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Title: SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems

Abstract

Purpose To compare online image registrations of TrueBeam cone-beam CT (CBCT) and BrainLab ExacTrac imaging systems. Methods Tests were performed on a Varian TrueBeam STx linear accelerator (Version 2.0), which is integrated with a BrainLab ExacTrac imaging system (Version 6.0.5). The study was focused on comparing the online image registrations for translational shifts. A Rando head phantom was placed on treatment couch and immobilized with a BrainLab mask. The phantom was shifted by moving the couch translationally for 8 mm with a step size of 1 mm, in vertical, longitudinal, and lateral directions, respectively. At each location, the phantom was imaged with CBCT and ExacTrac x-ray. CBCT images were registered with TrueBeam and ExacTrac online registration algorithms, respectively. And ExacTrac x-ray image registrations were performed. Shifts calculated from different registrations were compared with nominal couch shifts. Results The averages and ranges of absolute differences between couch shifts and calculated phantom shifts obtained from ExacTrac x-ray registration, ExacTrac CBCT registration with default window, ExaxTrac CBCT registration with adjusted window (bone), Truebeam CBCT registration with bone window, and Truebeam CBCT registration with soft tissue window, were: 0.07 (0.02–0.14), 0.14 (0.01–0.35), 0.12 (0.02–0.28), 0.09 (0–0.20), and 0.06 (0–0.10) mm, in vertical direction; 0.06more » (0.01–0.12), 0.27 (0.07–0.57), 0.23 (0.02–0.48), 0.04 (0–0.10), and 0.08 (0– 0.20) mm, in longitudinal direction; 0.05 (0.01–0.21), 0.35 (0.14–0.80), 0.25 (0.01–0.56), 0.19 (0–0.40), and 0.20 (0–0.40) mm, in lateral direction. Conclusion The shifts calculated from ExacTrac x-ray and TrueBeam CBCT registrations were close to each other (the differences between were less than 0.40 mm in any direction), and had better agreements with couch shifts than those from ExacTrac CBCT registrations. There were no significant differences between TrueBeam CBCT registrations using different windows. In ExacTrac CBCT registrations, using bone window led to better agreements than using default window.« less

Authors:
; ; ; ; ;  [1]
  1. Thomas Jefferson University, Philadelphia, PA (United States)
Publication Date:
OSTI Identifier:
22494070
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; ALGORITHMS; ANIMAL TISSUES; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; HEAD; IMAGES; LINEAR ACCELERATORS; PHANTOMS; SKELETON

