Abstract
Retrospective kV x-ray 4DCT treatment planning for lung cancer MV linac treatment is becoming a standard-of-care for this widely used procedure for the largest cancer cause-of-death in the US. It currently provides the best estimate of a fixed-in-time but undulating and closed 3D shell to which a minimum curative-intent radiation dose should be delivered to provide the best estimated patient survival and the least morbidity, usually characterized by quantitative dose-volume-histograms (DVHs). Unfortunately this closed shell volume or internal target volume (ITV) currently has to be increased enough to enclose the full range of respiratory lesion motion (plus set-up etc. uncertainties) which cannot yet be accurately determined in real time during treatment delivery. With accurate motion-tracking, the planning target volume (PTV) or outer "shell" may be reduced by up to 40%. However there is no single 2D plane that precisely follows the reduced-PTV-volume's 3D respiratory motion, currently best estimated by the retrospective hand contouring by a trained and experienced MD radiation oncology MD using the full 3D-time information of 4DCT. Once available, 3D motion tracking in real time has the potential to substantially decrease DVH doses to surrounding organs-at-risk (OARs), while maintaining or raising the curative-intent dose to the lesion itself. The assertion argued here is that, the 3D volume-rendered imaging of lung cancer lesion-trajectories in real-time from TumoTrak digital x-ray tomosythesis, has the potential to provide more accurate 3D motion tracking and improved dose delivery at lower cost than the real time, 2D single slice imaging of MRI-guided radiotherapy.
| Original language | English (US) |
|---|---|
| Title of host publication | Medical Imaging 2019 |
| Subtitle of host publication | Physics of Medical Imaging |
| Editors | Hilde Bosmans, Guang-Hong Chen, Taly Gilat Schmidt |
| Publisher | SPIE |
| ISBN (Electronic) | 9781510625433 |
| DOIs | |
| State | Published - Jan 1 2019 |
| Event | Medical Imaging 2019: Physics of Medical Imaging - San Diego, United States Duration: Feb 17 2019 → Feb 20 2019 |
Publication series
| Name | Progress in Biomedical Optics and Imaging - Proceedings of SPIE |
|---|---|
| Volume | 10948 |
| ISSN (Print) | 1605-7422 |
Conference
| Conference | Medical Imaging 2019: Physics of Medical Imaging |
|---|---|
| Country | United States |
| City | San Diego |
| Period | 2/17/19 → 2/20/19 |
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Keywords
- Digital tomosynthesis
- Image guidance
- Kilovoltage x-ray
- Lung radiotherapy
- MRI
- Real-time
ASJC Scopus subject areas
- Electronic, Optical and Magnetic Materials
- Atomic and Molecular Physics, and Optics
- Biomaterials
- Radiology Nuclear Medicine and imaging
Cite this
Comparisons of 6 fps volume-rendered x-ray digital tomosynthesis TumoTrak-guided to 2D-MRI-guided radiotherapy of lung cancer. / Partain, Larry; Benedict, Stanley; Kim, Namho; Daly, Megan; Ely, Austin; Hernandez, Andrew; Song, Samuel; Weil, Micheal; Ziskin, Vitaliy; Foletta, Kyle; Boone, John; Boyd, Douglas.
Medical Imaging 2019: Physics of Medical Imaging. ed. / Hilde Bosmans; Guang-Hong Chen; Taly Gilat Schmidt. SPIE, 2019. 109483L (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 10948).Research output: Chapter in Book/Report/Conference proceeding › Conference contribution
}
TY - GEN
T1 - Comparisons of 6 fps volume-rendered x-ray digital tomosynthesis TumoTrak-guided to 2D-MRI-guided radiotherapy of lung cancer
AU - Partain, Larry
AU - Benedict, Stanley
AU - Kim, Namho
AU - Daly, Megan
AU - Ely, Austin
AU - Hernandez, Andrew
AU - Song, Samuel
AU - Weil, Micheal
AU - Ziskin, Vitaliy
AU - Foletta, Kyle
AU - Boone, John
AU - Boyd, Douglas
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Retrospective kV x-ray 4DCT treatment planning for lung cancer MV linac treatment is becoming a standard-of-care for this widely used procedure for the largest cancer cause-of-death in the US. It currently provides the best estimate of a fixed-in-time but undulating and closed 3D shell to which a minimum curative-intent radiation dose should be delivered to provide the best estimated patient survival and the least morbidity, usually characterized by quantitative dose-volume-histograms (DVHs). Unfortunately this closed shell volume or internal target volume (ITV) currently has to be increased enough to enclose the full range of respiratory lesion motion (plus set-up etc. uncertainties) which cannot yet be accurately determined in real time during treatment delivery. With accurate motion-tracking, the planning target volume (PTV) or outer "shell" may be reduced by up to 40%. However there is no single 2D plane that precisely follows the reduced-PTV-volume's 3D respiratory motion, currently best estimated by the retrospective hand contouring by a trained and experienced MD radiation oncology MD using the full 3D-time information of 4DCT. Once available, 3D motion tracking in real time has the potential to substantially decrease DVH doses to surrounding organs-at-risk (OARs), while maintaining or raising the curative-intent dose to the lesion itself. The assertion argued here is that, the 3D volume-rendered imaging of lung cancer lesion-trajectories in real-time from TumoTrak digital x-ray tomosythesis, has the potential to provide more accurate 3D motion tracking and improved dose delivery at lower cost than the real time, 2D single slice imaging of MRI-guided radiotherapy.
AB - Retrospective kV x-ray 4DCT treatment planning for lung cancer MV linac treatment is becoming a standard-of-care for this widely used procedure for the largest cancer cause-of-death in the US. It currently provides the best estimate of a fixed-in-time but undulating and closed 3D shell to which a minimum curative-intent radiation dose should be delivered to provide the best estimated patient survival and the least morbidity, usually characterized by quantitative dose-volume-histograms (DVHs). Unfortunately this closed shell volume or internal target volume (ITV) currently has to be increased enough to enclose the full range of respiratory lesion motion (plus set-up etc. uncertainties) which cannot yet be accurately determined in real time during treatment delivery. With accurate motion-tracking, the planning target volume (PTV) or outer "shell" may be reduced by up to 40%. However there is no single 2D plane that precisely follows the reduced-PTV-volume's 3D respiratory motion, currently best estimated by the retrospective hand contouring by a trained and experienced MD radiation oncology MD using the full 3D-time information of 4DCT. Once available, 3D motion tracking in real time has the potential to substantially decrease DVH doses to surrounding organs-at-risk (OARs), while maintaining or raising the curative-intent dose to the lesion itself. The assertion argued here is that, the 3D volume-rendered imaging of lung cancer lesion-trajectories in real-time from TumoTrak digital x-ray tomosythesis, has the potential to provide more accurate 3D motion tracking and improved dose delivery at lower cost than the real time, 2D single slice imaging of MRI-guided radiotherapy.
KW - Digital tomosynthesis
KW - Image guidance
KW - Kilovoltage x-ray
KW - Lung radiotherapy
KW - MRI
KW - Real-time
UR - http://www.scopus.com/inward/record.url?scp=85068373748&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068373748&partnerID=8YFLogxK
U2 - 10.1117/12.2511993
DO - 10.1117/12.2511993
M3 - Conference contribution
AN - SCOPUS:85068373748
T3 - Progress in Biomedical Optics and Imaging - Proceedings of SPIE
BT - Medical Imaging 2019
A2 - Bosmans, Hilde
A2 - Chen, Guang-Hong
A2 - Schmidt, Taly Gilat
PB - SPIE
ER -