A GPU-based framework for modeling real-time 3D lung tumor conformal dosimetry with subject-specific lung tumor motion

A Novel Approach for Position Verification and Dose Calculation through Local MVCT Reconstruction

Traditional positioning verification using cone-beam computed tomography (CBCT) may incur errors due to potential misalignments between the isocenter of CBCT and the treatment beams in radiotherapy. This study introduces an innovative method for verifying patient positioning in radiotherapy. Initially, the transmission images from an electronic portal imaging device (EPID) are acquired from 10 distinct angles. Utilizing the ART-TV algorithm, a sparse reconstruction of local megavoltage computed tomography (MVCT) is performed. Subsequently, this MVCT is aligned with the planning CT via a three-dimensional mutual information registration technique, pinpointing any patient-positioning discrepancies and facilitating corrective adjustments to the treatment setup. Notably, this approach employs the same radiation source as used in treatment to obtain three-dimensional images, thereby circumventing errors stemming from misalignment between the isocenter of CBCT and the accelerator. The registration process requires only 10 EPID images, and the dose absorbed during this process is included in the total dose calculation. The results show that our method's reconstructed MVCT images fulfill the requirements for registration, and the registration algorithm accurately detects positioning errors, thus allowing for adjustments in the patient's treatment position and precise calculation of the absorbed dose.

Development of patient-controlled respiratory gating system based on visual guidance for magnetic-resonance image-guided radiation therapy

PURPOSE

The aim of this study is to develop a visual guidance patient-controlled (VG-PC) respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy (MR-IGRT) and to evaluate the performance of the developed system.

METHODS

The near-real-time cine planar MR image of a patient acquired during treatment was transmitted to a beam projector in the treatment room through an optical fiber cable. The beam projector projected the cine MR images inside the bore of the ViewRay system in order to be visible to a patient during treatment. With this visual information, patients voluntarily controlled their respiration to put the target volume into the gating boundary (gating window). The effect of the presence of the beam projector in the treatment room on the image quality of the MRI was investigated by evaluating the signal-to-noise ratio (SNR), uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity with the VG-PC gating system. To evaluate the performance of the developed system, we applied the VG-PC gating system to a total of seven patients; six patients received stereotactic ablative radiotherapy (SABR) and one patient received conventional fractionated radiation therapy.

RESULTS

The projected cine MR images were visible even when the room light was on. No image data loss or additional time delay during delivery of image data were observed. Every indicator representing MRI quality, including SNR, uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity exhibited values higher than the tolerance levels of the manufacturer with the VG-PC gating system; therefore, the presence of the VG-PC gating system in the treatment room did not degrade the MR image quality. The average beam-off times due to respiratory gating with and without the VG-PC gating system were 830.3 ± 278.2 s and 1264.2 ± 302.1 s respectively (P = 0.005). Consequently, the total treatment times excluding the time for patient setup with and without the VG-PC gating system were 1453.3 ± 297.3 s and 1887.2 ± 469.6 s, respectively, on average (P = 0.005). The average number of beam-off events during whole treatment session was reduced from 457 ± 154 times to 195 ± 90 times by using the VG-PC gating system (P < 0.001).

CONCLUSIONS

The developed system could improve treatment efficiency when performing respiratory-gated MR-IGRT. The VG-PC gating system could be applied to any kind of bore-type radiotherapy machine.

Parallelized multi-graphics processing unit framework for high-speed Gabor-domain optical coherence microscopy

Gabor-domain optical coherence microscopy (GD-OCM) is a volumetric high-resolution technique capable of acquiring three-dimensional (3-D) skin images with histological resolution. Real-time image processing is needed to enable GD-OCM imaging in a clinical setting. We present a parallelized and scalable multi-graphics processing unit (GPU) computing framework for real-time GD-OCM image processing. A parallelized control mechanism was developed to individually assign computation tasks to each of the GPUs. For each GPU, the optimal number of amplitude-scans (A-scans) to be processed in parallel was selected to maximize GPU memory usage and core throughput. We investigated five computing architectures for computational speed-up in processing 1000×1000 A-scans. The proposed parallelized multi-GPU computing framework enables processing at a computational speed faster than the GD-OCM image acquisition, thereby facilitating high-speed GD-OCM imaging in a clinical setting. Using two parallelized GPUs, the image processing of a 1×1×0.6  mm3 skin sample was performed in about 13 s, and the performance was benchmarked at 6.5 s with four GPUs. This work thus demonstrates that 3-D GD-OCM data may be displayed in real-time to the examiner using parallelized GPU processing.

A multi-GPU real-time dose simulation software framework for lung radiotherapy

PURPOSE

Medical simulation frameworks facilitate both the preoperative and postoperative analysis of the patient's pathophysical condition. Of particular importance is the simulation of radiation dose delivery for real-time radiotherapy monitoring and retrospective analyses of the patient's treatment.

METHODS

In this paper, a software framework tailored for the development of simulation-based real-time radiation dose monitoring medical applications is discussed. A multi-GPU-based computational framework coupled with inter-process communication methods is introduced for simulating the radiation dose delivery on a deformable 3D volumetric lung model and its real-time visualization. The model deformation and the corresponding dose calculation are allocated among the GPUs in a task-specific manner and is performed in a pipelined manner. Radiation dose calculations are computed on two different GPU hardware architectures. The integration of this computational framework with a front-end software layer and back-end patient database repository is also discussed.

RESULTS

Real-time simulation of the dose delivered is achieved at once every 120 ms using the proposed framework. With a linear increase in the number of GPU cores, the computational time of the simulation was linearly decreased. The inter-process communication time also improved with an increase in the hardware memory. Variations in the delivered dose and computational speedup for variations in the data dimensions are investigated using D70 and D90 as well as gEUD as metrics for a set of 14 patients. Computational speed-up increased with an increase in the beam dimensions when compared with a CPU-based commercial software while the error in the dose calculation was <1%.

CONCLUSION

Our analyses show that the framework applied to deformable lung model-based radiotherapy is an effective tool for performing both real-time and retrospective analyses.