Cone-beam-CT guided radiation therapy:: A model for on-line application
Cone-beam-CT guided radiation therapy:: A model for on-line application
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DOI：
10.1016/j.radonc.2005.03.026
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发表时间：
2005-06-01
影响因子：
5.7
通讯作者：
Wong, JW
中科院分区：
文献类型：
--
作者：
Oldham, M;Létourneau, D;Wong, JW
背景和目的：本文介绍了有效的和一般化的过程中的临床应用的在线X射线体积锥束CT成像（XVI），以提高准确性的病人设置在放射治疗。XVI图像引导治疗说明了两个对比的网站，颅内放射外科和前列腺放射治疗，具有非常不同的特点，关于器官运动，治疗精度和成像conditions.Patients和方法：在线设置错误确定在一个两步的过程。首先，通过分别将机器等中心点与规划等中心点匹配，将XVI数据配准到规划数据。在重建期间，在XVI数据中定义机器等中心点。计划等中心在计划过程期间在计划CT数据中定义。然后，从第二配准确定设置误差，以去除残余位移。在线设置误差校正的整个过程的准确性进行了研究，在精密radiosurgery幻影studies.Results：幻影研究表明，亚像素大小的设置误差（低至0.5 mm），可以正确地确定和实施在radiosurgery环境。XVI被证明可以提供高质量的颅骨细节，从而在放射外科手术中实现基于颅骨的精确在线对准。发现“局部XVI”技术在高散射盆腔环境中提供令人鼓舞的软组织细节，从而实现基于在线软组织的前列腺治疗设置。两个步骤的过程中，用于确定的设置错误被认为是高效和有效的，当实施一个专用的六面板接口，使同时可视化的XVI和规划CT datasets.Conclusions：XVI有可能显着提高放射治疗的准确性。目前的图像质量是非常令人鼓舞的，可以使骨和软组织患者设置错误的确定和纠正。与所有图像引导治疗技术一样，开发利用在线数据的有效程序至关重要。(C)2005爱思唯尔爱尔兰有限公司保留所有权利。
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. (C) 2005 Elsevier Ireland Ltd. All rights reserved.