TY - JOUR
T1 - Clinical Development and Evaluation of Megavoltage Topogram for Fast Patient Alignment on Helical Tomotherapy
AU - Qi, X. Sharon
AU - Chu, Fang I.
AU - Zhang, Zhe
AU - Chin, Robert K.
AU - Raldow, Ann
AU - Kishan, Amar U.
AU - Lee, Percy
AU - Chang, Albert
AU - Kalbasi, Anusha
AU - Kamrava, Mitchell
AU - Steinberg, Michael L.
AU - Low, Daniel A.
N1 - Funding Information:
Disclosures: Dr Lee reports personal fees and non-financial support from Varian, Inc, grants, personal fees and non-financial support from AstraZeneca, Inc, grants, personal fees, and non-financial support from ViewRay, Inc, outside the submitted work. Dr Qi reports grants from Accuray Inc. Dr Steinberg reports personal fees from ViewRay and personal fees from VisionRT, outside the submitted work. Dr Low reports grants from Accuray during the conduct of the study. Dr Raldow reports other from Intelligent Automation, Inc, other from Varian Medical Systems, outside the submitted work. Dr Chin reports grants and personal fees from Varian Medical Systems and non-financial support from Brain Laboratory, outside the submitted work. Dr Chang reports grants from AstraZeneca, personal fees from Augmenix, personal fees from Noxopharm, outside the submitted work. Dr Kishan reports personal fees from Varian Medical Systems, Inc, personal fees from Janssen Pharmaceuticals, Inc, personal fees from ViewRay, Inc, and personal fees from Intelligent Automation, Inc, outside the submitted work.
Funding Information:
Sources of support: This work is partially supported by a research grant from Accuray Inc (Sunnyvale, CA).
Publisher Copyright:
© 2020 The Authors
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: To develop and evaluate a fast patient localization tool using megavoltage (MV)-topogram on helical tomotherapy. Methods and Materials: Eighty-one MV-topogram pairs for 18 pelvis patients undergoing radiation were acquired weekly under an institutional review board–approved clinical trial. The MV-topogram imaging protocol requires 2 orthogonal acquisitions at static gantry angles of 0 degrees and 90 degrees for a programed scan length. A MATLAB based in-house software was developed to reconstruct the MV-topograms offline. Reference images (digitally reconstructed topograms, digitally reconstructed topograms) were generated using the planning computed tomography and tomotherapy geometry. The MV-topogram based alignment was determined by registering the MV-topograms to the digitally reconstructed topogram using bony landmark on commercial MIM software. The daily shifts in 3 translational directions determined from MV-topograms were compared with the megavoltage computed tomography (MVCT) based patient shifts. Linear-regression and two one-sided tests equivalence tests were performed to investigate the relation and equivalence between the 2 techniques. Seventy-eight MV-topogram pairs for 19 head and neck patients were included to validate the finding. Results: The magnitudes of alignment differences of (MVCT − MV-topogram) (and standard deviations) were −0.3 ± 2.1, −0.8 ± 2.4, and 1.6 ± 1.7 mm for pelvis and 0.6 ± 1.2, 0.8 ± 4.2, 1.6 ± 2.6 mm for head and neck; the linear-regression coefficients between 2 imaging techniques were 1.18, 1.10, 0.94, and 0.86, 0.63, 0.38 in the lateral, longitudinal, vertical directions for pelvis and head and neck, respectively. The acquisition time for a pair of MV-topograms was up to 12.7 times less than MVCT scans (coarse scan mode) while covering longer longitudinal length. Conclusions: MV-topograms showed equivalent clinical performance to the standard MVCT with significantly less acquisition time for pelvis and H&N patients. The MV-topogram can be used as an alternative or complimentary tool for bony landmark-based patient alignment on tomotherapy.
AB - Purpose: To develop and evaluate a fast patient localization tool using megavoltage (MV)-topogram on helical tomotherapy. Methods and Materials: Eighty-one MV-topogram pairs for 18 pelvis patients undergoing radiation were acquired weekly under an institutional review board–approved clinical trial. The MV-topogram imaging protocol requires 2 orthogonal acquisitions at static gantry angles of 0 degrees and 90 degrees for a programed scan length. A MATLAB based in-house software was developed to reconstruct the MV-topograms offline. Reference images (digitally reconstructed topograms, digitally reconstructed topograms) were generated using the planning computed tomography and tomotherapy geometry. The MV-topogram based alignment was determined by registering the MV-topograms to the digitally reconstructed topogram using bony landmark on commercial MIM software. The daily shifts in 3 translational directions determined from MV-topograms were compared with the megavoltage computed tomography (MVCT) based patient shifts. Linear-regression and two one-sided tests equivalence tests were performed to investigate the relation and equivalence between the 2 techniques. Seventy-eight MV-topogram pairs for 19 head and neck patients were included to validate the finding. Results: The magnitudes of alignment differences of (MVCT − MV-topogram) (and standard deviations) were −0.3 ± 2.1, −0.8 ± 2.4, and 1.6 ± 1.7 mm for pelvis and 0.6 ± 1.2, 0.8 ± 4.2, 1.6 ± 2.6 mm for head and neck; the linear-regression coefficients between 2 imaging techniques were 1.18, 1.10, 0.94, and 0.86, 0.63, 0.38 in the lateral, longitudinal, vertical directions for pelvis and head and neck, respectively. The acquisition time for a pair of MV-topograms was up to 12.7 times less than MVCT scans (coarse scan mode) while covering longer longitudinal length. Conclusions: MV-topograms showed equivalent clinical performance to the standard MVCT with significantly less acquisition time for pelvis and H&N patients. The MV-topogram can be used as an alternative or complimentary tool for bony landmark-based patient alignment on tomotherapy.
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U2 - 10.1016/j.adro.2020.05.014
DO - 10.1016/j.adro.2020.05.014
M3 - Article
C2 - 33305096
AN - SCOPUS:85087941515
SN - 2452-1094
VL - 5
SP - 1334
EP - 1341
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 6
ER -