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Title: MO-FG-CAMPUS-JeP3-03: Detection of Unpredictable Patient Movement During SBRT Using a Single KV Projection of An On-Board CBCT System: Simulation Study

Abstract

Purpose: An unpredictable movement of a patient can occur during SBRT even when immobilization devices are applied. In the SBRT treatments using a conventional linear accelerator detection of such movements relies heavily on human interaction and monitoring. This study aims to detect such positional abnormalities in real-time by assessing intra-fractional gantry mounted kV projection images of a patient’s spine. Methods: We propose a self-CBCT image based spine tracking method consisting of the following steps: (1)Acquire a pre-treatment CBCT image; (2)Transform the CBCT volume according to the couch correction; (3)Acquire kV projections during treatment beam delivery; (4)Simultaneously with each acquisition generate a DRR from the CBCT volume based-on the current projection geometry; (5)Perform an intensity gradient-based 2D registration between spine ROI images of the projection and the DRR images; (6)Report an alarm if the detected 2D displacement is beyond a threshold value. To demonstrate the feasibility, retrospective simulations were performed on 1,896 projections from nine CBCT sessions of three patients who received lung SBRT. The unpredictable movements were simulated by applying random rotations and translations to the reference CBCT prior to each DRR generation. As the ground truth, the 3D translations and/or rotations causing >3 mm displacement of the midpoint ofmore » the thoracic spine were regarded as abnormal. In the measurements, different threshold values of 2D displacement were tested to investigate sensitivity and specificity of the proposed method. Results: A linear relationship between the ground truth 3D displacement and the detected 2D displacement was observed (R{sup 2} = 0.44). When the 2D displacement threshold was set to 3.6 mm the overall sensitivity and specificity were 77.7±5.7% and 77.9±3.5% respectively. Conclusion: In this simulation study, it was demonstrated that intrafractional kV projections from an on-board CBCT system have a potential to detect unpredictable patient movement during SBRT. This research is funded by Interfractional Imaging Research Grant from Elekta.« less

Authors:
; ;  [1]
  1. Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
Publication Date:
OSTI Identifier:
22653915
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 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; 61 RADIATION PROTECTION AND DOSIMETRY; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; EQUIPMENT; GROUND TRUTH MEASUREMENTS; IMAGES; LINEAR ACCELERATORS; PATIENTS; SIMULATION; VERTEBRAE

Citation Formats

Park, Y, Sharp, G, and Winey, B. MO-FG-CAMPUS-JeP3-03: Detection of Unpredictable Patient Movement During SBRT Using a Single KV Projection of An On-Board CBCT System: Simulation Study. United States: N. p., 2016. Web. doi:10.1118/1.4957378.
Park, Y, Sharp, G, & Winey, B. MO-FG-CAMPUS-JeP3-03: Detection of Unpredictable Patient Movement During SBRT Using a Single KV Projection of An On-Board CBCT System: Simulation Study. United States. doi:10.1118/1.4957378.
Park, Y, Sharp, G, and Winey, B. Wed . "MO-FG-CAMPUS-JeP3-03: Detection of Unpredictable Patient Movement During SBRT Using a Single KV Projection of An On-Board CBCT System: Simulation Study". United States. doi:10.1118/1.4957378.
@article{osti_22653915,
title = {MO-FG-CAMPUS-JeP3-03: Detection of Unpredictable Patient Movement During SBRT Using a Single KV Projection of An On-Board CBCT System: Simulation Study},
author = {Park, Y and Sharp, G and Winey, B},
abstractNote = {Purpose: An unpredictable movement of a patient can occur during SBRT even when immobilization devices are applied. In the SBRT treatments using a conventional linear accelerator detection of such movements relies heavily on human interaction and monitoring. This study aims to detect such positional abnormalities in real-time by assessing intra-fractional gantry mounted kV projection images of a patient’s spine. Methods: We propose a self-CBCT image based spine tracking method consisting of the following steps: (1)Acquire a pre-treatment CBCT image; (2)Transform the CBCT volume according to the couch correction; (3)Acquire kV projections during treatment beam delivery; (4)Simultaneously with each acquisition generate a DRR from the CBCT volume based-on the current projection geometry; (5)Perform an intensity gradient-based 2D registration between spine ROI images of the projection and the DRR images; (6)Report an alarm if the detected 2D displacement is beyond a threshold value. To demonstrate the feasibility, retrospective simulations were performed on 1,896 projections from nine CBCT sessions of three patients who received lung SBRT. The unpredictable movements were simulated by applying random rotations and translations to the reference CBCT prior to each DRR generation. As the ground truth, the 3D translations and/or rotations causing >3 mm displacement of the midpoint of the thoracic spine were regarded as abnormal. In the measurements, different threshold values of 2D displacement were tested to investigate sensitivity and specificity of the proposed method. Results: A linear relationship between the ground truth 3D displacement and the detected 2D displacement was observed (R{sup 2} = 0.44). When the 2D displacement threshold was set to 3.6 mm the overall sensitivity and specificity were 77.7±5.7% and 77.9±3.5% respectively. Conclusion: In this simulation study, it was demonstrated that intrafractional kV projections from an on-board CBCT system have a potential to detect unpredictable patient movement during SBRT. This research is funded by Interfractional Imaging Research Grant from Elekta.},
doi = {10.1118/1.4957378},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}