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Title: A simple device for high-precision head image registration: Preliminary performance and accuracy tests

Abstract

The purpose of this paper is to present a new device for multimodal head study registration and to examine its performance in preliminary tests. The device consists of a system of eight markers fixed to mobile carbon pipes and bars which can be easily mounted on the patient's head using the ear canals and the nasal bridge. Four graduated scales fixed to the rigid support allow examiners to find the same device position on the patient's head during different acquisitions. The markers can be filled with appropriate substances for visualisation in computed tomography (CT), magnetic resonance, single photon emission computer tomography (SPECT) and positron emission tomography images. The device's rigidity and its position reproducibility were measured in 15 repeated CT acquisitions of the Alderson Rando anthropomorphic phantom and in two SPECT studies of a patient. The proposed system displays good rigidity and reproducibility characteristics. A relocation accuracy of less than 1,5 mm was found in more than 90% of the results. The registration parameters obtained using such a device were compared to those obtained using fiducial markers fixed on phantom and patient heads, resulting in differences of less than 1 deg. and 1 mm for rotation and translation parameters, respectively.more » Residual differences between fiducial marker coordinates in reference and in registered studies were less than 1 mm in more than 90% of the results, proving that the device performed as accurately as noninvasive stereotactic devices. Finally, an example of multimodal employment of the proposed device is reported.« less

Authors:
 [1]
  1. Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze (Italy)
Publication Date:
OSTI Identifier:
20951287
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 34; Journal Issue: 5; Other Information: DOI: 10.1118/1.2717412; (c) 2007 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; ACCURACY; AUDITORY ORGANS; EQUIPMENT; IMAGE PROCESSING; IMAGES; NOSE; PATIENTS; PHANTOMS; PHOTON EMISSION; POSITRON COMPUTED TOMOGRAPHY; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY

