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Zhang YX, Huan FK, Wan B, Li ZH, Li W, Zhu GQ, Wang ZW, Chen H, Hou L, Jing H, Wang SL, Lu NN. Optical Surface-guided Radiation Therapy for Upper and Lower Limb Sarcomas: An Analysis of Setup Errors and Clinical Target Volume-To-Planning Target Volume Margins. Adv Radiat Oncol 2024; 9:101526. [PMID: 39026611 PMCID: PMC11255107 DOI: 10.1016/j.adro.2024.101526] [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: 07/19/2023] [Accepted: 04/19/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To assess the clinical benefits of surface-guided radiation therapy (SGRT) in terms of setup error, positioning time, and clinical target volume-to-planning target volume (CTV-PTV) margin in extremity soft tissue sarcoma (STS). Methods and Materials Fifty consecutive patients treated with radiation therapy were selected retrospectively. Treatment setup was performed with either laser-based imaging only (control group), or with laser-based and daily optical surface-based imaging (SGRT group). Pretreatment cone beam computed tomography images were acquired daily for the first 3 to 5 fractions and weekly thereafter, with the frequency adjusted as necessary. Translational and rotational errors were collected. CTV-PTV margin was calculated using the formula, 2.5Σ + 0.7σ. Results Each group consisted of 10 and 15 upper and lower limb STSs, respectively. For patients with upper limb sarcomas, the translation errors were 1.64 ± 1.34 mm, 1.10 ± 1.50 mm, and 1.24 ± 1.45 mm in the SGRT group, and 1.48 ± 3.16 mm, 2.84 ± 2.85 mm, and 3.14 ± 3.29 mm in control group in the left-right, supero-inferior, and antero-posterior directions, respectively. Correspondingly, for patients with lower limb sarcomas, the translation errors were 1.21 ± 1.65 mm, 1.39 ± 1.71 mm, and 1.48 ± 2.10 mm in the SGRT group, and 1.81 ± 2.60 mm, 2.93 ± 3.28 mm, and 3.53 ± 3.75 mm in control group, respectively. The calculated CTV-PTV margins of the SGRT group and control group were 5.0, 3.8, 4.1 versus 5.9, 9.1, 10.1 mm for upper limb sarcomas; and 4.2, 4.7, 5.2 mm versus 6.3, 9.6, and 11.4 mm for lower limb sarcomas in the left-right, supero-inferior, and antero-posterior directions, respectively. Conclusions Daily optical surface guidance can effectively improve the setup accuracy of extremity STS patients, and safely reduce the required CTV-PTV margins.
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Affiliation(s)
| | | | - Bao Wan
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zhao-Hui Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Wei Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Geng-Qiang Zhu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zhi-Wei Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Huan Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Lu Hou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Hao Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
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Saito T, Hayashi N, Amma H, Onishi K, Muraki Y, Nozue M. Development of a new coordinate calibration phantom for a light-section-based optical surface monitoring system. Radiol Phys Technol 2023; 16:366-372. [PMID: 37248443 DOI: 10.1007/s12194-023-00726-1] [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: 04/11/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023]
Abstract
A calibration phantom made of Derlin requires manual translational and rotational adjustments when calibrating a light-section-based optical surface monitoring system (VOXELAN) with a phantom material that insufficiently reflects the red-slit laser of the system. This study aimed to develop a new calibration phantom using different materials and to propose a procedure that minimizes setup errors. The new phantom, primarily made of PET100, which exhibits good reflectivity without scattering or attenuating the red-slit laser at the phantom surface, was shaped in a manner similar to that of previous designs. The detection accuracy and stability were evaluated using six different regions of interest (ROIs) and compared with previous phantom designs. The coordinate coincidence between the machine and VOXELAN was compared for both phantom designs. The detection accuracy and stability of the new phantom in the reference ROI setting were found to be better than those of previous phantoms. In the lateral, longitudinal, and vertical directions, the coordinate coincidences in translational directions for the previous phantom were obtained at 1.07 ± 0.66, 1.46 ± 0.47, and 0.26 ± 0.83 mm, whereas those for the new phantom were obtained at 0.28 ± 0.21, 0.18 ± 0.30, and - 0.30 ± 0.29 mm, respectively. The rotational errors of the two phantoms were identical. The new phantom exhibited improved detection stability because of its good reflectivity. Additionally, the new placement procedure was linked to the six-degrees-of-freedom couch. A combination of the new phantom and its new placement procedure is suitable for coordinate calibration of VOXELAN.
