Evaluation of Kv Cone-beam CT Performance for IGRT of the Prostate: Comparison of Automatic Alignment Methods to Implanted Fiducial Marker Alignment

Shi, Wenyin; Li, J.; Yeung, Andy Wai Kan; Newlin, Heather E.; Palta, Jatinder; Chvetsov, A; Liu, C.; Olivier, Kenneth R.

doi:10.1016/j.ijrobp.2008.06.1059

Cited by 9 publications

(16 citation statements)

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“…The mean displacement of the heart was 19 mm anteriorly to study whether the prone setup would better spare the heart. Concerns about this work have been discussed (Lymberis and Formenti, 2008). …”

Section: Heart Exposure When Pronementioning

confidence: 99%

The Role of a Prone Setup in Breast Radiation Therapy

Huppert¹,

Jozsef²,

DeWyngaert³

et al. 2011

Front. Oncol.

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Most patients undergoing breast conservation therapy receive radiotherapy in the supine position. Historically, prone breast irradiation has been advocated for women with large pendulous breasts in order to decrease acute and late toxicities. With the advent of CT planning, the prone technique has become both feasible and reproducible. It was shown to be advantageous not only for women with larger breasts but in most patients since it consistently reduces, if not eliminates, the inclusion of heart and lung within the field. The prone setup has been accepted as the best localizing position for both MRI and stereotactic biopsy, but its adoption has been delayed in radiotherapy. New technological advances including image-modulated radiation therapy and image-guided radiation therapy have made possible the exploration of accelerated fractionation schemes with a concomitant boost to the tumor bed in the prone position, along with better imaging and verification of reproducibility of patient setup. This review describes some of the available techniques for prone breast radiotherapy and the available experience in their application. The NYU prone breast radiotherapy approach is discussed, including a summary of the results from several prospective trials.

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Section: Heart Exposure When Pronementioning

confidence: 99%

The Role of a Prone Setup in Breast Radiation Therapy

Huppert¹,

Jozsef²,

DeWyngaert³

et al. 2011

Front. Oncol.

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“…[3][4][5][6][7][8][9]37 On-board CBCT is widely available on C-arm medical linear accelerators and in combination with automatic and/or manual registration can be used for quick prostate repositiong. 38 However, in contrast to other anatomical sites, such as brain and lung, performing this process automatically and accurately is complicated by two factors: (a) the inherently low image contrast of the prostate and (b) substantial daily prostate position changes and some prostate deformations because of the absence or presence of bladder/rectal filling and/or bowel gas during treatment. 10,39 As a result of image content changes, accurate correspondence between a planning CT (pCT) and a CBCT acquired at a different time does not exist.…”

Section: Introductionmentioning

confidence: 99%

A deep learning framework for prostate localization in cone beam CT‐guided radiotherapy

et al. 2020

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Purpose: To develop a deep learning-based model for prostate planning target volume (PTV) localization on cone beam computed tomography (CBCT) to improve the workflow of CBCT-guided patient setup. Methods: A two-step task-based residual network (T 2 RN) is proposed to automatically identify inherent landmarks in prostate PTV. The input to the T 2 RN is the pretreatment CBCT images of the patient, and the output is the deep learning-identified landmarks in the PTV. To ensure robust PTV localization, the T 2 RN model is trained by using over thousand sets of CT images with labeled landmarks, each of the CTs corresponds to a different scenario of patient position and/or anatomy distribution generated by synthetically changing the planning CT (pCT) image. The changes, including translation, rotation, and deformation, represent vast possible clinical situations of anatomy variations during a course of radiation therapy (RT). The trained patient-specific T 2 RN model is tested by using 240 CBCTs from six patients. The testing CBCTs consists of 120 original CBCTs and 120 synthetic CBCTs. The synthetic CBCTs are generated by applying rotation/translation transformations to each of the original CBCT. Results: The systematic/random setup errors between the model prediction and the reference are found to be <0.25/2.46 mm and 0.14/1.41°in translation and rotation dimensions, respectively. Pearson's correlation coefficient between model prediction and the reference is higher than 0.94 in translation and rotation dimensions. The Bland-Altman plots show good agreement between the two techniques. Conclusions: A novel T 2 RN deep learning technique is established to localize the prostate PTV for RT patient setup. Our results show that highly accurate marker-less prostate setup is achievable by leveraging the state-of-the-art deep learning strategy.

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“…By using fiducials, the uncertainty associated with CBCT soft‐tissue definition can be avoided. A comparison of CBCT automatic grey‐value alignment to implanted fiducial marker alignment was made by Shi et al (6) with the conclusion that “CBCT with soft‐tissue‐based automatic corrections is not an accurate alignment compared with manual alignment to fiducial markers.” Therefore a daily manual alignment to fiducials is considered to be one of the most reliable methods to maintain accuracy in prostate IGRT.…”

Section: Introductionmentioning

confidence: 99%

Utilization of cone‐beam CT for reconstruction of dose distribution delivered in image‐guided radiotherapy of prostate carcinoma — bony landmark setup compared to fiducial markers setup

Paluska

Hanus

Sefrova

et al. 2013

J Applied Clin Med Phys

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The purpose of this study was to compare two different styles of prostate IGRT: bony landmark (BL) setup vs. fiducial markers (FM) setup. Twenty‐nine prostate patients were treated with daily BL setup and 30 patients with daily FM setup. Delivered dose distribution was reconstructed on cone‐beam CT (CBCT) acquired once a week immediately after the alignment. Target dose coverage was evaluated by the proportion of the CTV encompassed by the 95% isodose. Original plans employed 1 cm safety margin. Alternative plans assuming smaller 7 mm margin between CTV and PTV were evaluated in the same way. Rectal and bladder volumes were compared with initial ones. While the margin reduction in case of BL setup makes the prostate coverage significantly worse (p=0.0003, McNemar's test), in case of FM setup with the reduced 7 mm margin, the prostate coverage is even better compared to BL setup with 10 mm margin (p=0.049, Fisher's exact test). Moreover, partial volumes of organs at risk irradiated with a specific dose can be significantly lowered (p<0.0001, unpaired t‐test). Reducing of safety margin is not acceptable in case of BL setup, while the margin can be lowered from 10 mm to 7 mm in case of FM setup.PACS numbers: 87.55.dk, 87.55.km, 87.55.tm

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Evaluation of Kv Cone-beam CT Performance for IGRT of the Prostate: Comparison of Automatic Alignment Methods to Implanted Fiducial Marker Alignment

Cited by 9 publications

References 0 publications

The Role of a Prone Setup in Breast Radiation Therapy

The Role of a Prone Setup in Breast Radiation Therapy

A deep learning framework for prostate localization in cone beam CT‐guided radiotherapy

Utilization of cone‐beam CT for reconstruction of dose distribution delivered in image‐guided radiotherapy of prostate carcinoma — bony landmark setup compared to fiducial markers setup

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