Citation Formats

Pallotta, Stefania. A simple device for high-precision head image registration: Preliminary performance and accuracy tests. United States: N. p., 2007. Web. doi:10.1118/1.2717412.
Pallotta, Stefania. A simple device for high-precision head image registration: Preliminary performance and accuracy tests. United States. doi:10.1118/1.2717412.
Pallotta, Stefania. Tue . "A simple device for high-precision head image registration: Preliminary performance and accuracy tests". United States. doi:10.1118/1.2717412.
@article{osti_20951287,
title = {A simple device for high-precision head image registration: Preliminary performance and accuracy tests},
author = {Pallotta, Stefania},
abstractNote = {The purpose of this paper is to present a new device for multimodal head study registration and to examine its performance in preliminary tests. The device consists of a system of eight markers fixed to mobile carbon pipes and bars which can be easily mounted on the patient's head using the ear canals and the nasal bridge. Four graduated scales fixed to the rigid support allow examiners to find the same device position on the patient's head during different acquisitions. The markers can be filled with appropriate substances for visualisation in computed tomography (CT), magnetic resonance, single photon emission computer tomography (SPECT) and positron emission tomography images. The device's rigidity and its position reproducibility were measured in 15 repeated CT acquisitions of the Alderson Rando anthropomorphic phantom and in two SPECT studies of a patient. The proposed system displays good rigidity and reproducibility characteristics. A relocation accuracy of less than 1,5 mm was found in more than 90% of the results. The registration parameters obtained using such a device were compared to those obtained using fiducial markers fixed on phantom and patient heads, resulting in differences of less than 1 deg. and 1 mm for rotation and translation parameters, respectively. Residual differences between fiducial marker coordinates in reference and in registered studies were less than 1 mm in more than 90% of the results, proving that the device performed as accurately as noninvasive stereotactic devices. Finally, an example of multimodal employment of the proposed device is reported.},
doi = {10.1118/1.2717412},
journal = {Medical Physics},
number = 5,
volume = 34,
place = {United States},
year = {Tue May 15 00:00:00 EDT 2007},
month = {Tue May 15 00:00:00 EDT 2007}
}
  • Purpose: To compare deformable image registration (DIR) accuracy and precision for normal and tumor tissues in head and neck cancer patients during the course of radiation therapy (RT). Methods and Materials: Thirteen patients with oropharyngeal tumors, who underwent submucosal implantation of small gold markers (average 6, range 4-10) around the tumor and were treated with RT were retrospectively selected. Two observers identified 15 anatomical features (landmarks) representative of normal tissues in the planning computed tomography (pCT) scan and in weekly cone beam CTs (CBCTs). Gold markers were digitally removed after semiautomatic identification in pCTs and CBCTs. Subsequently, landmarks and goldmore » markers on pCT were propagated to CBCTs, using a b-spline-based DIR and, for comparison, rigid registration (RR). To account for observer variability, the pair-wise difference analysis of variance method was applied. DIR accuracy (systematic error) and precision (random error) for landmarks and gold markers were quantified. Time trend of the precisions for RR and DIR over the weekly CBCTs were evaluated. Results: DIR accuracies were submillimeter and similar for normal and tumor tissue. DIR precision (1 SD) on the other hand was significantly different (P<.01), with 2.2 mm vector length in normal tissue versus 3.3 mm in tumor tissue. No significant time trend in DIR precision was found for normal tissue, whereas in tumor, DIR precision was significantly (P<.009) degraded during the course of treatment by 0.21 mm/week. Conclusions: DIR for tumor registration proved to be less precise than that for normal tissues due to limited contrast and complex non-elastic tumor response. Caution should therefore be exercised when applying DIR for tumor changes in adaptive procedures.« less
  • The quality of dosimetry in radiotherapy treatment requires the accurate delimitation of the gross tumor volume. This can be achieved by complementing the anatomical detail provided by CT images through fusion with other imaging modalities that provide additional metabolic and physiological information. Therefore, use of multiple imaging modalities for radiotherapy treatment planning requires an accurate image registration method. This work describes tests carried out on a Discovery LS positron emission/computed tomography (PET/CT) system by General Electric Medical Systems (GEMS), for its later use to obtain images to delimit the target in radiotherapy treatment. Several phantoms have been used to verifymore » image correlation, in combination with fiducial markers, which were used as a system of external landmarks. We analyzed the geometrical accuracy of two different fusion methods with the images obtained with these phantoms. We first studied the fusion method used by the PET/CT system by GEMS (hardware fusion) on the basis that there is satisfactory coincidence between the reconstruction centers in CT and PET systems; and secondly the fiducial fusion, a registration method, by means of least-squares fitting algorithm of a landmark points system. The study concluded with the verification of the centroid position of some phantom components in both imaging modalities. Centroids were estimated through a calculation similar to center-of-mass, weighted by the value of the CT number and the uptake intensity in PET. The mean deviations found for the hardware fusion method were: vertical bar {delta}x vertical bar {+-}{sigma}=3.3 mm{+-}1.0 mm and vertical bar {delta}y vertical bar {+-}{sigma}=3.6 mm{+-}1.0 mm. These values were substantially improved upon applying fiducial fusion based on external landmark points: vertical bar {delta}x vertical bar {+-}{sigma}=0.7 mm{+-}0.8 mm and vertical bar {delta}y vertical bar {+-}{sigma}=0.3 mm{+-}1.7 mm. We also noted that differences found for each of the fusion methods were similar for both the axial and helical CT image acquisition protocols.« less
