Digital tomosynthesis for respiratory gated liver treatment: clinical feasibility for daily image guidance.

International Journal of Radiation Oncology, Biology, Physics
Q Jackie WuFang-Fang Yin

Abstract

Breath-hold (BH) treatment minimizes internal target volumes (ITV) when treating sites prone to motion. Digital tomosynthesis (DTS) imaging has advantages over cone-beam CT (CBCT) for BH imaging: BH-DTS scan can be completed during a single breath-hold, whereas BH-CBCT is usually acquired by parsing the gantry rotation into multiple BH segments. This study evaluates the localization accuracy of DTS for BH treatment of liver tumors. Both planning CT and on-board DTS/CBCT images were acquired under BH, using the planning CT BH window as reference. Onboard imaging data sets included two independent DTS orientations (coronal and sagittal), and CBCT images. Soft tissue target positioning was measured by each imaging modality and translated into couch shifts. Performance of the two DTS orientations was evaluated by comparing target positioning with the CBCT benchmark, determined by two observers. Image data sets were collected from thirty-eight treatment fractions (14 patients). Mean differences between the two DTS methods and the CBCT method were <1 mm in all directions (except the lateral direction with sagittal-DTS: 1.2 mm); the standard deviation was in the range of 2.1-3.5 mm for all techniques. The Pearson correlation showed go...Continue Reading

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