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Gherman B, Hajjar NA, Tucan P, Radu C, Vaida C, Mois E, Burz A, Pisla D. Risk Assessment-Oriented Design of a Needle Insertion Robotic System for Non-Resectable Liver Tumors. Healthcare (Basel) 2022; 10:healthcare10020389. [PMID: 35207006 PMCID: PMC8872014 DOI: 10.3390/healthcare10020389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
Medical robotics is a highly challenging and rewarding field of research, especially in the development of minimally invasive solutions for the treatment of the worldwide leading cause of death, cancer. The aim of the paper is to provide a design methodology for the development of a safe and efficient medical robotic system for the minimally invasive, percutaneous, targeted treatment of hepatocellular carcinoma, which can be extended with minimal modification for other types of abdominal cancers. Using as input a set of general medical requirements to comply with currently applicable standards, and a set of identified hazards and failure modes, specific methods, such as the Analytical Hierarchy Prioritization, Risk Analysis and fuzzy logic Failure Modes and Effect Analysis have been used within a stepwise approach to help in the development of a medical device targeting the insertion of multiple needles in brachytherapy procedures. The developed medical device, which is visually guided using CT scanning, has been tested for validation in a medical environment using a human-size ballistic gel liver, with promising results. These prove that the robotic system can be used for the proposed medical task, while the modular approach increases the chances of acceptance.
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Affiliation(s)
- Bogdan Gherman
- CESTER—Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, Bulevardul Muncii Street, No. 103-105, 400641 Cluj-Napoca, Romania; (B.G.); (P.T.); (C.V.); (A.B.)
| | - Nadim Al Hajjar
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Croitorilor Street, No. 19-21, 400162 Cluj-Napoca, Romania; (N.A.H.); (C.R.); (E.M.)
| | - Paul Tucan
- CESTER—Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, Bulevardul Muncii Street, No. 103-105, 400641 Cluj-Napoca, Romania; (B.G.); (P.T.); (C.V.); (A.B.)
| | - Corina Radu
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Croitorilor Street, No. 19-21, 400162 Cluj-Napoca, Romania; (N.A.H.); (C.R.); (E.M.)
| | - Calin Vaida
- CESTER—Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, Bulevardul Muncii Street, No. 103-105, 400641 Cluj-Napoca, Romania; (B.G.); (P.T.); (C.V.); (A.B.)
| | - Emil Mois
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Croitorilor Street, No. 19-21, 400162 Cluj-Napoca, Romania; (N.A.H.); (C.R.); (E.M.)
| | - Alin Burz
- CESTER—Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, Bulevardul Muncii Street, No. 103-105, 400641 Cluj-Napoca, Romania; (B.G.); (P.T.); (C.V.); (A.B.)
| | - Doina Pisla
- CESTER—Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, Bulevardul Muncii Street, No. 103-105, 400641 Cluj-Napoca, Romania; (B.G.); (P.T.); (C.V.); (A.B.)
- Correspondence:
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Ogilvy A, Collins S, Tuokko T, Hilts M, Deardon R, Hare W, Jirasek A. Optimization of solid tank design for fan-beam optical CT based 3D radiation dosimetry. Phys Med Biol 2020; 65:245012. [PMID: 33032269 DOI: 10.1088/1361-6560/abbf98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Optical computed tomography (CT) is one of the leading modalities for imaging gel dosimeters for 3D radiation dosimetry. There exist multiple scanner designs that have showcased excellent 3D dose verification capabilities of optical CT gel dosimetry. However, due to multiple experimental and reconstruction based factors there is currently no single scanner that has become a preferred standard. A significant challenge with setup and maintenance can be attributed to maintaining a large refractive index bath (1-15 l). In this work, a prototype solid 'tank' optical CT scanner is proposed that minimizes the volume of refractive index bath to between 10 and 35 ml. A ray-path simulator was created to optimize the design such that the solid tank geometry maximizes light collection across the detector array, maximizes the volume of the dosimeter scanned, and maximizes the collected signal dynamic range. An objective function was created to score possible geometries, and was optimized to find a local maximum geometry score from a set of possible design parameters. The design parameters optimized include the block length x bl , bore position x bc , fan-laser position x lp , lens block face semi-major axis length x ma , and the lens block face eccentricity x be . For the proposed design it was found that each of these parameters can have a significant effect on the signal collection efficacy within the scanner. Simulations scores are specific to the attenuation characteristics and refractive index of a simulated dosimeter. It was found that for a FlexyDos3D dosimeter, the ideal values for each of the five variables were: x bl = 314 mm, x bc = 6.5 mm, x lp = 50 mm, x ma = 66 mm, and x be = 0. In addition, a ClearView™ dosimeter was found to have ideal values at: x bl = 204 mm, x bc = 13 mm, x lp = 58 mm, x ma = 69 mm, and x be = 0. The ray simulator can also be used for further design and testing of new, unique and purpose-built optical CT geometries.