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Affiliation(s)
- Tatsunori Saito
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Naoki Hayashi
- School of Medical Sciences, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
| | - Hiroshi Amma
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Kazuki Onishi
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Yuta Muraki
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Masashi Nozue
- Department of Radiation Oncology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
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Bellala R, Kuppusamy A, Bellala VM, Tyagi T, Manoharan S, Gangarapu G, Bellala R. Review of clinical applications and challenges with surface-guided radiation therapy. J Cancer Res Ther 2023; 19:1160-1169. [PMID: 37787279 DOI: 10.4103/jcrt.jcrt_1147_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Aim To evaluate the use of this new technique, surface-guided radiotherapy (SGRT), for patient setup and motion management in various cancers. Materials and Methods Data was collected from 533 patients, who received treatment in our hospital for various malignancies using SGRT from October 2019 to April 2021. We studied patient setup, interfraction position, and patient position during the breath-hold (BH) technique. The main advantage of SGRT is that, it is completely non-invasive and uses visible light to compare the patient's skin surface in the treatment room and planned treatment position. In this analysis, Monaco 5.51.10 (Elekta) treatment planning system, Versa HD Linear Accelerator, and AlignRT 6.2 (Vision RT) SGRT system were used. Results With SGRT, treatment setup time can be reduced with more precision and techniques like Deep inspiration breathhold (DIBH) can be done with very good compliance. Conclusion SGRT has shown improved accuracy in patient setup compared to conventional laser setup. The daily kilo voltage imaging frequency can be reduced; it helps in reducing additional radiation exposure due to imaging. SGRT has demonstrated reproducibility with adequate accuracy in BH treatments in DIBH for breast and SBRT.
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Affiliation(s)
- Ravishankar Bellala
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
| | - Anandakrishnan Kuppusamy
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
| | - Venkat Madhavi Bellala
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
| | - Tulika Tyagi
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
| | - Surendhiran Manoharan
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
| | - Gunasekhar Gangarapu
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
| | - Rishik Bellala
- Department of Radiation Oncology, Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh, India
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Chow VUY, Cheung MLM, Kan MWK, Chan ATC. Shift detection discrepancy between ExacTrac Dynamic system and cone‐beam computed tomography. J Appl Clin Med Phys 2022; 23:e13567. [PMID: 35188333 PMCID: PMC9121052 DOI: 10.1002/acm2.13567] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/12/2022] [Accepted: 02/03/2022] [Indexed: 02/01/2023] Open
Abstract
Accurate detection of patient shift is essential during radiation therapy such that optimal dose is delivered to the tumor while minimizing radiation to surrounding normal tissues. The shift detectability of a newly developed optical surface and thermal tracking system, which was known as ExacTrac Dynamic (EXTD), was evaluated by comparing its performance with the image guidance under cone‐beam computed tomography (CBCT). Anthropomorphic cranial and pelvis phantoms with internal bone‐like structures and external heat pad were utilized to study the shift detection discrepancy between EXTD system and CBCT. Random displacements within the range of ± 2 cm for translations and ± 2 degrees for rotations were intentionally applied to the phantom. Positional shifts detected by optical surface and thermal tracking (EXTD_Thml), stereoscopic X‐ray (EXTD_Xray), and CBCT were compared in 6 degrees of freedom. The translational difference between EXTD_Thml and CBCT was 0.57 ± 0.41 mm and 0.66 ± 0.40 mm for cranial and pelvis phantom, respectively, while it was 0.60 ± 0.43 mm and 0.76 ± 0.49 mm between EXTD_Xray and CBCT, respectively. For rotational movement, the difference between EXTD_Thml and CBCT was 0.19 ± 0.16° and 0.19 ± 0.22° for cranial and pelvis phantom, respectively, while it was 0.13 ± 0.18° and 0.65 ± 0.46° between EXTD_Xray and CBCT, respectively. This study demonstrated that the EXTD system with thermal mapping ability could offer comparable accuracy for shift detection with CBCT on both cranial and pelvis phantoms.
