Accuracy of ultrasound-based (BAT) prostate-repositioning:: A three-dimensional on-line fiducial-based assessment with cone-beam computed tomography
Accuracy of ultrasound-based (BAT) prostate-repositioning:: A three-dimensional on-line fiducial-based assessment with cone-beam computed tomography
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DOI：
10.1016/j.ijrobp.2007.12.003
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发表时间：
2008-03-15
影响因子：
7
通讯作者：
Wenz, Frederik
中科院分区：
文献类型：
--
作者：
Boda-Heggemann, Judit;Koehler, Frederick Marc;Wenz, Frederik
目的：为了评估前列腺放射前超声复位（BAT）的准确性与基准为基础的三维匹配与锥形束计算机断层扫描（CBCT）Patients and Methods：五十四个定位在8例患者I-125种子/前列腺内钙化作为基准进行了评价。患者最初根据皮肤标记定位，之后根据基于CBCT的骨结构定位。然后用BAT进行前列腺位置矫正。根据皮肤标记、骨骼解剖结构和BAT重新定位后的残余误差通过基于用户独立自动基准配准的第二次CBCT进行估计。基于CBCT基准配准的BAT后的（MV +/- SD）残留误差为0.7 +/- 1.7 mm（x（组系统误差[M] = 0.5 mm;系统误差SD [Sigma] = 0.8 mm;随机误差SD [sigma] 1.4 mm），y = 0.9 +/- 3.3 mm（M = 0.5 mm，Sigma = 2.2 mm，sigma = 2.8 mm），z- 1.7 +/- 3.4圈（M =-1.7 mm，Sigma = 2.3 mm，Sigma = 3.0 mm）方向，而相对于基于皮肤标记的定位的残余误差在x射线中为2.1 +/-4.6mm（M = 2.6 mm，Sigma = 3.3 mm，sigma = 3.9 mm），y方向-4.8 +/- 8.5 mm（M = -4.4 mm，Sigma = 3.7 mm，sigma = 6.7 mm），z为-5.2 +/- 3.6 mm（M = -4.8 mm，Sigma = 1.7 mm，Sigma = 3.5 mm）方向和相对于基于骨解剖结构的定位为0 +/- 1.8 mm，x（M = 0.2 mm，Sigma = 0.9 mm，Sigma = 1.1 mm），y方向为-3.5 +/- 6.8 mm（M = -3.0 mm，Sigma = 1.8 mm，sigma = 3.7 mm），z为-1.9 +/- 5.2 mm（M =-2.0mm，Sigma = 1.3mm，Sigma = 4.0mm）方向。BAT获得的结果在颅外立体定向手术的精度范围内，代表了不同教育水平的多名用户可以达到的值。如果超声可见性不足，建议使用植入基准点的CBCT或kV/MV射野成像。(C)2008年爱思唯尔公司
Purpose: To assess the accuracy of ultrasound-based repositioning (BAT) before prostate radiation with fiducial-based three-dimensional matching with cone-beam computed tomography (CBCT).Patients and Methods: Fifty-four positionings in 8 patients with I-125 seeds/intraprostatic calcifications as fiducials were evaluated. Patients were initially positioned according to skin marks and after this according to bony structures based on CBCT. Prostate position correction was then performed with BAT. Residual error after repositioning based on skin marks, bony anatomy, and BAT was estimated by a second CBCT based on user-independent automatic fiducial registration.Results: Overall mean value (MV +/- SD) residual error after BAT based on fiducial registration by CBCT was 0.7 +/- 1.7 mm in x (group systematic error [M] = 0.5 mm; SD of systematic error [Sigma] = 0.8 mm; SD of random error [sigma] 1.4 mm), 0.9 +/- 3.3 mm in y (M = 0.5 mm, Sigma = 2.2 mm, sigma = 2.8 mm), and - 1.7 +/- 3.4 turn in z (M = - 1.7 mm, Sigma = 2.3 mm, sigma = 3.0 mm) directions, whereas residual error relative to positioning based on skin marks was 2.1 +/- 4.6 mm in x (M = 2.6 mm, Sigma = 3.3 mm, sigma = 3.9 mm), -4.8 +/- 8.5 mm in y (M = -4.4 mm, Sigma = 3.7 mm, sigma = 6.7 mm), and -5.2 +/- 3.6 mm in z (M = -4.8 mm, Sigma = 1.7 mm, sigma = 3.5mm) directions and relative to positioning based on bony anatomy was 0 +/- 1.8 mm in x (M = 0.2 mm, Sigma = 0.9 mm, sigma = 1.1 mm), -3.5 +/- 6.8 mm in y (M = -3.0 mm, Sigma = 1.8 mm, sigma = 3.7 mm), and -1.9 +/- 5.2 mm in z (M = -2.0 mm, Sigma = 1.3 mm, sigma = 4.0 mm) directions.Conclusions: BAT improved the daily repositioning accuracy over skin marks or even bony anatomy. The results obtained with BAT are within the precision of extracranial stereotactic procedures and represent values that can be achieved with several users with different education levels. If sonographic visibility is insufficient, CBCT or kV/MV portal imaging with implanted fiducials are recommended. (C) 2008 Elsevier Inc.