Novel breath-hold liver target stereotactic ablative radiotherapy using the intrafraction diaphragm registration of kilovoltage projection streaming image with digitally reconstructed radiography of the planning computed tomography

Katano, Atsuto; Nozawa, Yuki; Minamitani, Masanari; Yamashita, Hideomi; Nakagawa, Keiichi

doi:10.1016/j.tipsro.2023.100217

Cited by 6 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We recently proposed a new method for multiple breath-hold volumetric modulated arc therapy (VMAT) for abdominal tumors such as a liver tumor, where DRR and kV projection images were aimed to be registered during the entire period of VMAT delivery every 180 ms. 11 A patient case report was subsequently published including real-time diaphragm monitoring video data during multiple breath-hold liver VMAT delivery. 12 It is well known that breath-hold beam delivery reduces dose to OARs, as compared to free-breathing internal tumor volume (ITV) techniques in various tumor sites.…”

Section: Introductionmentioning

confidence: 99%

Initial validation of a diaphragm tracking system for multiple breath‐hold volumetric modulated arc therapy of abdominal tumors: A phantom study

Nozawa,

Ohta,

Katano

et al. 2024

Medical Physics

Self Cite

View full text Add to dashboard Cite

BackgroundThe breath‐hold radiotherapy has been increasingly used to mitigate interfractional and intrafractional breathing impact on treatment planning and beam delivery. Previous techniques include body surface measurements or radiopaque metal markers, each having known disadvantages.PurposeWe recently proposed a new markerless technique without the disadvantages, where diaphragm was registered between DRR and fluoroscopic x‐ray projection images every 180 ms during VMAT delivery. An initial validation of the proposed diaphragm tracking system (DiaTrak) was performed using a chest phantom to evaluate its characteristics.MethodsDiaphragm registration was performed between DRR and projection streaming kV x‐ray images of a chest phantom during VMAT delivery. Streaming data including the projection images and the beam angles were transferred from a linac system to an external PC, where the diaphragm registration accuracy and beam‐off latency were measured based on image cross correlation between the DRR and the projection images every 180 ms.ResultsIt was shown that the average of the beam‐off latency was 249.5 ms and the average of the diaphragm registration error was 0.84 mmConclusionsInitial validation of the proposed DiaTrak system for multiple breath‐hold VMAT of abdominal tumors has been successfully completed with a chest phantom. The resulting beam‐off latency and the diaphragm registration error were regarded clinically acceptable.

show abstract

Section: Introductionmentioning

confidence: 99%

Initial validation of a diaphragm tracking system for multiple breath‐hold volumetric modulated arc therapy of abdominal tumors: A phantom study

Nozawa,

Ohta,

Katano

et al. 2024

Medical Physics

Self Cite

View full text Add to dashboard Cite

show abstract

“…This innovative technique enables us to assess the dynamic shifts in diaphragm position within a single breath-hold, thereby offering valuable insights into the possible sources of uncertainty in tumor targeting. Detailed information on these technologies was outlined in our previous report [ 10 ]. Understanding the intra-breath-hold variations of the diaphragm position is crucial for optimizing treatment planning and delivery strategies in SBRT for liver tumors.…”

Section: Introductionmentioning

confidence: 99%

Intrafractional Diaphragm Variations During Breath-Hold Stereotactic Body Radiotherapy for a Liver Tumor Based on Real-Time Registration Between Kilovoltage Projection Streaming and Digitally Reconstructed Radiograph Images: A Case Report

Katano,

Nozawa,

Minamitani

et al. 2023

Cureus

Self Cite

View full text Add to dashboard Cite

In liver stereotactic body radiotherapy (SBRT), precise image guidance is paramount, serving as the foundation of this treatment approach. The accuracy of SBRT in liver cancer treatment heavily relies on meticulous imaging techniques. The diaphragm, situated adjacent to the liver, is a crucial anatomical structure susceptible to positional and motion variations, which can potentially impact the accuracy of liver tumor targeting. This study explores the application of real-time kilovoltage projection streaming images (KVPSI) in comparison to digitally reconstructed radiography (DRR) for assessing diaphragm position deviations during breath-hold liver tumor SBRT. A 76-year-old male diagnosed with cholangiocarcinoma underwent breath-hold SBRT using split arc volumetric modulated arc therapy (VMAT), where a full arc was split into six sub-arcs, each spanning 60 degrees. The diaphragm dome positions were continuously monitored through KVPSI during treatment. The intrafractional position deviations of the diaphragm were calculated and analyzed for each split arc. The case report revealed a mean diaphragm dome deviation of 0.47 mm (standard deviation: 4.47 mm) in the entire arc. This pioneering study showcases the feasibility of intrafractional diaphragm position variation assessment using real-time KVPSI during the breath-hold liver tumor VMAT-SBRT. Integrating real-time imaging techniques enhances our comprehension of the intra-breath-hold variations, thereby guiding adaptive treatment strategies and potentially improving treatment outcomes. Clinical validation through further research is essential.

show abstract

“… 12 Recent developments have emerged for evaluating intra-fractional tumor positioning during radiation therapy through real-time registration using kilovoltage x-ray volume imaging. 13 Vogel et al 14 sought to evaluate intrafractional motion in abdominal SBRT during deep-inspiration-breath-hold by employing ultrasound images to track the motion of target structures. Real-time tumor tracking has substantial benefits to target coverage and the potential for safe dose escalation in SBRT.…”

mentioning

confidence: 99%

Recent Advances and Challenges in Stereotactic Body Radiotherapy

Katano,

Minamitani,

Ohira

et al. 2024

Technol Cancer Res Treat

Self Cite

View full text Add to dashboard Cite

Novel breath-hold liver target stereotactic ablative radiotherapy using the intrafraction diaphragm registration of kilovoltage projection streaming image with digitally reconstructed radiography of the planning computed tomography

Cited by 6 publications

References 21 publications

Initial validation of a diaphragm tracking system for multiple breath‐hold volumetric modulated arc therapy of abdominal tumors: A phantom study

Initial validation of a diaphragm tracking system for multiple breath‐hold volumetric modulated arc therapy of abdominal tumors: A phantom study

Intrafractional Diaphragm Variations During Breath-Hold Stereotactic Body Radiotherapy for a Liver Tumor Based on Real-Time Registration Between Kilovoltage Projection Streaming and Digitally Reconstructed Radiograph Images: A Case Report

Recent Advances and Challenges in Stereotactic Body Radiotherapy

Contact Info

Product

Resources

About