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Towards clinical implementation of ultrafast combined kV-MV CBCT for IGRT of lung cancer: evaluation of registration accuracy based on phantom study

Purpose: Combined kV-MV cone-beam CT (CBCT) is a promising approach to accelerate imaging for patients with lung tumors treated with deep inspiration breath-hold. During a single breath-hold (15 s), a 3D kV-MV CBCT can be acquired, thus minimizing motion artifacts and increasing patient comfort. Pri...

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Main Authors: Arns, Anna Maria (Author) , Blessing, Manuel (Author) , Fleckenstein, Jens (Author) , Stsepankou, Dzmitry (Author) , Boda-Heggemann, Judit (Author) , Simeonova-Chergou, Anna (Author) , Hesser, Jürgen (Author) , Lohr, Frank (Author) , Wenz, Frederik (Author) , Wertz, Hansjörg (Author)
Format: Article (Journal)
Language:English
Published: 10 February 2016
In: Strahlentherapie und Onkologie
Year: 2016, Volume: 192, Issue: 5, Pages: 312-321
ISSN:1439-099X
DOI:10.1007/s00066-016-0947-2
Online Access:Verlag, Volltext: https://doi.org/10.1007/s00066-016-0947-2
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Author Notes:Anna Arns, Manuel Blessing, Jens Fleckenstein, Dzmitry Stsepankou, Judit Boda-Heggemann, Anna Simeonova-Chergou, Jürgen Hesser, Frank Lohr, Frederik Wenz, Hansjörg Wertz
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Summary:Purpose: Combined kV-MV cone-beam CT (CBCT) is a promising approach to accelerate imaging for patients with lung tumors treated with deep inspiration breath-hold. During a single breath-hold (15 s), a 3D kV-MV CBCT can be acquired, thus minimizing motion artifacts and increasing patient comfort. Prior to clinical implementation, positioning accuracy was evaluated and compared to clinically established imaging techniques. Methods and materials: An inhomogeneous thorax phantom with four tumor-mimicking inlays was imaged in 10 predefined positions and registered to a planning CT. Novel kV-MV CBCT imaging (90° arc) was compared to clinically established kV-chest CBCT (360°) as well as nonclinical kV-CBCT and low-dose MV-CBCT (each 180°). Manual registration, automatic registration provided by the manufacturer and an additional in-house developed manufacturer-independent framework based on the MATLAB registration toolkit were applied. Results: Systematic setup error was reduced to 0.05 mm by high-precision phantom positioning with optical tracking. Stochastic mean displacement errors were 0.5 ± 0.3 mm in right-left, 0.4 ± 0.4 mm in anteroposterior and 0.0 ± 0.4 mm in craniocaudal directions for kV-MV CBCT with manual registration (maximum errors of no more than 1.4 mm). Clinical kV-chest CBCT resulted in mean errors of 0.2 mm (other modalities: 0.4-0.8 mm). Similar results were achieved with both automatic registration methods. Conclusion: The comparison study of repositioning accuracy between novel kV-MV CBCT and clinically established volume imaging demonstrated that registration accuracy is maintained below 1 mm. Since imaging time is reduced to one breath-hold, kV-MV CBCT is ideal for image guidance, e.g., in lung stereotactic ablative radiotherapy.
Item Description:Gesehen am 29.04.2019
Physical Description:Online Resource
ISSN:1439-099X
DOI:10.1007/s00066-016-0947-2

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