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Title: Gated CT imaging using a free-breathing respiration signal from flow-volume spirometry

Abstract

Respiration-induced tumor motion is known to cause artifacts on free-breathing spiral CT images used in treatment planning. This leads to inaccurate delineation of target volumes on planning CT images. Flow-volume spirometry has been used previously for breath-holds during CT scans and radiation treatments using the active breathing control (ABC) system. We have developed a prototype by extending the flow-volume spirometer device to obtain gated CT scans using a PQ 5000 single-slice CT scanner. To test our prototype, we designed motion phantoms to compare image quality obtained with and without gated CT scan acquisition. Spiral and axial (nongated and gated) CT scans were obtained of phantoms with motion periods of 3-5 s and amplitudes of 0.5-2 cm. Errors observed in the volume estimate of these structures were as much as 30% with moving phantoms during CT simulation. Application of motion-gated CT with active breathing control reduced these errors to within 5%. Motion-gated CT was then implemented in patients and the results are presented for two clinical cases: lung and abdomen. In each case, gated scans were acquired at end-inhalation, end-exhalation in addition to a conventional free-breathing (nongated) scan. The gated CT scans revealed reduced artifacts compared with the conventional free-breathing scan.more » Differences of up to 20% in the volume of the structures were observed between gated and free-breathing scans. A comparison of the overlap of structures between the gated and free-breathing scans revealed misalignment of the structures. These results demonstrate the ability of flow-volume spirometry to reduce errors in target volumes via gating during CT imaging.« less

Authors:
; ; ; ; ; ;  [1];  [2];  [2];  [2]
  1. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201 (United States)
  2. (United States)
Publication Date:
OSTI Identifier:
20726863
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 32; Journal Issue: 12; Other Information: DOI: 10.1118/1.2128089; (c) 2005 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; AMPLITUDES; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; ERRORS; EXHALATION; IMAGES; INHALATION; LUNGS; PATIENTS; PHANTOMS; PLANNING; RADIOTHERAPY; RESPIRATION

Citation Formats

D'Souza, Warren D., Kwok, Young, Deyoung, Chad, Zacharapoulos, Nicholas, Pepelea, Mark, Klahr, Paul, Yu, Cedric X., Aktina Inc., Congers, New York 10920, Philips Medical Systems, Cleveland, Ohio 44143, and Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201. Gated CT imaging using a free-breathing respiration signal from flow-volume spirometry. United States: N. p., 2005. Web. doi:10.1118/1.2128089.
D'Souza, Warren D., Kwok, Young, Deyoung, Chad, Zacharapoulos, Nicholas, Pepelea, Mark, Klahr, Paul, Yu, Cedric X., Aktina Inc., Congers, New York 10920, Philips Medical Systems, Cleveland, Ohio 44143, & Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201. Gated CT imaging using a free-breathing respiration signal from flow-volume spirometry. United States. doi:10.1118/1.2128089.
D'Souza, Warren D., Kwok, Young, Deyoung, Chad, Zacharapoulos, Nicholas, Pepelea, Mark, Klahr, Paul, Yu, Cedric X., Aktina Inc., Congers, New York 10920, Philips Medical Systems, Cleveland, Ohio 44143, and Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201. Thu . "Gated CT imaging using a free-breathing respiration signal from flow-volume spirometry". United States. doi:10.1118/1.2128089.
@article{osti_20726863,
title = {Gated CT imaging using a free-breathing respiration signal from flow-volume spirometry},
author = {D'Souza, Warren D. and Kwok, Young and Deyoung, Chad and Zacharapoulos, Nicholas and Pepelea, Mark and Klahr, Paul and Yu, Cedric X. and Aktina Inc., Congers, New York 10920 and Philips Medical Systems, Cleveland, Ohio 44143 and Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201},
abstractNote = {Respiration-induced tumor motion is known to cause artifacts on free-breathing spiral CT images used in treatment planning. This leads to inaccurate delineation of target volumes on planning CT images. Flow-volume spirometry has been used previously for breath-holds during CT scans and radiation treatments using the active breathing control (ABC) system. We have developed a prototype by extending the flow-volume spirometer device to obtain gated CT scans using a PQ 5000 single-slice CT scanner. To test our prototype, we designed motion phantoms to compare image quality obtained with and without gated CT scan acquisition. Spiral and axial (nongated and gated) CT scans were obtained of phantoms with motion periods of 3-5 s and amplitudes of 0.5-2 cm. Errors observed in the volume estimate of these structures were as much as 30% with moving phantoms during CT simulation. Application of motion-gated CT with active breathing control reduced these errors to within 5%. Motion-gated CT was then implemented in patients and the results are presented for two clinical cases: lung and abdomen. In each case, gated scans were acquired at end-inhalation, end-exhalation in addition to a conventional free-breathing (nongated) scan. The gated CT scans revealed reduced artifacts compared with the conventional free-breathing scan. Differences of up to 20% in the volume of the structures were observed between gated and free-breathing scans. A comparison of the overlap of structures between the gated and free-breathing scans revealed misalignment of the structures. These results demonstrate the ability of flow-volume spirometry to reduce errors in target volumes via gating during CT imaging.},
doi = {10.1118/1.2128089},
journal = {Medical Physics},
number = 12,
volume = 32,
place = {United States},
year = {Thu Dec 15 00:00:00 EST 2005},
month = {Thu Dec 15 00:00:00 EST 2005}
}