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Prostate image-guided radiotherapy by megavolt cone-beam CT

Abstract

To test megavolt cone-beam CT (MV-CBCT) in order to evaluate setup errors in prostate radiotherapy. The setup of 9 patients was verified weekly by electronic portal imaging (EPI) and MV-CBCT, both performed in the same treatment session. EPI were compared with digitally reconstructed radiographies (DRRs). MV-CBCTs were matched to simulation CTs by manual registration based on bone markers (BMR), by manual registration based on soft tissues (STR) - rectum, bladder, and seminal vesicles - and by automatic registration (AR) performed by a mutual information algorithm. Shifts were evaluated along the three main axes: anteroposterior (AP), craniocaudal (CC), and laterolateral (LL). Finally, in 4 additional patients showing intraprostatic calcifications, the calcification mismatch error was used to evaluate the three MV-CBCT matching methods. A total of 50 pairs of orthogonal EPIs and 50 MV-CBCTs were analyzed. Assuming an overall tolerance of 2 mm, no significant differences were observed comparing EPI vs BMR in any axis. A significant difference (p < 0.001) was observed along the AP axis comparing EPI vs AR and EPI vs STR. On the calcification data set (22 measures), the calcification mismatch along the AP direction was significantly lower (p < 0.05) after STR than after BMR or AR.  More>>
Authors:
Zucca, Sergio; Carau, Barbara; Solla, Ignazio; Garibaldi, Elisabetta; Farace, Paolo; Lay, Giancarlo; Meleddu, Gianfranco; Gabriele, Pietro [1] 
  1. Regional Oncological Hospital, Cagliari (Italy). Dept. of Radiooncology
Publication Date:
Aug 15, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Strahlentherapie und Onkologie; Journal Volume: 187; Journal Issue: 8
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL MARKERS; COMPUTERIZED TOMOGRAPHY; CONNECTIVE TISSUE; CT-GUIDED RADIOTHERAPY; ERRORS; IMAGE PROCESSING; OPTIMIZATION; PORTAL SYSTEM; PROSTATE; TOLERANCE; X-RAY RADIOGRAPHY
OSTI ID:
21515462
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0179-7158; STONE4; TRN: DE11FF007
Submitting Site:
DEN
Size:
page(s) 473-478
Announcement Date:
Dec 22, 2011

Citation Formats

Zucca, Sergio, Carau, Barbara, Solla, Ignazio, Garibaldi, Elisabetta, Farace, Paolo, Lay, Giancarlo, Meleddu, Gianfranco, and Gabriele, Pietro. Prostate image-guided radiotherapy by megavolt cone-beam CT. Germany: N. p., 2011. Web. doi:10.1007/s00066-011-2241-7.
Zucca, Sergio, Carau, Barbara, Solla, Ignazio, Garibaldi, Elisabetta, Farace, Paolo, Lay, Giancarlo, Meleddu, Gianfranco, &amp; Gabriele, Pietro. Prostate image-guided radiotherapy by megavolt cone-beam CT. Germany. https://doi.org/10.1007/s00066-011-2241-7
Zucca, Sergio, Carau, Barbara, Solla, Ignazio, Garibaldi, Elisabetta, Farace, Paolo, Lay, Giancarlo, Meleddu, Gianfranco, and Gabriele, Pietro. 2011. "Prostate image-guided radiotherapy by megavolt cone-beam CT." Germany. https://doi.org/10.1007/s00066-011-2241-7.
@misc{etde_21515462,
title = {Prostate image-guided radiotherapy by megavolt cone-beam CT}
author = {Zucca, Sergio, Carau, Barbara, Solla, Ignazio, Garibaldi, Elisabetta, Farace, Paolo, Lay, Giancarlo, Meleddu, Gianfranco, and Gabriele, Pietro}
abstractNote = {To test megavolt cone-beam CT (MV-CBCT) in order to evaluate setup errors in prostate radiotherapy. The setup of 9 patients was verified weekly by electronic portal imaging (EPI) and MV-CBCT, both performed in the same treatment session. EPI were compared with digitally reconstructed radiographies (DRRs). MV-CBCTs were matched to simulation CTs by manual registration based on bone markers (BMR), by manual registration based on soft tissues (STR) - rectum, bladder, and seminal vesicles - and by automatic registration (AR) performed by a mutual information algorithm. Shifts were evaluated along the three main axes: anteroposterior (AP), craniocaudal (CC), and laterolateral (LL). Finally, in 4 additional patients showing intraprostatic calcifications, the calcification mismatch error was used to evaluate the three MV-CBCT matching methods. A total of 50 pairs of orthogonal EPIs and 50 MV-CBCTs were analyzed. Assuming an overall tolerance of 2 mm, no significant differences were observed comparing EPI vs BMR in any axis. A significant difference (p < 0.001) was observed along the AP axis comparing EPI vs AR and EPI vs STR. On the calcification data set (22 measures), the calcification mismatch along the AP direction was significantly lower (p < 0.05) after STR than after BMR or AR. Bone markers were not an effective surrogate of the target position and significant differences were observed comparing EPI or BMR vs STR, supporting the assessment of soft tissue position by MVCBs to verify and correct patient setup in prostate radiotherapy. (orig.)}
doi = {10.1007/s00066-011-2241-7}
journal = []
issue = {8}
volume = {187}
place = {Germany}
year = {2011}
month = {Aug}
}