Tumor tracking based on correlation models in scanned ion beam therapy: an experimental study

Accurate dose delivery to extra-cranial lesions requires tumor motion compensation. An effective compensation can be achieved by real-time tracking of the target position, either measured in fluoroscopy or estimated through correlation models as a function of external surrogate motion. In this work, we integrated two internal/external correlation models (a state space model and an artificial neural network-based model) into a custom infra-red optical tracking system (OTS). Dedicated experiments were designed and conducted at GSI (Helmholtzzentrum für Schwerionenforschung). A robotic breathing phantom was used to reproduce regular and irregular internal target motion as well as external thorax motion. The position of a set of markers placed on the phantom thorax was measured with the OTS and used by the correlation models to infer the internal target position in real-time. Finally, the estimated target position was provided as input for the dynamic steering of a carbon ion beam. Geometric results showed that the correlation models transversal (2D) targeting error was always lower than 1.3 mm (root mean square). A significant decrease of the dosimetric error with respect to the uncompensated irradiation was achieved in four out of six experiments, demonstrating that phase shifts are the most critical irregularity for external/internal correlation models.

[1]  G Baroni,et al.  Robustness of external/internal correlation models for real-time tumor tracking to breathing motion variations , 2012, Physics in medicine and biology.

[2]  Marco Durante,et al.  Speed and accuracy of a beam tracking system for treatment of moving targets with scanned ion beams , 2009, Physics in medicine and biology.

[3]  Shinichiro Mori,et al.  Effects of intrafractional motion on water equivalent pathlength in respiratory-gated heavy charged particle beam radiotherapy. , 2007, International journal of radiation oncology, biology, physics.

[4]  Martin J Murphy,et al.  Optimization of an adaptive neural network to predict breathing. , 2008, Medical physics.

[5]  P J Keall,et al.  Accuracy in the localization of thoracic and abdominal tumors using respiratory displacement, velocity, and phase. , 2009, Medical physics.

[6]  J. Adler,et al.  Robotic Motion Compensation for Respiratory Movement during Radiosurgery , 2000, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[7]  C. Maurer,et al.  The CyberKnife® Robotic Radiosurgery System in 2010 , 2010, Technology in cancer research & treatment.

[8]  Marco Durante,et al.  Charged particles in radiation oncology , 2010, Nature Reviews Clinical Oncology.

[9]  Christoph Bert,et al.  4D treatment planning for scanned ion beams , 2007, Radiation oncology.

[10]  D. Schardt,et al.  Out-of-field dose measurements in a water phantom using different radiotherapy modalities , 2012, Physics in medicine and biology.

[11]  C Bert,et al.  Motion in radiotherapy: particle therapy , 2011, Physics in medicine and biology.

[12]  G. Ferrigno,et al.  Implementation and application of real-time motion analysis based on passive markers , 1998, Medical and Biological Engineering and Computing.

[13]  G. Kraft,et al.  Tumor therapy with heavy charged particles , 2000 .

[14]  Danny Y Song,et al.  Respiratory motion changes of lung tumors over the course of radiation therapy based on respiration-correlated four-dimensional computed tomography scans. , 2009, International journal of radiation oncology, biology, physics.

[15]  M. Hoogeman,et al.  Clinical accuracy of the respiratory tumor tracking system of the cyberknife: assessment by analysis of log files. , 2009, International journal of radiation oncology, biology, physics.

[16]  C Bert,et al.  A breathing thorax phantom with independently programmable 6D tumour motion for dosimetric measurements in radiation therapy , 2012, Physics in medicine and biology.

[17]  K. Langen,et al.  Organ motion and its management. , 2001, International journal of radiation oncology, biology, physics.

[18]  Cristina Garibaldi,et al.  Integration of Enhanced Optical Tracking Techniques and Imaging in IGRT. , 2007, Journal of radiation research.

[19]  Shinichi Shimizu,et al.  Real-time tumour-tracking radiotherapy , 1999, The Lancet.

