Browsing by Subject "Respiratory-Gated Imaging Techniques"
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Item Open Access Evaluation of integrated respiratory gating systems on a Novalis Tx system.(Journal of applied clinical medical physics, 2011-04-04) Chang, Zheng; Liu, Tonghai; Cai, Jing; Chen, Qing; Wang, Zhiheng; Yin, Fang-FangThe purpose of this study was to investigate the accuracy of motion tracking and radiation delivery control of integrated gating systems on a Novalis Tx system. The study was performed on a Novalis Tx system, which is equipped with Varian Real-time Position Management (RPM) system, and BrainLAB ExacTrac gating systems. In this study, the two systems were assessed on accuracy of both motion tracking and radiation delivery control. To evaluate motion tracking, two artificial motion profiles and five patients' respiratory profiles were used. The motion trajectories acquired by the two gating systems were compared against the references. To assess radiation delivery control, time delays were measured using a single-exposure method. More specifically, radiation is delivered with a 4 mm diameter cone within the phase range of 10%-45% for the BrainLAB ExacTrac system, and within the phase range of 0%-25% for the Varian RPM system during expiration, each for three times. Radiochromic films were used to record the radiation exposures and to calculate the time delays. In the work, the discrepancies were quantified using the parameters of mean and standard deviation (SD). Pearson's product-moment correlational analysis was used to test correlation of the data, which is quantified using a parameter of r. The trajectory profiles acquired by the gating systems show good agreement with those reference profiles. A quantitative analysis shows that the average mean discrepancies between BrainLAB ExacTrac system and known references are 1.5 mm and 1.9 mm for artificial and patient profiles, with the maximum motion amplitude of 28.0 mm. As for the Varian RPM system, the corresponding average mean discrepancies are 1.1 mm and 1.7 mm for artificial and patient profiles. With the proposed single-exposure method, the time delays are found to be 0.20 ± 0.03 seconds and 0.09 ± 0.01 seconds for BrainLAB ExacTrac and Varian RPM systems, respectively. The results indicate the systems can track motion and control radiation delivery with reasonable accuracy. The proposed single-exposure method has been demonstrated to be feasible in measuring time delay efficiently.Item Open Access Investigation of sliced body volume (SBV) as respiratory surrogate.(Journal of applied clinical medical physics, 2013-01-07) Cai, Jing; Chang, Zheng; O'Daniel, Jennifer; Yoo, Sua; Ge, Hong; Kelsey, Christopher; Yin, Fang-FangThe purpose of this study was to evaluate the sliced body volume (SBV) as a respiratory surrogate by comparing with the real-time position management (RPM) in phantom and patient cases. Using the SBV surrogate, breathing signals were extracted from unsorted 4D CT images of a motion phantom and 31 cancer patients (17 lung cancers, 14 abdominal cancers) and were compared to those clinically acquired using the RPM system. Correlation coefficient (R), phase difference (D), and absolute phase difference (D(A)) between the SBV-derived breathing signal and the RPM signal were calculated. 4D CT reconstructed based on the SBV surrogate (4D CT(SBV)) were compared to those clinically generated based on RPM (4D CT(RPM)). Image quality of the 4D CT were scored (S(SBV) and S(RPM), respectively) from 1 to 5 (1 is the best) by experienced evaluators. The comparisons were performed for all patients, and for the lung cancer patients and the abdominal cancer patients separately. RPM box position (P), breathing period (T), amplitude (A), period variability (V(T)), amplitude variability (V(A)), and space-dependent phase shift (F) were determined and correlated to S(SBV). The phantom study showed excellent match between the SBV-derived breathing signal and the RPM signal (R = 0.99, D= -3.0%, D(A) = 4.5%). In the patient study, the mean (± standard deviation (SD)) R, D, D(A), T, V(T), A, V(A), and F were 0.92 (± 0.05), -3.3% (± 7.5%), 11.4% (± 4.6%), 3.6 (± 0.8) s, 0.19 (± 0.10), 6.6 (± 2.8) mm, 0.20 (± 0.08), and 0.40 (± 0.18) s, respectively. Significant differences in R and D(A) (p = 0.04 and 0.001, respectively) were found between the lung cancer patients and the abdominal cancer patients. 