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Title: SU-C-18C-03: Dual-Energy X-Ray Fluoroscopy Imaging System

Purpose: This work studies the clinical utility of dual energy (DE) subtraction fluoroscopy for fiducial-free tumor tracking in lung radiation therapy (RT). Improvement in tumor visualization and quantification of tumor shift within a breathing cycle were analyzed. Methods: Twenty subjects who were undergoing RT for lung cancer were recruited following institutional review board approval. The subjects had a range of tumor sizes, locations in the lungs, and body sizes. An x-ray imaging system was setup with the following components: (a) x-ray tube (Varian G-242, Varian Medical Systems (VMS), CA) (b) flat panel detector (4030CB, VMS, CA) and (c) x-ray generator (EPS 50RF, EMD, Canada). Firmware and software modifications were made to the generator to allow 10 x-ray pulse pairs with alternating low/high kV, 100 ms apart for ∼4s (one breathing cycle). Images were obtained at 4 angles: 0°, 45°, 90° and 135°. Weighted subtraction of a kV-pair image set was used to create a “bone-free” image of the lungs. The 2D tumor-shift in each subtracted image and the 3D shift during a breathing cycle was calculated using all views. Results: The subjects enrolled had the following statistics: average age 62.3±7.1 years, 5 female/15 male, 11 had tumors on the rightmore » and 9 on the left and the average tumor size was ∼31.4±10.8 mm. X-ray imaging conditions for the pulse pairs were: 70/120 kVp, 280/221 mA and 65/8 ms. For views where these parameters were insufficient 80/130 kVp, 280/221 mA and 60/12 ms was used. Tumor visibility improved for 0°, 45°, 90° and 135° in 100%, 55%, 75% and 80% of the cases respectively. Tumor shift during a breathing cycle was: 2.4±1.0 mm AP, 2.7±1.4 mm LR and 7.6±4.8 mm IS. Conclusion: DE subtraction fluoroscopy allowed improved visualization and quantification of movement of tumors in the lungs during a breathing cycle. This study was entirely funded by Varian Medical Systems.« less
Authors:
; ; ;  [1] ;  [2]
  1. Ginzton Technology Center, Varian Medical Systems Inc, Palo Alto, CA (United States)
  2. Ruier Medical, Wuxi, Jiangsu Province (China)
Publication Date:
OSTI Identifier:
22334123
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 41; Journal Issue: 6; Other Information: (c) 2014 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; COMPUTER CODES; FLUOROSCOPY; IMAGES; LUNGS; NEOPLASMS; RADIOTHERAPY; RESPIRATION; SKELETON; X RADIATION; X-RAY TUBES