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Affiliation(s)
- A Ogilvy
- Department of Physics, University of British Columbia-Okanagan campus, Kelowna BC V1V 1V7, Canada
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Vergalasova I, McKenna M, Yue NJ, Reyhan M. Impact of computed tomography (CT) reconstruction kernels on radiotherapy dose calculation. J Appl Clin Med Phys 2020; 21:178-186. [PMID: 32889789 PMCID: PMC7497921 DOI: 10.1002/acm2.12994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 06/27/2020] [Accepted: 07/11/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To quantitatively evaluate the effect of computed tomography (CT) reconstruction kernels on various dose calculation algorithms with heterogeneity correction. METHODS The gammex electron density (ED) Phantom was scanned with the Siemens PET/CT Biograph20 mCT and reconstructed with twelve different kernel options. Hounsfield unit (HU) vs electron density (ED) curves were generated to compare absolute differences. Scans were repeated under head and pelvis protocols and reconstructed per H40s (head) and B40s (pelvis) kernels. In addition, raw data from a full-body patient scan were also reconstructed using the four B kernels. Per reconstruction, photon (3D and VMAT), electron (18 and 20 MeV) and proton (single field) treatment plans were generated using Varian Eclipse dose calculation algorithms. Photon and electron plans were also simulated to pass through cortical bone vs liver plugs of the phantom for kernel comparison. Treatment field monitor units (MU) and isodose volumes were compared across all scenarios. RESULTS The twelve kernels resulted in minor differences in HU, except at the extreme ends of the density curve with a maximum absolute difference of 55.2 HU. The head and pelvis scans of the phantom resulted in absolute HU differences of up to 49.1 HU for cortical bone and 45.1 HU for lung 300, which is a relative difference of 4.1% and 6.2%, respectively. MU comparisons across photon and proton calculation algorithms for the patient and phantom scans were within 1-2 MU, with a maximum difference of 5.4 MU found for the 20 MeV electron plan. The 20MeV electron plan also displayed maximum differences in isodose volumes of 20.4 cc for V90%. CONCLUSION Clinically insignificant differences were found among the various kernel generated plans for photon and proton plans calculated on patient and phantom scan data. However, differences in isodose volumes found for higher energy electron plans amongst the kernels may have clinical implications for prescribing dose to an isodose level.
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Affiliation(s)
- Irina Vergalasova
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Michael McKenna
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Ning Jeff Yue
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Meral Reyhan
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
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Effects of image distortion and Hounsfield unit variations on radiation treatment plans: An extended field-of-view reconstruction in a large bore CT scanner. Sci Rep 2020; 10:473. [PMID: 31949301 PMCID: PMC6965617 DOI: 10.1038/s41598-020-57422-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/11/2019] [Indexed: 11/20/2022] Open
Abstract
This study aimed to evaluate the effect of image distortion and Hounsfield unit (HU) variation due to the extended field-of-view (eFOV) of the large-bore (LB) computed tomography (CT) on dose distribution. Both home-made inhomogeneity and breast phantoms were scanned at the geometric center position and four different offset positions. We also performed dose optimizations based on different breast phantom CT sets for evaluating the effects of image artifacts on the intensity-modulated radiation techniques. The volume changes were 0.0% to 0.5% in the air, −0.5% to 3.0% in the water, and 4.0% to 5.0% in the high-density material of the inhomogeneity phantom. Both phantoms scanning results indicate that more distortions occurred in the eFOV area due to the biased scanning center. The gamma index differences ranged from 0.87% to 4.87% for the FIF plan and from 0.52% to 6.26% for the VMAT plan. This resulted in decrease of the minimum (7.3–13.1%), maximum (−0.8–2.2%), and mean doses (−0.2–4.4%). We recommend that it should be evaluated whether the applied CT would have an appropriate eFOV range for clinical radiation treatment planning for patients.
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Wu RY, Williamson TD, Sahoo N, Nguyen T, Ikner SM, Liu AY, Wisdom PG, Lii M, Hunter RA, Alvarez PE, Gunn GB, Frank SJ, Hojo Y, Zhu XR, Gillin MT. Evaluation of the high definition field of view option of a large-bore computed tomography scanner for radiation therapy simulation. Phys Imaging Radiat Oncol 2020; 13:44-49. [PMID: 32551371 PMCID: PMC7302052 DOI: 10.1016/j.phro.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and purpose Computed tomography (CT) scanning is the basis for radiation treatment planning, but the 50-cm standard scanning field of view (sFOV) may be too small for imaging larger patients. We evaluated the 65-cm high-definition (HD) FOV of a large-bore CT scanner for CT number accuracy, geometric distortion, image quality degradation, and dosimetric accuracy of photon treatment plans. Materials and methods CT number accuracy was tested by placing two 16-cm acrylic phantoms on either side of a 40-cm phantom to simulate a large patient extending beyond the 50-cm-diameter standard scanning FOV. Dosimetric accuracy was tested using anthropomorphic pelvis and thorax phantoms, with additional acrylic body parts on either side of the phantoms. Two volumetric modulated arc therapy beams (a 15-MV and a 6-MV) were used to cover the planning target volumes. Two-dimensional dose distributions were evaluated with GAFChromic film and point dose accuracy was checked with multiple thermoluminescent dosimeter (TLD) capsules placed in the phantoms. Image quality was tested by placing an American College of Radiology accreditation phantom inside the 40-cm phantom. Results The HD FOV showed substantial changes in CT numbers, with differences of 314 HU–725 HU at different density levels. The volume of the body parts extending into the HD FOV was distorted. However, TLD-reported doses for all PTVs agreed within ±3%. Dose agreement in organs at risk were within the passing criteria, and the gamma index pass rate was >97%. Image quality was degraded. Conclusions The HD FOV option is adequate for RT simulation and met accreditation standards, although care should be taken during contouring because of reduced image quality.
