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Cai W, Fan Q, Li F, He X, Zhang P, Cervino L, Li X, Li T. Markerless motion tracking with simultaneous MV and kV imaging in spine SBRT treatment-a feasibility study. Phys Med Biol 2023; 68:10.1088/1361-6560/acae16. [PMID: 36549010 PMCID: PMC9944511 DOI: 10.1088/1361-6560/acae16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
Objective. Motion tracking with simultaneous MV-kV imaging has distinct advantages over single kV systems. This research is a feasibility study of utilizing this technique for spine stereotactic body radiotherapy (SBRT) through phantom and patient studies.Approach. A clinical spine SBRT plan was developed using 6xFFF beams and nine sliding-window IMRT fields. The plan was delivered to a chest phantom on a linear accelerator. Simultaneous MV-kV image pairs were acquired during beam delivery. KV images were triggered at predefined intervals, and synthetic MV images showing enlarged MLC apertures were created by combining multiple raw MV frames with corrections for scattering and intensity variation. Digitally reconstructed radiograph (DRR) templates were generated using high-resolution CBCT reconstructions (isotropic voxel size (0.243 mm)3) as the reference for 2D-2D matching. 3D shifts were calculated from triangulation of kV-to-DRR and MV-to-DRR registrations. To evaluate tracking accuracy, detected shifts were compared to known phantom shifts as introduced before treatment. The patient study included a T-spine patient and an L-spine patient. Patient datasets were retrospectively analyzed to demonstrate the performance in clinical settings.Main results. The treatment plan was delivered to the phantom in five scenarios: no shift, 2 mm shift in one of the longitudinal, lateral and vertical directions, and 2 mm shift in all the three directions. The calculated 3D shifts agreed well with the actual couch shifts, and overall, the uncertainty of 3D detection is estimated to be 0.3 mm. The patient study revealed that with clinical patient image quality, the calculated 3D motion agreed with the post-treatment cone beam CT. It is feasible to automate both kV-to-DRR and MV-to-DRR registrations using a mutual information-based method, and the difference from manual registration is generally less than 0.3 mm.Significance. The MV-kV imaging-based markerless motion tracking technique was validated through a feasibility study. It is a step forward toward effective motion tracking and accurate delivery for spinal SBRT.
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Affiliation(s)
- Weixing Cai
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Qiyong Fan
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Feifei Li
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Xiuxiu He
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Pengpeng Zhang
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Laura Cervino
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Xiang Li
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
| | - Tianfang Li
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Avenue, New York, NY 10065, United States of America
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Graeper G, Cetnar A, Ayan AS, Weldon M. Interpretation of intrafraction motion review data and method for verification. J Appl Clin Med Phys 2021; 22:196-202. [PMID: 34582118 PMCID: PMC8598153 DOI: 10.1002/acm2.13379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/02/2021] [Accepted: 07/16/2021] [Indexed: 11/24/2022] Open
Abstract
The current clinical interface for Varian's intrafraction motion review (IMR) is limited, providing only qualitative data for review at the treatment console. This study provides a method of extracting and interpreting data from combined log files for quantitative evaluation. Combined log files acquired during patient treatment and a parsing code was developed to scan the combined log file looking for unique identifiers pertaining to the data of interest. We were able to extract clinically relevant parameters from the log files including date and time, gantry angle, expected marker position, found marker position, pixel size, and detection result. This study details how to compare IMR data to Calypso investigating dual‐surrogates for intrafraction monitoring during treatment for other researchers to build on these methods. Understanding data recorded during treatment within the combined log files can be helpful in quality improvement of patient care by retrospectively reviewing intrafraction motion.
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Affiliation(s)
- Gavin Graeper
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ashley Cetnar
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ahmet S Ayan
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Michael Weldon
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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