.026
Oldham, Mark ; Létourneau, Daniel ; Watt, Lindsay ; Hugo, Geoffrey ; Yan, Di ; Lockman, David ; Kim, Leonard H. ; Chen, Peter Y. ; Martinez, Alvaro ; Wong, John. / Cone-beam-CT guided radiation therapy : A model for on-line application. In: Radiotherapy and Oncology. 2005 ; Vol. 75, No. 3.
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