Citation Formats

Li, J, Shi, W, Andrews, D, Werner-Wasik, M, Yu, Y, and Liu, H. SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems. United States: N. p., 2015. Web. doi:10.1118/1.4924134.
Li, J, Shi, W, Andrews, D, Werner-Wasik, M, Yu, Y, & Liu, H. SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems. United States. doi:10.1118/1.4924134.
Li, J, Shi, W, Andrews, D, Werner-Wasik, M, Yu, Y, and Liu, H. Mon . "SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems". United States. doi:10.1118/1.4924134.
@article{osti_22494070,
title = {SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems},
author = {Li, J and Shi, W and Andrews, D and Werner-Wasik, M and Yu, Y and Liu, H},
abstractNote = {Purpose To compare online image registrations of TrueBeam cone-beam CT (CBCT) and BrainLab ExacTrac imaging systems. Methods Tests were performed on a Varian TrueBeam STx linear accelerator (Version 2.0), which is integrated with a BrainLab ExacTrac imaging system (Version 6.0.5). The study was focused on comparing the online image registrations for translational shifts. A Rando head phantom was placed on treatment couch and immobilized with a BrainLab mask. The phantom was shifted by moving the couch translationally for 8 mm with a step size of 1 mm, in vertical, longitudinal, and lateral directions, respectively. At each location, the phantom was imaged with CBCT and ExacTrac x-ray. CBCT images were registered with TrueBeam and ExacTrac online registration algorithms, respectively. And ExacTrac x-ray image registrations were performed. Shifts calculated from different registrations were compared with nominal couch shifts. Results The averages and ranges of absolute differences between couch shifts and calculated phantom shifts obtained from ExacTrac x-ray registration, ExacTrac CBCT registration with default window, ExaxTrac CBCT registration with adjusted window (bone), Truebeam CBCT registration with bone window, and Truebeam CBCT registration with soft tissue window, were: 0.07 (0.02–0.14), 0.14 (0.01–0.35), 0.12 (0.02–0.28), 0.09 (0–0.20), and 0.06 (0–0.10) mm, in vertical direction; 0.06 (0.01–0.12), 0.27 (0.07–0.57), 0.23 (0.02–0.48), 0.04 (0–0.10), and 0.08 (0– 0.20) mm, in longitudinal direction; 0.05 (0.01–0.21), 0.35 (0.14–0.80), 0.25 (0.01–0.56), 0.19 (0–0.40), and 0.20 (0–0.40) mm, in lateral direction. Conclusion The shifts calculated from ExacTrac x-ray and TrueBeam CBCT registrations were close to each other (the differences between were less than 0.40 mm in any direction), and had better agreements with couch shifts than those from ExacTrac CBCT registrations. There were no significant differences between TrueBeam CBCT registrations using different windows. In ExacTrac CBCT registrations, using bone window led to better agreements than using default window.},
doi = {10.1118/1.4924134},
journal = {Medical Physics},
number = 6,
volume = 42,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}
  • Purpose: To compare online image registrations of TrueBeam cone-beam CT (CBCT) and BrainLab ExacTrac x-ray imaging systems for cranial radiotherapy. Method: Phantom and patient studies were performed on a Varian TrueBeam STx linear accelerator (Version 2.5), which is integrated with a BrainLab ExacTrac imaging system (Version 6.1.1). The phantom study was based on a Rando head phantom, which was designed to evaluate isocenter-location dependence of the image registrations. Ten isocenters were selected at various locations in the phantom, which represented clinical treatment sites. CBCT and ExacTrac x-ray images were taken when the phantom was located at each isocenter. The patientmore » study included thirteen patients. CBCT and ExacTrac x-ray images were taken at each patient’s treatment position. Six-dimensional image registrations were performed on CBCT and ExacTrac, and residual errors calculated from CBCT and ExacTrac were compared. Results: In the phantom study, the average residual-error differences between CBCT and ExacTrac image registrations were: 0.16±0.10 mm, 0.35±0.20 mm, and 0.21±0.15 mm, in the vertical, longitudinal, and lateral directions, respectively. The average residual-error differences in the rotation, roll, and pitch were: 0.36±0.11 degree, 0.14±0.10 degree, and 0.12±0.10 degree, respectively. In the patient study, the average residual-error differences in the vertical, longitudinal, and lateral directions were: 0.13±0.13 mm, 0.37±0.21 mm, 0.22±0.17 mm, respectively. The average residual-error differences in the rotation, roll, and pitch were: 0.30±0.10 degree, 0.18±0.11 degree, and 0.22±0.13 degree, respectively. Larger residual-error differences (up to 0.79 mm) were observed in the longitudinal direction in the phantom and patient studies where isocenters were located in or close to frontal lobes, i.e., located superficially. Conclusion: Overall, the average residual-error differences were within 0.4 mm in the translational directions and were within 0.4 degree in the rotational directions.« less
  • Purpose: To estimate the sensitivity of TrueBeam 2.0 Imaging System 6DoF automatic matching tool through the acquisition of cone-beam CT images in different phantoms applying submillimeter translations and rotations of tenths of a degree and registered with image simulation CT. Methods: To evaluate overall system-wide image, we consider two uncertainties source; First, the uncertainty of the manual phantom displacement (ε-m). This uncertainty is calculated by a digital caliper (0.01 mm) for vertical (Vrt), lateral (Lat) and longitudinal (Lng). A digital inclinometer (0.01°) for the pitch and roll and the own phantom scale to evaluate the coordinate rotation (Rtn). The secondmore » uncertainty is the displacement detected by the algorithm system of matching (σ-d) that we obtain from the standard deviations of the different measurements. We use three different phantoms. The BrainLab Radiosurgery system for supporting masks with an anthropomorphic dummy adapted to allow displacements of 0.1 mm in Vrt, Lat and Lng dimensions and rotations of 0.1° in Pitch dimension. For the analysis of the Rtn and Roll dimensions we use two homemade phantoms (RinoRot and RinoRoll, La Fe Hospital, Valencia, Spain) that allow rotations of 0.3°. Results: In the case of manual displacement of 0.10 ± 0.03 mm in the translations, the system detect 0.10 ± 0.07 mm, 0.12 ± 0.07 mm and 0.13 ± 0.07 mm (mean ± SD) in Lat, Vrt and Lng respectively. In the case of rotational dimension, manual displacement of 0.3 ± 0.1° was detected with 0.19 ± 0.06°, 0.29 ± 0.03° and 0.27 ± 0.06° in Pitch, Roll and Rtn. Conclusion: We conclude that the sensitivity of the automatic matching system is within 0.10 mm in translations and 0.3° in rotations. These values are under the own sensitivity of the software.« less
