Active Breathing Control in Combination With Ultrasound Imaging: A Feasibility Study of Image Guidance in Stereotactic Body Radiation Therapy of Liver Lesions

Gurp, Esther Bloemen-van; Meer, Skadi van der; Hendry, Janet; Buijsen, Jeroen; Visser, P.; Fontanarosa, Davide; Lachaı̂ne, M.; Lammering, Guido; Verhaegen, Frank

doi:10.1016/j.ijrobp.2012.08.016

Cited by 26 publications

(30 citation statements)

References 9 publications

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“…Lediju et al extended the use of a robotic US probe for lower abdomen in an animal study and reported that the average 3D reproducibility of their robotic US probe was less than 2 mm [17]. Moreover, the feasibility of implementing US imaging into liver SBRT for eleven patients was shown by Gurp [18]. To our knowledge, this study is the first to investigate and compare the intra-and inter-observer variations between US and CBCT system in kidney cancer.…”

Section: Fargier Et Al Compared the Inter-observer Variations Of Tramentioning

confidence: 86%

A Technical Note: Inter-Observer and Inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer

Leung¹,

Wong²,

Lee³

et al. 2017

IJMPCERO

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Introduction: To investigate the inter-observer and inter-modality variabilities of two imaging guided equipments-cone-beam computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body radiotherapy. Methods: A renal metastasis case implanted with three gold anchor fiducial markers was firstly scanned by US to acquire a 3-dimension US image and followed by 4-dimension CBCT in every fraction. Seven observers retrospectively registered the pre-treatment images with the corresponding reference images based on the gold markers. Registration uncertainty of the observers between two imaging modalities was evaluated. Results: The uncertainties over whole treatment course in CBCT were 0.88 mm, 1.94 mm and 0.86 mm in lateral, longitudinal and vertical directions respectively; while 0.8 mm, 0.97 mm and 1.36 mm were found in US.

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Section: Fargier Et Al Compared the Inter-observer Variations Of Tramentioning

confidence: 86%

A Technical Note: Inter-Observer and Inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer

Leung¹,

Wong²,

Lee³

et al. 2017

IJMPCERO

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“…Inverse-planned IMRT is likely to be of benefit in selected patients, especially when delivering a simultaneous integrated boost, and the feasibility of using VBH in these patients needs to be assessed. Finally, breath-holding techniques may be of benefit when treating other tumors, including lung 28 , liver 29 , and gastric 30 cancers. Further work is needed to assess the suitability of using the VBH technique for treating sites other than breast.…”

Section: Discussionmentioning

confidence: 99%

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

Bartlett

Colgan

Donovan

et al. 2014

JoVE

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Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these techniques, patients hold their breath while radiotherapy is delivered, pushing the heart down and away from the radiotherapy field. Despite clear dosimetric benefits, these techniques are not yet in widespread use. One reason for this is that commercially available solutions require specialist equipment, necessitating not only significant capital investment, but often also incurring ongoing costs such as a need for daily disposable mouthpieces. The voluntary breath-hold technique described here does not require any additional specialist equipment. All breathholding techniques require a surrogate to monitor breath-hold consistency and whether breath-hold is maintained. Voluntary breath-hold uses the distance moved by the anterior and lateral reference marks (tattoos) away from the treatment room lasers in breath-hold to monitor consistency at CT-planning and treatment setup. Light fields are then used to monitor breath-hold consistency prior to and during radiotherapy delivery.

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“…Early approaches did include fluoroscopic visualization to quantify diaphragmatic excursion and/or align to implanted metallic fiducials markers [74]. Abdominal compression [4,5,75] and active breath hold [6,76] are two means of minimizing motion associated with respiration, but may be associated with patient discomfort and are affected by patient compliance. The internal target volume (ITV) method strives to account for motion by creating an "envelope" around the tumor volume that encompasses motion of the tumor as visualized on a free-breathing scan [9,10].…”

Section: Motion Managementmentioning

confidence: 99%

“…The ITV approach is practical and easy to employ, but the generation of the ITV can become inaccurate in situations of large tumor motion, and larger volumes of adjacent tissues may receive radiation dose when treating the entire potential extent of tumor motion [77]. Respiratory gating [76,78,79] involves continuously monitoring the respiratory cycle and only treating when the target volume is within a predefined boundary region, constituting only a certain part of the respiratory cycle. Typically, this requires sophisticated imaging capabilities in order to monitor tumor motion and may in fact require fiducial markers, unless the on-board imaging capabilities are accurate enough to allow direct target visualization.…”

Section: Motion Managementmentioning

confidence: 99%

MRI-guided radiotherapy: Opening our eyes to the future

Kishan¹,

Lee²

2016

Integr Cancer Sci Therap

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When discussing local treatment modalities, physicians often quip that there can be no blind surgeons, suggesting that an inherent advantage to surgery is the ability to precisely visualize the target. Advances in radiation therapy (RT) technology over the years have significantly improved the radiation oncologists' abilities to precisely sculpt high-dose radiation to a variety of targets, simultaneously improving local control and toxicity profiles. However, even the most sophisticated methods of CT-based image-guided radiotherapy (IGRT) are hampered by limitations that can compromise target localization and motion management. Additionally, realtime adaptive radiotherapy (ART) programs, wherein radiation plans can be molded to fit the often malleable anatomy of tumors and organs-at-risk, have not yet been developed. For these reasons, MRI-guided RT is considered the next frontier of radiation oncology. However, the development of integrated MRI/RT-delivery platforms is complicated by several technical challenges that have precluded development of MRI-guided linear accelerators. By virtue of employing a low-field (0.35 T) MRI and three 60 Co sources, a newly available tri-60 Co teletherapy system (MRIdian System™, ViewRay™, Cleveland, OH, USA) has tackled these technical concerns and has thus become the first MRI-guided RT platform with FDA approval for medical use. In this Review, we describe the abilities of this device to accomplish the goals of MRI-guided RT-improved target localization, sophisticated motion management, and on-line ART-by exploring published feasibility, proof-of-principle, and proof-of-practice studies.

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Active Breathing Control in Combination With Ultrasound Imaging: A Feasibility Study of Image Guidance in Stereotactic Body Radiation Therapy of Liver Lesions

Abstract: 3DUS imaging for IGRT of liver lesions is feasible, although using anatomic surrogates in the close vicinity of the lesion may be needed. ABC-based breath-hold in midventilation during 3DUS imaging can reduce the uncertainty of US-based 3D table shift correction.

Cited by 26 publications

References 9 publications

A Technical Note: Inter-Observer and Inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer

A Technical Note: Inter-Observer and Inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

MRI-guided radiotherapy: Opening our eyes to the future

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