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Affiliation(s)
- Vivian U. Y. Chow
- Department of Clinical Oncology Prince of Wales Hospital Hong Kong SAR China
| | | | - Monica W. K. Kan
- Department of Clinical Oncology Prince of Wales Hospital Hong Kong SAR China
- Department of Clinical Oncology The Chinese University of Hong Kong Hong Kong SAR China
| | - Anthony T. C. Chan
- Department of Clinical Oncology Prince of Wales Hospital Hong Kong SAR China
- Department of Clinical Oncology The Chinese University of Hong Kong Hong Kong SAR China
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Al-Hallaq HA, Cerviño L, Gutierrez AN, Havnen-Smith A, Higgins SA, Kügele M, Padilla L, Pawlicki T, Remmes N, Smith K, Tang X, Tomé WA. AAPM task group report 302: Surface guided radiotherapy. Med Phys 2022; 49:e82-e112. [PMID: 35179229 PMCID: PMC9314008 DOI: 10.1002/mp.15532] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/26/2021] [Accepted: 02/05/2022] [Indexed: 11/06/2022] Open
Abstract
The clinical use of surface imaging has increased dramatically with demonstrated utility for initial patient positioning, real-time motion monitoring, and beam gating in a variety of anatomical sites. The Therapy Physics Subcommittee and the Imaging for Treatment Verification Working Group of the American Association of Physicists in Medicine commissioned Task Group 302 to review the current clinical uses of surface imaging and emerging clinical applications. The specific charge of this task group was to provide technical guidelines for clinical indications of use for general positioning, breast deep-inspiration breath-hold (DIBH) treatment, and frameless stereotactic radiosurgery (SRS). Additionally, the task group was charged with providing commissioning and on-going quality assurance (QA) requirements for surface guided radiation therapy (SGRT) as part of a comprehensive QA program including risk assessment. Workflow considerations for other anatomic sites and for computed tomography (CT) simulation, including motion management are also discussed. Finally, developing clinical applications such as stereotactic body radiotherapy (SBRT) or proton radiotherapy are presented. The recommendations made in this report, which are summarized at the end of the report, are applicable to all video-based SGRT systems available at the time of writing. Review current use of non-ionizing surface imaging functionality and commercially available systems. Summarize commissioning and on-going quality assurance (QA) requirements of surface image-guided systems, including implementation of risk or hazard assessment of surface guided radiotherapy as a part of a total quality management program (e.g., TG-100). Provide clinically relevant technical guidelines that include recommendations for the use of SGRT for general patient positioning, breast DIBH, and frameless brain SRS, including potential pitfalls to avoid when implementing this technology. Discuss emerging clinical applications of SGRT and associated QA implications based on evaluation of technology and risk assessment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hania A Al-Hallaq
- Department of Radiation & Cellular Oncology, University of Chicago, Chicago, IL, 60637, USA
| | - Laura Cerviño
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Alonso N Gutierrez
- Department of Radiation Oncology, Miami Cancer Institute, Miami, FL, 33173, USA
| | | | - Susan A Higgins
- Department of Therapeutic Radiology, Yale University, New Haven, CT, 06520, USA
| | - Malin Kügele
- Department of Hematology, Oncology and Radiation Physics, Skåne University, Lund, 221 00, Sweden.,Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, 221 00, Sweden
| | - Laura Padilla
- Department of Radiation Medicine & Applied Sciences, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Todd Pawlicki
- Department of Radiation Medicine & Applied Sciences, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Nicholas Remmes
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Koren Smith
- IROC Rhode Island, University of Massachusetts Chan Medical School, Lincoln, RI, 02865, USA
| | | | - Wolfgang A Tomé
- Department of Radiation Oncology and Department of Neurology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, 10461, USA
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Freislederer P, Kügele M, Öllers M, Swinnen A, Sauer TO, Bert C, Giantsoudi D, Corradini S, Batista V. Recent advanced in Surface Guided Radiation Therapy. Radiat Oncol 2020; 15:187. [PMID: 32736570 PMCID: PMC7393906 DOI: 10.1186/s13014-020-01629-w] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 01/27/2023] Open
Abstract
The growing acceptance and recognition of Surface Guided Radiation Therapy (SGRT) as a promising imaging technique has supported its recent spread in a large number of radiation oncology facilities. Although this technology is not new, many aspects of it have only recently been exploited. This review focuses on the latest SGRT developments, both in the field of general clinical applications and special techniques.SGRT has a wide range of applications, including patient positioning with real-time feedback, patient monitoring throughout the treatment fraction, and motion management (as beam-gating in free-breathing or deep-inspiration breath-hold). Special radiotherapy modalities such as accelerated partial breast irradiation, particle radiotherapy, and pediatrics are the most recent SGRT developments.The fact that SGRT is nowadays used at various body sites has resulted in the need to adapt SGRT workflows to each body site. Current SGRT applications range from traditional breast irradiation, to thoracic, abdominal, or pelvic tumor sites, and include intracranial localizations.Following the latest SGRT applications and their specifications/requirements, a stricter quality assurance program needs to be ensured. Recent publications highlight the need to adapt quality assurance to the radiotherapy equipment type, SGRT technology, anatomic treatment sites, and clinical workflows, which results in a complex and extensive set of tests.Moreover, this review gives an outlook on the leading research trends. In particular, the potential to use deformable surfaces as motion surrogates, to use SGRT to detect anatomical variations along the treatment course, and to help in the establishment of personalized patient treatment (optimized margins and motion management strategies) are increasingly important research topics. SGRT is also emerging in the field of patient safety and integrates measures to reduce common radiotherapeutic risk events (e.g. facial and treatment accessories recognition).This review covers the latest clinical practices of SGRT and provides an outlook on potential applications of this imaging technique. It is intended to provide guidance for new users during the implementation, while triggering experienced users to further explore SGRT applications.
