A feasibility study for image guided radiotherapy using low dose, high speed, cone beam X-ray volumetric imaging

Sykes, J.; Amer, Ali M; Czajka, Jadwiga; Moore, Christopher

doi:10.1016/j.radonc.2005.05.005

Cited by 93 publications

(59 citation statements)

References 13 publications

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“…Sykes et al [48] showed that systematic errors for CT to cone beam CT registration increased from approximately 0.1 mm to 0.8 mm when the CT slice separation was increased from 0.6 mm to 5 mm in a skull phantom [48]. Since both the CT and MRI were acquired with a 5 mm slice separation, registration errors of the order of 1 mm should be expected from this source.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

Dean

Sykes²,

Cooper³

et al. 2012

BJR

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Objectives: MRI is the preferred staging modality for rectal carcinoma patients. This work assesses the CT-MRI co-registration accuracy of four commercial rigid-body techniques for external beam radiotherapy treatment planning for patients treated in the prone position without fiducial markers. Methods: 17 patients with biopsy-proven rectal carcinoma were scanned with CT and MRI in the prone position without the use of fiducial markers. A reference co-registration was performed by consensus of a radiologist and two physicists. This was compared with two automated and two manual techniques on two separate treatment planning systems. Accuracy and reproducibility were analysed using a measure of target registration error (TRE) that was based on the average distance of the mis-registration between vertices of the clinically relevant gross tumour volume as delineated on the CT image. Results: An automated technique achieved the greatest accuracy, with a TRE of 2.3 mm. Both automated techniques demonstrated perfect reproducibility and were significantly faster than their manual counterparts. There was a significant difference in TRE between registrations performed on the two planning systems, but there were no significant differences between the manual and automated techniques. Conclusion: For patients with rectal cancer, MRI acquired in the prone treatment position without fiducial markers can be accurately registered with planning CT. An automated registration technique offered a fast and accurate solution with associated uncertainties within acceptable treatment planning limits. Randomised trials have demonstrated that adjuvant radiotherapy (RT) in patients with resectable rectal cancer offers a statistically significant reduction in the risk of local recurrence compared with surgery alone [1]. Two meta-analyses and a systematic review have confirmed this finding [2-4]: cancer-specific survival was found to be improved when RT was delivered with biological equivalent doses of .30 Gy pre-operatively. Two further trials have confirmed similar benefit when short-course pre-operative RT was combined with total mesorectal excision (TME) [5,6].Three further randomised trials have evaluated the role of pre-operative adjuvant chemoradiotherapy (CRT) for patients with stage T3-T4 or node-positive disease. Two of these studies demonstrated a reduction in local recurrence when pre-operative adjuvant CRT was used rather than long-course adjuvant RT alone [7,8]. The third study demonstrated both reduced local recurrence and reduced acute and late toxicity for pre-operative CRT compared with post-operative CRT [9]. The Cochrane review [4] also examined CRT and concluded that CRT provided incremental benefit in local control, irrespective of the timing of the chemotherapy. These results have led to a significant increase in the use of pre-operative radiation for patients with rectal cancer.MRI offers increased soft-tissue contrast compared with other radiographic imaging modalities such as CT. This improvement allows the accurate...

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Section: Discussionmentioning

confidence: 99%

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

Dean

Sykes²,

Cooper³

et al. 2012

BJR

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“…Evaluations of technologies in practice are frequently performed in terms of scientific descriptions of the technical system 6,7 , patient survival 8 , ease of use or more technical quality assurance issues 7 . Evaluating technologies using these methods, however, tends to ignore the changing scene, professional changes and the social context for technology introduction.…”

Section: Rhetoric In Evaluating Technologiesmentioning

confidence: 99%

Cakes for cure: the role of charities in the embedding of innovative cancer treatment technologies

Ashmore

2011

Health Expectations

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Background and Aims Investment in innovative health technologies has been a focus of increasing critical interest in the social sciences. With proponents of such systems expounding new techniques, a strong normative context emerges for their adoption. Informed by the field of Science and Technology Studies (STS), this study focuses on the discourse used by charitable organizations involved in such investments and how their involvement contributes to the enrolment of vulnerable groups, such as cancer sufferers. A central concern of STS is the strategies scientists use when talking about their work. Methods of communication may often suggest there is only one possible solution to a perceived problem. Such determinism may be reflected in material used by fundraisers where technologies are discussed in a normative, deterministic and definitely desirable way. Charitable organizations in charge of fundraising may thus become deeply enrolled within programmes of development in which the legitimacy of knowledge claims and evidence production are difficult to examine.

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“…Those degrading effects have been studied by several investigators, and solutions to alleviate them have been proposed. ( 10 – 12 ) Alternatively, the second strategy to reduce the patient's dose underlies the reduction of sampling frequency during image acquisition. The major advantage of the second method versus the first one is that it is a time saver.…”

Section: Introductionmentioning

confidence: 99%

“…A preliminary study on the strategy to decrease the radiotherapy dose by reducing the projection number was conducted by Sykes et al ( 12 ) using a head‐and‐neck phantom. Their study showed that for a specific phantom and using a reduced number of projections (one‐fifth of a full set), registration accuracy could be preserved as the on‐board imaging was reconstructed.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive study on decreasing the kilovoltage cone‐beam CT dose by reducing the projection number

Lü

Palta

2010

J Applied Clin Med Phys

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The objective of this study was to evaluate the effect of kilovoltage cone‐beam computed tomography (CBCT) on registration accuracy and image qualities with a reduced number of planar projections used in volumetric imaging reconstruction. The ultimate goal is to evaluate the possibility of reducing the patient dose while maintaining registration accuracy under different projection‐number schemes for various clinical sites. An Elekta Synergy Linear accelerator with an onboard CBCT system was used in this study. The quality of the Elekta XVI cone‐beam three‐dimensional volumetric images reconstructed with a decreasing number of projections was quantitatively evaluated by a Catphan phantom. Subsequently, we tested the registration accuracy of imaging data sets on three rigid anthropomorphic phantoms and three real patient sites under the reduced projection‐number (as low as 1/6th) reconstruction of CBCT data with different rectilinear shifts and rotations. CBCT scan results of the Catphan phantom indicated the CBCT images got noisier when the number of projections was reduced, but their spatial resolution and uniformity were hardly affected. The maximum registration errors under the small amount transformation of the reference CT images were found to be within 0.7 mm translation and 0.3° rotation. However, when the projection number was lower than one‐fourth of the full set with a large amount of transformation of reference CT images, the registration could easily be trapped into local minima solutions for a nonrigid anatomy. We concluded, by using projection‐number reduction strategy under conscientious care, imaging‐guided localization procedure could achieve a lower patient dose without losing the registration accuracy for various clinical sites and situations. A faster scanning time is the main advantage compared to the mA decrease‐based, dose‐reduction method.PACS numbers: 87.57.C‐, 87.57.cf, 87.57.cj, 87.57.cm, 87.57.cp, 87.57.N‐, 87.57.nf, 87.57.nj

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A feasibility study for image guided radiotherapy using low dose, high speed, cone beam X-ray volumetric imaging

Cited by 93 publications

References 13 publications

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

Cakes for cure: the role of charities in the embedding of innovative cancer treatment technologies

A comprehensive study on decreasing the kilovoltage cone‐beam CT dose by reducing the projection number

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