Real‐time monitoring and control on deep inspiration breath‐hold for lung cancer radiotherapy—Combination of ABC and external marker tracking

Wong, Victy Y. W.; Tung, Stewart Y.; Ng, Aik Seng; Li, Francis A. S.; Leung, J.

doi:10.1118/1.3476463

Cited by 40 publications

(34 citation statements)

References 25 publications

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“…DI was simulated by reducing the margins according to Wong et al [12] to 1 cm and 0.5 cm, respectively. The corresponding volumes for FB and DI were 611.9 cm 3 and 322.2 cm 3 for mediastinal both sides, 1153.6 cm 3 and 433.6 cm 3 for mediastinal and supraclavicular both sides, 882.7 cm 3 and 375.6 cm 3 for mediastinal both sides and supraclavicular left, and 291.9 cm 3 and 126.1 cm 3 for mediastinal left.…”

Section: Methodsmentioning

confidence: 99%

Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study

Schneider

Sumila²,

Robotka

et al. 2014

Radiat Oncol

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BackgroundTo estimate the risk of radiation induced second cancers after radiotherapy using deep-inspiration breath-hold (DI) technique with three-dimensional conformal (3DCRT) and volumetric arc therapy (VMAT) for patients with Hodgkin’s lymphoma (HL).MethodsEarly-stage HL with mediastinal and supraclavicular involvement was studied using an Alderson phantom. A whole body CT was performed and all tissues were delineated. The clinical target volumes and planning target volumes (PTV) were determined according to the German Hodgkin study group guidelines. Free-breathing (FB) technique and DI technique were simulated by different safety margins for the PTV definition. In both cases, 30 Gy in 15 fractions was prescribed. Second cancer risk was estimated for various tissues with a second cancer model including fractionation.ResultsWhen compared with FB-3DCRT, estimated relative life time attributable risk (LAR) of cancer induction after DI-3DCRT was 0.86, 0.76, 0.94 and 0.92 for breast, lung, esophagus and stomach, respectively. With DI-VMAT, the corresponding values were 2.05, 1.29, 1.01, 0.93, respectively. For breast cancer, the LAR observed with DI-VMAT was not substantially distinguishable from the LAR computed for mantle RT with an administered dose of 40 Gy.ConclusionsThis study suggests that DI may reduce the LAR of secondary cancers of all OARs and may be a valuable technique when using 3DCRT. Conversely, VMAT may increase substantially the LAR and should be cautiously implemented in clinical practice.

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Section: Methodsmentioning

confidence: 99%

Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study

Schneider

Sumila²,

Robotka

et al. 2014

Radiat Oncol

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“…Breasts are deformable structures capable of motion independent from chest bones (10) . As some authors previously noticed, it is reasonable to assume surface motion to be a suitable surrogate for tumor motion, 11 , 12 , 13 and surface imaging to be an adequate monitoring method for respiratory motion gating. Novel, low‐cost optical methods have recently emerged to measure patient external motion (14) and show promising results, but still require manually pinpointing the initial location of markers.…”

Section: Introductionmentioning

confidence: 99%

Technical Note: A respiratory monitoring and processing system based on computer vision: prototype and proof of principle

Leduc

Atallah

Escarmant

et al. 2016

J Applied Clin Med Phys

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Monitoring and controlling respiratory motion is a challenge for the accuracy and safety of therapeutic irradiation of thoracic tumors. Various commercial systems based on the monitoring of internal or external surrogates have been developed but remain costly. In this article we describe and validate Madibreast, an in‐house‐made respiratory monitoring and processing device based on optical tracking of external markers. We designed an optical apparatus to ensure real‐time submillimetric image resolution at 4 m. Using OpenCv libraries, we optically tracked high‐contrast markers set on patients' breasts. Validation of spatial and time accuracy was performed on a mechanical phantom and on human breast. Madibreast was able to track motion of markers up to a 5 cm/s speed, at a frame rate of 30 fps, with submillimetric accuracy on mechanical phantom and human breasts. Latency was below 100 ms. Concomitant monitoring of three different locations on the breast showed discrepancies in axial motion up to 4 mm for deep‐breathing patterns. This low‐cost, computer‐vision system for real‐time motion monitoring of the irradiation of breast cancer patients showed submillimetric accuracy and acceptable latency. It allowed the authors to highlight differences in surface motion that may be correlated to tumor motion.PACS number(s): 87.55.km

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“…This results in excessive lung tissue irradiation and restricts the ability of dose escalation. In attempt to attain more focusing irradiation to a moving target, several sophisticated treatment delivery methods such as gating, tracking or tumor immobilization with breath‐hold have been developed 7 , 8 , 9 . Those advanced delivery techniques, however, require patients’ compliance with the equipment to achieve the desired outcomes; otherwise the results could be adversely affected (10) …”

Section: Introductionmentioning

confidence: 99%

A design of a DICOM‐RT‐based tool box for nonrigid 4D dose calculation

Wong

Baker

Leung

et al. 2016

J Applied Clin Med Phys

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The study was aimed to introduce a design of a DICOM‐RT‐based tool box to facilitate 4D dose calculation based on deformable voxel‐dose registration. The computational structure and the calculation algorithm of the tool box were explicitly discussed in the study. The tool box was written in MATLAB in conjunction with CERR. It consists of five main functions which allow a) importation of DICOM‐RT‐based 3D dose plan, b) deformable image registration, c) tracking voxel doses along breathing cycle, d) presentation of temporal dose distribution at different time phase, and e) derivation of 4D dose. The efficacy of using the tool box for clinical application had been verified with nine clinical cases on retrospective‐study basis. The logistic and the robustness of the tool box were tested with 27 applications and the results were shown successful with no computational errors encountered. In the study, the accumulated dose coverage as a function of planning CT taken at end‐inhale, end‐exhale, and mean tumor position were assessed. The results indicated that the majority of the cases (67%) achieved maximum target coverage, while the planning CT was taken at the temporal mean tumor position and 56% at the end‐exhale position. The comparable results to the literature imply that the studied tool box can be reliable for 4D dose calculation. The authors suggest that, with proper application, 4D dose calculation using deformable registration can provide better dose evaluation for treatment with moving target.PACS number(s): 87.55.kh

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Real‐time monitoring and control on deep inspiration breath‐hold for lung cancer radiotherapy—Combination of ABC and external marker tracking

Cited by 40 publications

References 25 publications

Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study

Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study

Technical Note: A respiratory monitoring and processing system based on computer vision: prototype and proof of principle

A design of a DICOM‐RT‐based tool box for nonrigid 4D dose calculation

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