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Affiliation(s)
- P. Freislederer
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - M. Kügele
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
- Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - M. Öllers
- Maastricht Radiation Oncology (MAASTRO), Maastricht, the Netherlands
| | - A. Swinnen
- Maastricht Radiation Oncology (MAASTRO), Maastricht, the Netherlands
| | - T.-O. Sauer
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - C. Bert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - D. Giantsoudi
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - S. Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - V. Batista
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
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Development of MRI Projection Mapping System for Breast-Conserving Surgery in the Operating Room: Preliminary Clinical Results in Invasive Breast Cancer. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5314120. [PMID: 32685501 PMCID: PMC7341375 DOI: 10.1155/2020/5314120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 12/19/2022]
Abstract
Aim To evaluate the feasibility of a newly developed prototype MRI projection mapping (PM) system for localization of invasive breast cancer before breast-conserving surgery. Methods This prospective study enrolled 10 women with invasive breast cancer. MRI was performed in both prone and supine positions. The tumor location was drawn on the breast skin using palpation and sonography while referring to the prone MRI (i.e., a conventional method). A maximum intensity projection image generated from the supine MRI was projected using our PM system, and the tumor location was drawn. The PM system consisted of a projector and a camera and was used to measure the shape of the breast surface using the structured light method. Breast-conserving surgery was performed based on the conventional method. We compared the tumor size and location between the PM and conventional methods or pathology. Results There were no significant differences in the maximum diameters of invasive cancers between the PM system and the conventional method or pathology. The maximum discrepancy in tumor location between the PM and conventional method was 3–8 mm. Conclusions This PM system may support breast-conserving surgery by showing the tumor size and location on the breast surface.
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Lin Q, Cai K, Yang R, Xiao W, Huang J, Zhan Y, Zhuang J. Geometric calibration of markerless optical surgical navigation system. Int J Med Robot 2019; 15:e1978. [PMID: 30556944 DOI: 10.1002/rcs.1978] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patient-to-image registration is required for image-guided surgical navigation, but marker-based registration is time consuming and is subject to manual error. Markerless registration is an alternative solution to avoid these issues. METHODS This study designs a calibration board and proposes a geometric calibration method to calibrate the near-infrared tracking and structured light components of the proposed optical surgical navigation system simultaneously. RESULTS A planar board and a cylinder are used to evaluate the accuracy of calibration. The mean error for the board experiment is 0.035 mm, and the diameter error for the cylinder experiment is 0.119 mm. A calibration board is reconstructed to evaluate the accuracy of the calibration, and the measured mean error is 0.012 mm. A head phantom is reconstructed and tracked by the proposed optical surgical navigation system. The tracking error is less than 0.3 mm. CONCLUSIONS Experimental results show that the proposed method obtains high accessibility and accuracy and satisfies application requirements.
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Affiliation(s)
- Qinyong Lin
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Ken Cai
- School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,College of Automation, Zhongkai University of Agriculture and Engineering, Guangzhou, China
| | - Rongqian Yang
- Department of Biomedical Engineering, South China University of Technology, Guangzhou, China.,School of Medicine, Yale University, New Haven, Connecticut.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Weihu Xiao
- Department of Biomedical Engineering, South China University of Technology, Guangzhou, China
| | - Jinhua Huang
- Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yinwei Zhan
- School of Computer Science and Technology, Guangdong University of Technology, Guangzhou, China
| | - Jian Zhuang
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, China
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Jöhl A, Bogowicz M, Ehrbar S, Guckenberger M, Klöck S, Meboldt M, Riesterer O, Zeilinger M, Schmid Daners M, Tanadini-Lang S. Body motion during dynamic couch tracking with healthy volunteers. Phys Med Biol 2018; 64:015001. [PMID: 30523943 DOI: 10.1088/1361-6560/aaf361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In precision radiotherapy, the intrafractional motion can cause a considerable uncertainty of the location of the tumor to be treated. An established approach is the expansion of the target volume to account for the motion. An alternative approach is couch-tracking, in which the patient is continually moved to compensate the intrafractional motion. However, couch-tracking itself might induce uncertainty of the patient's body position, because the body is non-rigid. One hundred healthy volunteers were positioned supine on a robotic couch. Optical markers were placed on the torso of the volunteers as well as on the couch, and their positions were tracked with an optical surface measurement system. Using these markers, the uncertainty of the body position relative to the couch position was estimated while the couch was static or moving. Over the included 83 healthy volunteers, the median of the uncertainty increased by 0.8 mm (SI), 0.4 mm (LR) and 0.4 mm (AP) when the couch moved. Couch motion was found to increase the uncertainty of the body position relative to the couch. However, this uncertainty is one order of magnitude smaller than the intrafractional tumor motion amplitudes to be compensated. Therefore, even with body motion present, the couch-tracking approach is a viable option. The study was registered at ClinicalTrials.gov (NCT02820532) and the Swiss national clinical trials portal (SNCTP000001878).