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Affiliation(s)
- Richard Y. Wu
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Corresponding author at: Department of Radiation Physics, Box 94, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, United States.
| | - Tyler D. Williamson
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Narayan Sahoo
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Trang Nguyen
- Departments of Imaging and Radiation Oncology Core, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shane M. Ikner
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Amy Y. Liu
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Paul G. Wisdom
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - MingFu Lii
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Rachel A. Hunter
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Paola E. Alvarez
- Departments of Imaging and Radiation Oncology Core, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - G. Brandon Gunn
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Steven J. Frank
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Yoshifumi Hojo
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - X. Ronald Zhu
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael T. Gillin
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Ota S. [16. Commissioning of a Computed Tomography Simulator: A Single-institution Experience]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:413-422. [PMID: 32307369 DOI: 10.6009/jjrt.2020_jsrt_76.4.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Seiichi Ota
- Radiotherapy Unit, Division of Radiological Technology, University Hospital, Kyoto Prefectural University of Medicine
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Cheung JP, Shugard E, Mistry N, Pouliot J, Chen J. Evaluating the impact of extended field‐of‐view
CT
reconstructions on
CT
values and dosimetric accuracy for radiation therapy. Med Phys 2018; 46:892-901. [DOI: 10.1002/mp.13299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Joey P. Cheung
- Department of Radiation Oncology University of California San Francisco San Francisco CA 94143 USA
| | - Erin Shugard
- Department of Radiation Oncology University of California San Francisco San Francisco CA 94143 USA
| | | | - Jean Pouliot
- Department of Radiation Oncology University of California San Francisco San Francisco CA 94143 USA
| | - Josephine Chen
- Department of Radiation Oncology University of California San Francisco San Francisco CA 94143 USA
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Uppot RN. Technical challenges of imaging & image-guided interventions in obese patients. Br J Radiol 2018; 91:20170931. [PMID: 29869898 DOI: 10.1259/bjr.20170931] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Obese patients challenge imaging departments in their ability to obtain diagnostic quality images and to perform image-guided interventions. These technical challenges include properly accommodating large patients on imaging equipment, adjusting equipment settings to address imaging limitations, and pre-planning and preparation for image-guided interventions to insure safe and successful outcomes. Knowing and addressing these challenges can result in successfully addressing the imaging and image-guided interventions needs of obese patients.
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Affiliation(s)
- Raul N Uppot
- 1 Division of Interventional Radiology, Massachusetts General Hospital , Boston, MA , USA
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Davis AT, Palmer AL, Nisbet A. Can CT scan protocols used for radiotherapy treatment planning be adjusted to optimize image quality and patient dose? A systematic review. Br J Radiol 2017; 90:20160406. [PMID: 28452568 PMCID: PMC5603945 DOI: 10.1259/bjr.20160406] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 03/16/2017] [Accepted: 04/24/2017] [Indexed: 01/27/2023] Open
Abstract
This article reviews publications related to the use of CT scans for radiotherapy treatment planning, specifically the impact of scan protocol changes on CT number and treatment planning dosimetry and on CT image quality. A search on PubMed and EMBASE and a subsequent review of references yielded 53 relevant articles. CT scan parameters significantly affect image quality. Some will also affect Hounsfield unit (HU) values, though this is not comprehensively reported on. Changes in tube kilovoltage and, on some scanners, field of view and reconstruction algorithms have been found to produce notable HU changes. The degree of HU change which can be tolerated without changing planning dose by >1% depends on the body region and size, planning algorithms, treatment beam energy and type of plan. A change in soft-tissue HU value has a greater impact than changes in HU for bone and air. The use of anthropomorphic phantoms is recommended when assessing HU changes. There is limited published work on CT scan protocol optimization in radiotherapy. Publications suggest that HU tolerances of ±20 HU for soft tissue and of ±50 HU for the lung and bone would restrict dose changes in the treatment plan to <1%. Literature related to the use of CT images in radiotherapy planning has been reviewed to establish the acceptable level of HU change and the impact on image quality of scan protocol adjustment. Conclusions have been presented and further work identified.
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Affiliation(s)
- Anne T Davis
- Department of Physics, Faculty of Engineering and Physical Science, University of Surrey, Guildford, UK
- Department of Medical Physics, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Antony L Palmer
- Department of Physics, Faculty of Engineering and Physical Science, University of Surrey, Guildford, UK
- Department of Medical Physics, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Andrew Nisbet
- Department of Physics, Faculty of Engineering and Physical Science, University of Surrey, Guildford, UK
- Department of Medical Physics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
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