Development of a markerless tumor-tracking algorithm using prior four-dimensional cone-beam computed tomography

Abstract Respiratory motion management is a huge challenge in radiation therapy. Respiratory motion induces temporal anatomic changes that distort the tumor volume and its position. In this study, a markerless tumor-tracking algorithm was investigated by performing phase recognition during stereotactic body radiation therapy (SBRT) using four-dimensional cone-beam computer tomography (4D-CBCT) obtained at patient registration, and in-treatment cone-beam projection images. The data for 20 treatment sessions (five lung cancer patients) were selected for this study. Three of the patients were treated with conventional flattening filter (FF) beams, and the other two were treated with flattening filter-free (FFF) beams. Prior to treatment, 4D-CBCT was acquired to create the template projection images for 10 phases. In-treatment images were obtained at near real time during treatment. Template-based phase recognition was performed for 4D-CBCT re-projected templates using prior 4D-CBCT based phase recognition algorithm and was compared with the results generated by the Amsterdam Shroud (AS) technique. Visual verification technique was used for the verification of the phase recognition and AS technique at certain tumor-visible angles. Offline template matching analysis using the cross-correlation indicated that phase recognition performed using the prior 4D-CBCT and visual verification matched up to 97.5% in the case of FFF, and 95% in the case of FF, whereas the AS technique matched 83.5% with visual verification for FFF and 93% for FF. Markerless tumor tracking based on phase recognition using prior 4D-CBCT has been developed successfully. This is the first study that reports on the use of prior 4D-CBCT based on normalized cross-correlation technique for phase recognition.

[1]  Kazuyuki Demachi,et al.  Dynamic Image Prediction Using Principal Component and Multi-Channel Singular Spectral Analysis: A Feasibility Study , 2015 .

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

[3]  M. V. van Herk,et al.  Respiratory correlated cone beam CT. , 2005, Medical physics.

[4]  Michael Schwarz,et al.  Real-time markerless lung tumor tracking in fluoroscopic video: Handling overlapping of projected structures. , 2015, Medical physics.

[5]  Makoto Yoshizawa,et al.  A kernel-based method for markerless tumor tracking in kV fluoroscopic images , 2014, Physics in medicine and biology.

[6]  Jan-Jakob Sonke,et al.  Mid-ventilation CT scan construction from four-dimensional respiration-correlated CT scans for radiotherapy planning of lung cancer patients. , 2006, International journal of radiation oncology, biology, physics.

[7]  Toshikazu Imae,et al.  Volumetric modulated arc therapy for lung stereotactic radiation therapy can achieve high local control rates , 2014, Radiation oncology.

[8]  Hideomi Yamashita,et al.  Others: Four-dimensional Cone-Beam CT During SBRT , 2015 .

[9]  Steve B. Jiang,et al.  Technical aspects of image-guided respiration-gated radiation therapy. , 2006, Medical dosimetry : official journal of the American Association of Medical Dosimetrists.

[10]  Y. Raghavender Rao,et al.  APPLICATION OF NORMALIZED CROSS CORRELATION TO IMAGE REGISTRATION , 2014 .

[11]  Wolfgang Birkfellner,et al.  Real-time 2D/3D registration using kV-MV image pairs for tumor motion tracking in image guided radiotherapy , 2013, Acta oncologica.

[12]  Jing Wang,et al.  Clinical Investigation : Thoracic Cancer A Novel Markerless Technique to Evaluate Daily Lung Tumor Motion Based on Conventional Cone-Beam CT Projection Data , 2012 .

[13]  Toshikazu Imae,et al.  In-treatment 4D cone-beam CT with image-based respiratory phase recognition , 2012, Radiological Physics and Technology.

[14]  H. Liberman,et al.  Use of cross-correlation function to detect patient motion during SPECT imaging. , 1987, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  Yasushi Nagata.  Stereotactic Body Radiation Therapy , 2015 .

[16]  Hideomi Yamashita,et al.  4D registration and 4D verification of lung tumor position for stereotactic volumetric modulated arc therapy using respiratory-correlated cone-beam CT , 2012, Journal of radiation research.

[17]  J. Sarvaiya,et al.  Image Registration by Template Matching Using Normalized Cross-Correlation , 2009, 2009 International Conference on Advances in Computing, Control, and Telecommunication Technologies.

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