  • Purpose: 4D-CBCT facilitates assessment of tumor motion at treatment position. We investigated the effect of gantry speed on 4D-CBCT image quality and dose using the Varian Edge On-Board Imager (OBI). Methods: A thoracic protocol was designed using a 125 kVp spectrum. Image quality parameters were obtained via 4D acquisition using a Catphan phantom with a gating system. A sinusoidal waveform was executed with a five second period and superior-inferior motion. 4D-CBCT scans were sorted into 4 and 10 phases. Image quality metrics included spatial resolution, contrast-to-noise ratio (CNR), uniformity index (UI), Hounsfield unit (HU) sensitivity, and RMS error (RMSE) ofmore » motion amplitude. Dosimetry was accomplished using Gafchromic XR-QA2 films within a CIRS Thorax phantom. This was placed on the gating phantom using the same motion waveform. Results: High contrast resolution decreased linearly from 5.93 to 4.18 lp/cm, 6.54 to 4.18 lp/cm, and 5.19 to 3.91 lp/cm for averaged, 4 phase, and 10 phase 4DCBCT volumes respectively as gantry speed increased from 1.0 to 6.0 degs/sec. CNRs decreased linearly from 4.80 to 1.82 as the gantry speed increased from 1.0 to 6.0 degs/sec, respectively. No significant variations in UIs, HU sensitivities, or RMSEs were observed with variable gantry speed. Ion chamber measurements compared to film yielded small percent differences in plastic water regions (0.1–9.6%), larger percent differences in lung equivalent regions (7.5–34.8%), and significantly larger percent differences in bone equivalent regions (119.1–137.3%). Ion chamber measurements decreased from 17.29 to 2.89 cGy with increasing gantry speed from 1.0 to 6.0 degs/sec. Conclusion: Maintaining technique factors while changing gantry speed changes the number of projections used for reconstruction. Increasing the number of projections by decreasing gantry speed decreases noise, however, dose is increased. The future of 4DCBCT’s clinical utility relies on further investigation of image optimization.« less
  • Purpose: To assess an accuracy of fiducial maker-based setup using ExacTrac (ExT-based setup) as compared with soft tissue-based setup using Cone-beam CT (CBCT-based setup) for patients with prostate cancer receiving intensity-modulated radiation therapy (IMRT) for the purpose of investigating whether ExT-based setup can be an alternative to CBCT-based setup. Methods: The setup accuracy was analyzed prospectively for 7 prostate cancer patients with implanted three fiducial markers received IMRT. All patients were treated after CBCT-based setup was performed and corresponding shifts were recorded. ExacTrac images were obtained before and after CBCT-based setup. The fiducial marker-based shifts were calculated based on thosemore » two images and recorded on the assumption that the setup correction was carried out by fiducial marker-based auto correction. Mean and standard deviation of absolute differences and the correlation between CBCT and ExT shifts were estimated. Results: A total of 178 image dataset were analyzed. On the differences between CBCT and ExT shifts, 133 (75%) of 178 image dataset resulted in smaller differences than 3 mm in all dimensions. Mean differences in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) dimensions were 1.8 ± 1.9 mm, 0.7 ± 1.9 mm, and 0.6 ± 0.8 mm, respectively. The percentages of shift agreements within ±3 mm were 76% for AP, 90% for SI, and 100% for LR. The Pearson coefficient of correlation for CBCT and ExT shifts were 0.80 for AP, 0.80 for SI, and 0.65 for LR. Conclusion: This work showed that the accuracy of ExT-based setup was correlated with that of CBCT-based setup, implying that ExT-based setup has a potential ability to be an alternative to CBCT-based setup. The further work is to specify the conditions that ExT-based setup can provide the accuracy comparable to CBCT-based setup.« less
  • Purpose: Quality assurance of the image quality for image guided localization systems is crucial to ensure accurate visualization and localization of target volumes. In this study, the long term stability of selected image parameters was assessed and evaluated for CBCT mode, planar radiographic kV mode and the radiographic MV EPID mode. Methods: The CATPHAN, QckV-1 and QC-3 phantoms were used to evaluate the image quality parameters. The planar radiographic images were analyzed in PIPSpro™ with spatial resolution (f30, f40, f50) being recorded. For OBI CBCT, High quality head Full-Fan acquisition and Pelvis Half-Fan acquisition modes were evaluated for Uniformity, Noise,more » Spatial Resolution, HU constancy and geometric distortion. Dose and kVp for the OBI were recorded using the Unfors RaySafe Xi system with the R/F High Detector for planar kV and the CT detector for CBCT. Dose for the MV EPID was recorded using a PTW975 Semiflex Ion Chamber, PTW Unidos electrometer and SolidWater™. Results: For each metric, values were normalized to the mean and the standard deviations were recorded. For the planar radiographic spatial resolution the f30, f40, f50 were 0.015, 0.008, 0.004 and 0.006, 0.009, 0.018 for the kV and MV, respectively. The standard deviation of the dose for kV was 0.010 and 0.005 for the MV. The standard deviations for Full and half fan were averaged together and the following standard deviations for each metric were recorded: 0.075(uniformity), 0.071(noise), 0.006(AP-Geometric Distortion), 0.005(LAT-Geometric Distortion), 0.058(mean slice thickness), 0.098(f30),0.101(f40),0.124(f50), 0.031(Lung/PMP-HU constancy), 0.063(Water/poly-HU constancy), 0.015(Bone/Derlin-HU constancy),0.006(Dose-Center), 0.004(Dose-Periphery). Using these, tolerances can be reported as a warning and action threshold of 1σ and 2σ. Conclusion: A study was performed to assess the stability of the basic image quality parameters recommended by TG-142 for the Varian OBI and EPID Imaging systems. The two systems show consistent imaging and dosimetric properties over the evaluated time frame.« less