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Affiliation(s)
- Alexander Jöhl
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, Zurich 8092, Switzerland. Department of Radiation Oncology, University Hospital Zurich, Zurich 8091, Switzerland
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Hoisak JD, Pawlicki T. The Role of Optical Surface Imaging Systems in Radiation Therapy. Semin Radiat Oncol 2018; 28:185-193. [DOI: 10.1016/j.semradonc.2018.02.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Belcher AH, Liu X, Grelewicz Z, Wiersma RD. Spatial and rotational quality assurance of 6DOF patient tracking systems. Med Phys 2017; 43:2785-2793. [PMID: 27277026 DOI: 10.1118/1.4948506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE External tracking systems used for patient positioning and motion monitoring during radiotherapy are now capable of detecting both translations and rotations. In this work, the authors develop a novel technique to evaluate the 6 degree of freedom 6(DOF) (translations and rotations) performance of external motion tracking systems. The authors apply this methodology to an infrared marker tracking system and two 3D optical surface mapping systems in a common tumor 6DOF workspace. METHODS An in-house designed and built 6DOF parallel kinematics robotic motion phantom was used to perform motions with sub-millimeter and subdegree accuracy in a 6DOF workspace. An infrared marker tracking system was first used to validate a calibration algorithm which associates the motion phantom coordinate frame to the camera frame. The 6DOF positions of the mobile robotic system in this space were then tracked and recorded independently by an optical surface tracking system after a cranial phantom was rigidly fixed to the moveable platform of the robotic stage. The calibration methodology was first employed, followed by a comprehensive 6DOF trajectory evaluation, which spanned a full range of positions and orientations in a 20 × 20 × 16 mm and 5° × 5° × 5° workspace. The intended input motions were compared to the calibrated 6DOF measured points. RESULTS The technique found the accuracy of the infrared (IR) marker tracking system to have maximal root-mean square error (RMSE) values of 0.18, 0.25, 0.07 mm, 0.05°, 0.05°, and 0.09° in left-right (LR), superior-inferior (SI), anterior-posterior (AP), pitch, roll, and yaw, respectively, comparing the intended 6DOF position and the measured position by the IR camera. Similarly, the 6DOF RSME discrepancy for the HD optical surface tracker yielded maximal values of 0.46, 0.60, 0.54 mm, 0.06°, 0.11°, and 0.08° in LR, SI, AP, pitch, roll, and yaw, respectively, over the same 6DOF evaluative workspace. An earlier generation 3D optical surface tracking unit was observed to have worse tracking capabilities than both the IR camera unit and the newer 3D surface tracking system with maximal RMSE of 0.69, 0.74, 0.47 mm, 0.28°, 0.19°, and 0.18°, in LR, SI, AP, pitch, roll, and yaw, respectively, in the same 6DOF evaluation space. CONCLUSIONS The proposed technique was found to be effective at evaluating the performance of 6DOF patient tracking systems. All observed optical tracking systems were found to exhibit tracking capabilities at the sub-millimeter and subdegree level within a 6DOF workspace.
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Affiliation(s)
- Andrew H Belcher
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637-1470
| | - Xinmin Liu
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637-1470
| | - Zachary Grelewicz
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637-1470
| | - Rodney D Wiersma
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637-1470
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Wasza J, Fischer P, Leutheuser H, Oefner T, Bert C, Maier A, Hornegger J. Real-Time Respiratory Motion Analysis Using 4-D Shape Priors. IEEE Trans Biomed Eng 2016; 63:485-95. [DOI: 10.1109/tbme.2015.2463769] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lang S, Zeimetz J, Ochsner G, Schmid Daners M, Riesterer O, Klöck S. Development and evaluation of a prototype tracking system using the treatment couch. Med Phys 2014; 41:021720. [DOI: 10.1118/1.4862077] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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