Robotic intrafractional US guidance for liver SABR: System design, beam avoidance, and clinical imaging

Schlosser, Jeffrey; Gong, Ren Hui; Bruder, Ralf; Schweikard, Achim; Jang, S; Henrie, John; Kamaya, Aya; Koong, Albert C.; Chang, Daniel T.; Hristov, Dimitre

doi:10.1118/1.4964454

Cited by 18 publications

(18 citation statements)

References 28 publications

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“…Another mitigation strategy has been pursued whereby a probe was manufactured using radiolucent materials to reduce interference with the treatment beam (Schlosser and Hristov 2016 ). Finally, an autonomous system for avoiding the treatment beam altogether has also been demonstrated (Schlosser et al 2016 ).…”

Section: Real-time Intrafraction Motion Monitoring Methodsmentioning

confidence: 99%

Real-time intrafraction motion monitoring in external beam radiotherapy

et al. 2019

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Radiotherapy (RT) aims to deliver a spatially conformal dose of radiation to tumours while maximizing the dose sparing to healthy tissues. However, the internal patient anatomy is constantly moving due to respiratory, cardiac, gastrointestinal and urinary activity. The long term goal of the RT community to ‘see what we treat, as we treat’ and to act on this information instantaneously has resulted in rapid technological innovation. Specialized treatment machines, such as robotic or gimbal-steered linear accelerators (linac) with in-room imaging suites, have been developed specifically for real-time treatment adaptation. Additional equipment, such as stereoscopic kilovoltage (kV) imaging, ultrasound transducers and electromagnetic transponders, has been developed for intrafraction motion monitoring on conventional linacs. Magnetic resonance imaging (MRI) has been integrated with cobalt treatment units and more recently with linacs. In addition to hardware innovation, software development has played a substantial role in the development of motion monitoring methods based on respiratory motion surrogates and planar kV or Megavoltage (MV) imaging that is available on standard equipped linacs. In this paper, we review and compare the different intrafraction motion monitoring methods proposed in the literature and demonstrated in real-time on clinical data as well as their possible future developments. We then discuss general considerations on validation and quality assurance for clinical implementation. Besides photon RT, particle therapy is increasingly used to treat moving targets. However, transferring motion monitoring technologies from linacs to particle beam lines presents substantial challenges. Lessons learned from the implementation of real-time intrafraction monitoring for photon RT will be used as a basis to discuss the implementation of these methods for particle RT.

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Section: Real-time Intrafraction Motion Monitoring Methodsmentioning

confidence: 99%

Real-time intrafraction motion monitoring in external beam radiotherapy

et al. 2019

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“…The virtual scenes were extended with 3D models of the robot that controlled the ultrasound probe for treatment guidance [ 76 ] and for simulation and/or verification of the robot setup (Fig. 5a ) [ 77 , 78 ]. The visualization of these virtual environments on head-mounted displays (HMDs) for a fully immersed experience seems logical to mimic a real experience.…”

Section: Trends and Future Directionsmentioning

confidence: 99%

“…5 Examples of VR and AR in robotic ultrasound. a Virtual radiotherapy scenario showing a linear accelerator and the robotic ultrasound acquiring data from a patient (copyright [2016] John Wiley & Sons, Inc. Used with permission from [ 78 ] and John Wiley & Sons, Inc.). b 2D ultrasound image superimposed on a laparoscopic video image (reprinted from [ 79 ], copyright [2014] with permission from Elsevier) …”

Section: Trends and Future Directionsmentioning

confidence: 99%

Medical Robotics for Ultrasound Imaging: Current Systems and Future Trends

et al. 2021

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Purpose of Review This review provides an overview of the most recent robotic ultrasound systems that have contemporary emerged over the past five years, highlighting their status and future directions. The systems are categorized based on their level of robot autonomy (LORA). Recent Findings Teleoperating systems show the highest level of technical maturity. Collaborative assisting and autonomous systems are still in the research phase, with a focus on ultrasound image processing and force adaptation strategies. However, missing key factors are clinical studies and appropriate safety strategies. Future research will likely focus on artificial intelligence and virtual/augmented reality to improve image understanding and ergonomics. Summary A review on robotic ultrasound systems is presented in which first technical specifications are outlined. Hereafter, the literature of the past five years is subdivided into teleoperation, collaborative assistance, or autonomous systems based on LORA. Finally, future trends for robotic ultrasound systems are reviewed with a focus on artificial intelligence and virtual/augmented reality.

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“…The integration of XACT into the clinical workflow will be aided by developments in intrafractional ultrasound imaging since many of the challenges arising from placing a transducer in contact with the patient during radiotherapy delivery have already been investigated in the literature. Intrafractional ultrasound imaging has been clinically demonstrated for tracking the target during prostate, liver and pancreas treatments. Due to the same requirements for acoustic wave propagation for both XACT and diagnostic ultrasound, XACT is expected to be applicable to the same clinical sites that are accessible by diagnostic ultrasound, namely the breast, liver, kidney, pancreas, prostate, cervix, uterus, bladder, and rectum …”

Section: Linac Photon Beam Dosimetrymentioning

confidence: 99%

Ionizing radiation‐induced acoustics for radiotherapy and diagnostic radiology applications

et al. 2018

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Acoustic waves are induced via the thermoacoustic effect in objects exposed to a pulsed beam of ionizing radiation. This phenomenon has interesting potential applications in both radiotherapy dosimetry and treatment guidance as well as low-dose radiological imaging. After initial work in the field in the 1980s and early 1990s, little research was done until 2013 when interest was rejuvenated, spurred on by technological advances in ultrasound transducers and the increasing complexity of radiotherapy delivery systems. Since then, many studies have been conducted and published applying ionizing radiation-induced acoustic principles into three primary research areas: Linear accelerator photon beam dosimetry, proton therapy range verification, and radiological imaging. This review article introduces the theoretical background behind ionizing radiation-induced acoustic waves, summarizes recent advances in the field, and provides an outlook on how the detection of ionizing radiationinduced acoustic waves can be used for relative and in vivo dosimetry in photon therapy, localization of the Bragg peak in proton therapy, and as a low-dose medical imaging modality. Future prospects and challenges for the clinical implementation of these techniques are discussed.

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Robotic intrafractional US guidance for liver SABR: System design, beam avoidance, and clinical imaging

Cited by 18 publications

References 28 publications

Real-time intrafraction motion monitoring in external beam radiotherapy

Real-time intrafraction motion monitoring in external beam radiotherapy

Medical Robotics for Ultrasound Imaging: Current Systems and Future Trends

Ionizing radiation‐induced acoustics for radiotherapy and diagnostic radiology applications

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