  • Purpose: Validating the usage of deformable image registration (DIR) for daily patient positioning is critical for adaptive radiotherapy (RT) applications pertaining to head and neck (HN) radiotherapy. The authors present a methodology for generating biomechanically realistic ground-truth data for validating DIR algorithms for HN anatomy by (a) developing a high-resolution deformable biomechanical HN model from a planning CT, (b) simulating deformations for a range of interfraction posture changes and physiological regression, and (c) generating subsequent CT images representing the deformed anatomy. Methods: The biomechanical model was developed using HN kVCT datasets and the corresponding structure contours. The voxels inside amore » given 3D contour boundary were clustered using a graphics processing unit (GPU) based algorithm that accounted for inconsistencies and gaps in the boundary to form a volumetric structure. While the bony anatomy was modeled as rigid body, the muscle and soft tissue structures were modeled as mass–spring-damper models with elastic material properties that corresponded to the underlying contoured anatomies. Within a given muscle structure, the voxels were classified using a uniform grid and a normalized mass was assigned to each voxel based on its Hounsfield number. The soft tissue deformation for a given skeletal actuation was performed using an implicit Euler integration with each iteration split into two substeps: one for the muscle structures and the other for the remaining soft tissues. Posture changes were simulated by articulating the skeletal structure and enabling the soft structures to deform accordingly. Physiological changes representing tumor regression were simulated by reducing the target volume and enabling the surrounding soft structures to deform accordingly. Finally, the authors also discuss a new approach to generate kVCT images representing the deformed anatomy that accounts for gaps and antialiasing artifacts that may be caused by the biomechanical deformation process. Accuracy and stability of the model response were validated using ground-truth simulations representing soft tissue behavior under local and global deformations. Numerical accuracy of the HN deformations was analyzed by applying nonrigid skeletal transformations acquired from interfraction kVCT images to the model’s skeletal structures and comparing the subsequent soft tissue deformations of the model with the clinical anatomy. Results: The GPU based framework enabled the model deformation to be performed at 60 frames/s, facilitating simulations of posture changes and physiological regressions at interactive speeds. The soft tissue response was accurate with a R{sup 2} value of >0.98 when compared to ground-truth global and local force deformation analysis. The deformation of the HN anatomy by the model agreed with the clinically observed deformations with an average correlation coefficient of 0.956. For a clinically relevant range of posture and physiological changes, the model deformations stabilized with an uncertainty of less than 0.01 mm. Conclusions: Documenting dose delivery for HN radiotherapy is essential accounting for posture and physiological changes. The biomechanical model discussed in this paper was able to deform in real-time, allowing interactive simulations and visualization of such changes. The model would allow patient specific validations of the DIR method and has the potential to be a significant aid in adaptive radiotherapy techniques.« less
  • Purpose: 3D optical surface imaging has been applied to patient positioning in radiation therapy (RT). The optical patient positioning system is advantageous over conventional method using cone-beam computed tomography (CBCT) in that it is radiation free, frameless, and is capable of real-time monitoring. While the conventional radiographic method uses volumetric registration, the optical system uses surface matching for patient alignment. The relative accuracy of these two methods has not yet been sufficiently investigated. This study aims to investigate the theoretical accuracy of the surface registration based on a simulation study using patient data. Methods: This study compares the relative accuracymore » of surface and volumetric registration in head-and-neck RT. The authors examined 26 patient data sets, each consisting of planning CT data acquired before treatment and patient setup CBCT data acquired at the time of treatment. As input data of surface registration, patient’s skin surfaces were created by contouring patient skin from planning CT and treatment CBCT. Surface registration was performed using the iterative closest points algorithm by point–plane closest, which minimizes the normal distance between source points and target surfaces. Six degrees of freedom (three translations and three rotations) were used in both surface and volumetric registrations and the results were compared. The accuracy of each method was estimated by digital phantom tests. Results: Based on the results of 26 patients, the authors found that the average and maximum root-mean-square translation deviation between the surface and volumetric registrations were 2.7 and 5.2 mm, respectively. The residual error of the surface registration was calculated to have an average of 0.9 mm and a maximum of 1.7 mm. Conclusions: Surface registration may lead to results different from those of the conventional volumetric registration. Only limited accuracy can be achieved for patient positioning with an approach based solely on surface information.« less
  • Purpose: MRI-guided focused ultrasound (MRgFUS) has many potential and realized applications including controlled heating and localized drug delivery. The development of many of these applications requires extensive preclinical work, much of it in small animal models. The goal of this study is to characterize the spatial targeting accuracy and reproducibility of a preclinical high field MRgFUS system for thermal ablation and drug delivery applications. Methods: The RK300 (FUS Instruments, Toronto, Canada) is a motorized, 2-axis FUS positioning system suitable for small bore (72 mm), high-field MRI systems. The accuracy of the system was assessed in three ways. First, the precisionmore » of the system was assessed by sonicating regular grids of 5 mm squares on polystyrene plates and comparing the resulting focal dimples to the intended pattern, thereby assessing the reproducibility and precision of the motion control alone. Second, the targeting accuracy was assessed by imaging a polystyrene plate with randomly drilled holes and replicating the hole pattern by sonicating the observed hole locations on intact polystyrene plates and comparing the results. Third, the practicallyrealizable accuracy and precision were assessed by comparing the locations of transcranial, FUS-induced blood-brain-barrier disruption (BBBD) (observed through Gadolinium enhancement) to the intended targets in a retrospective analysis of animals sonicated for other experiments. Results: The evenly-spaced grids indicated that the precision was 0.11 +/− 0.05 mm. When image-guidance was included by targeting random locations, the accuracy was 0.5 +/− 0.2 mm. The effective accuracy in the four rodent brains assessed was 0.8 +/− 0.6 mm. In all cases, the error appeared normally distributed (p<0.05) in both orthogonal axes, though the left/right error was systematically greater than the superior/inferior error. Conclusions: The targeting accuracy of this device is sub-millimeter, suitable for many preclinical applications including focused drug delivery and thermal therapy. Funding support provided by Philips Healthcare.« less