4D CT(RPM) slightly outperformed 4D CT(SBV): the mean (± SD) S(RPM) and S(SBV) were 2.6 (± 0.6) and 2.9 (± 0.8), respectively, for all patients, 2.5 (± 0.6) and 3.1 (± 0.8), respectively, for the lung cancer patients, and 2.6 (± 0.7) and 2.8 (± 0.9), respectively, for the abdominal cancer patients. The difference between S(RPM) and S(SBV) was insignificant for the abdominal patients (p = 0.59). F correlated moderately with S(SBV) (r = 0.72). The correlation between SBV-derived breathing signal and RPM signal varied between patients and was significantly better in the abdomen than in the thorax. Space-dependent phase shift is a limiting factor of the accuracy of the SBV surrogate.Item Open Access Task Group 174 Report: Utilization of [18 F]Fluorodeoxyglucose Positron Emission Tomography ([18 F]FDG-PET) in Radiation Therapy.(Medical physics, 2019-10) Das, Shiva K; McGurk, Ross; Miften, Moyed; Mutic, Sasa; Bowsher, James; Bayouth, John; Erdi, Yusuf; Mawlawi, Osama; Boellaard, Ronald; Bowen, Stephen R; Xing, Lei; Bradley, Jeffrey; Schoder, Heiko; Yin, Fang-Fang; Sullivan, Daniel C; Kinahan, PaulThe use of positron emission tomography (PET) in radiation therapy (RT) is rapidly increasing in the areas of staging, segmentation, treatment planning, and response assessment. The most common radiotracer is 18 F-fluorodeoxyglucose ([18 F]FDG), a glucose analog with demonstrated efficacy in cancer diagnosis and staging. However, diagnosis and RT planning are different endeavors with unique requirements, and very little literature is available for guiding physicists and clinicians in the utilization of [18 F]FDG-PET in RT. The two goals of this report are to educate and provide recommendations. The report provides background and education on current PET imaging systems, PET tracers, intensity quantification, and current utilization in RT (staging, segmentation, image registration, treatment planning, and therapy response assessment). Recommendations are provided on acceptance testing, annual and monthly quality assurance, scanning protocols to ensure consistency between interpatient scans and intrapatient longitudinal scans, reporting of patient and scan parameters in literature, requirements for incorporation of [18 F]FDG-PET in treatment planning systems, and image registration. The recommendations provided here are minimum requirements and are not meant to cover all aspects of the use of [18 F]FDG-PET for RT.Item Open Access The impact of respiratory gating on improving volume measurement of murine lung tumors in micro-CT imaging.(PloS one, 2020-01) Blocker, SJ; Holbrook, MD; Mowery, YM; Sullivan, DC; Badea, CTSmall animal imaging has become essential in evaluating new cancer therapies as they are translated from the preclinical to clinical domain. However, preclinical imaging faces unique challenges that emphasize the gap between mouse and man. One example is the difference in breathing patterns and breath-holding ability, which can dramatically affect tumor burden assessment in lung tissue. As part of a co-clinical trial studying immunotherapy and radiotherapy in sarcomas, we are using micro-CT of the lungs to detect and measure metastases as a metric of disease progression. To effectively utilize metastatic disease detection as a metric of progression, we have addressed the impact of respiratory gating during micro-CT acquisition on improving lung tumor detection and volume quantitation. Accuracy and precision of lung tumor measurements with and without respiratory gating were studied by performing experiments with in vivo images, simulations, and a pocket phantom. When performing test-retest studies in vivo, the variance in volume calculations was 5.9% in gated images and 15.8% in non-gated images, compared to 2.9% in post-mortem images. Sensitivity of detection was examined in images with simulated tumors, demonstrating that reliable sensitivity (true positive rate (TPR) ≥ 90%) was achievable down to 1.0 mm3 lesions with respiratory gating, but was limited to ≥ 8.0 mm3 in non-gated images. Finally, a clinically-inspired "pocket phantom" was used during in vivo mouse scanning to aid in refining and assessing the gating protocols. Application of respiratory gating techniques reduced variance of repeated volume measurements and significantly improved the accuracy of tumor volume quantitation in vivo.