[20]  M. V. van Herk,et al.  Physical aspects of a real-time tumor-tracking system for gated radiotherapy. , 2000, International journal of radiation oncology, biology, physics.

[21]  Christoph Bert,et al.  Motion compensation with a scanned ion beam: a technical feasibility study , 2008, Radiation Oncology.

[22]  Pietro Cerveri,et al.  TU‐A‐BRA‐08: Integration of Optical Tracking for Organ Motion Compensation in Scanned Ion‐Beam Therapy , 2012 .

[23]  H. Shirato,et al.  Exhale fluctuation in respiratory-gated radiotherapy of the lung: a pitfall of respiratory gating shown in a synchronized internal/external marker recording study. , 2008, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[24]  Marco Riboldi,et al.  Real-time tumour tracking in particle therapy: technological developments and future perspectives. , 2012, The Lancet. Oncology.

[25]  David Sarrut,et al.  Multi-dimensional respiratory motion tracking from markerless optical surface imaging based on deformable mesh registration , 2012, Physics in medicine and biology.

[26]  D. Schardt,et al.  Magnetic scanning system for heavy ion therapy , 1993 .

[27]  Shinichiro Mori,et al.  Quantitative assessment of range fluctuations in charged particle lung irradiation. , 2008, International journal of radiation oncology, biology, physics.

[28]  M. V. van Herk,et al.  Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy. , 2002, International journal of radiation oncology, biology, physics.

[29]  Marco Riboldi,et al.  Targeting Accuracy in Real-time Tumor Tracking via External Surrogates: A Comparative Study , 2010, Technology in cancer research & treatment.

[30]  O Jäkel,et al.  Upgrade and benchmarking of a 4D treatment planning system for scanned ion beam therapy. , 2013, Medical physics.

[31]  Hans Blattmann,et al.  Tumor therapy with heavy charged particles , 2008 .

[32]  H Shirato,et al.  Detection of lung tumor movement in real-time tumor-tracking radiotherapy. , 2001, International journal of radiation oncology, biology, physics.

[33]  H Shirato,et al.  Inference of hysteretic respiratory tumor motion from external surrogates: a state augmentation approach , 2008, Physics in medicine and biology.

[34]  Steve B. Jiang,et al.  The management of respiratory motion in radiation oncology report of AAPM Task Group 76. , 2006, Medical physics.

[35]  Steve B. Jiang,et al.  The management of respiratory motion in radiation oncology report of AAPM Task Group 76. , 2006, Medical physics.

[36]  Alexander Schlaefer,et al.  Correlation between external and internal respiratory motion: a validation study , 2011, International Journal of Computer Assisted Radiology and Surgery.

[37]  Hiroki Shirato,et al.  Feasibility of synchronization of real-time tumor-tracking radiotherapy and intensity-modulated radiotherapy from viewpoint of excessive dose from fluoroscopy. , 2004, International journal of radiation oncology, biology, physics.

[38]  G Baroni,et al.  Enhanced Surface Registration Techniques for Patient Positioning Control in Breast Cancer Radiotherapy , 2004, Technology in cancer research & treatment.

[39]  C. Ling,et al.  Evaluation of respiratory movement during gated radiotherapy using film and electronic portal imaging. , 2002, International journal of radiation oncology, biology, physics.

[40]  R. Mohan,et al.  Motion adaptive x-ray therapy: a feasibility study , 2001, Physics in medicine and biology.

[41]  O Jäkel,et al.  A system for three-dimensional dosimetric verification of treatment plans in intensity-modulated radiotherapy with heavy ions. , 1999, Medical physics.

[42]  M. Langer,et al.  Site-specific volumetric analysis of lung tumour motion , 2010, Physics in medicine and biology.

[43]  Gregory C Sharp,et al.  Prediction of respiratory tumour motion for real-time image-guided radiotherapy. , 2004, Physics in medicine and biology.

[44]  Marco Durante,et al.  Dosimetric precision of an ion beam tracking system , 2010, Radiation oncology.