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Iommi D, Valladares A, Figl M, Grahovac M, Fichtinger G, Hummel J. 3D ultrasound guided navigation system with hybrid image fusion. Sci Rep 2021; 11:8838. [PMID: 33893323 PMCID: PMC8065055 DOI: 10.1038/s41598-021-86848-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
A prototype of a navigation system to fuse two image modalities is presented. The standard inter-modality registration is replaced with a tracker-based image registration of calibrated imaging devices. Intra-procedure transrectal US (TRUS) images were merged with pre-procedure magnetic resonance (MR) images for prostate biopsy. The registration between MR and TRUS images was performed by an additional abdominal 3D-US (ab-3D-US), which enables replacing the inter-modal MR/TRUS registration by an intra-modal ab-3D-US/3D-TRUS registration. Calibration procedures were carried out using an optical tracking system (OTS) for the pre-procedure image fusion of the ab-3D-US with the MR. Inter-modal ab-3D-US/MR image fusion was evaluated using a multi-cone phantom for the target registration error (TRE) and a prostate phantom for the Dice score and the Hausdorff distance of lesions . Finally, the pre-procedure ab- 3D-US was registered with the TRUS images and the errors for the transformation from the MR to the TRUS were determined. The TRE of the ab-3D-US/MR image registration was 1.81 mm. The Dice-score and the Hausdorff distance for ab-3D-US and MR were found to be 0.67 and 3.19 mm. The Dice score and the Hausdorff distance for TRUS and MR were 0.67 and 3.18 mm. The hybrid navigation system showed sufficient accuracy for fusion guided biopsy procedures with prostate phantoms. The system might provide intra-procedure fusion for most US-guided biopsy and ablation interventions.
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Affiliation(s)
- David Iommi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, Vienna, 1090, Austria
| | - Alejandra Valladares
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, Vienna, 1090, Austria
| | - Michael Figl
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, Vienna, 1090, Austria
| | - Marko Grahovac
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Gabor Fichtinger
- Queen's University, School of Computing, 25 Union St, 557 Goodwin Hall, Kingston, ON, K7L 3N6, Canada
| | - Johann Hummel
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, Vienna, 1090, Austria.
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Grimwood A, Rivaz H, Zhou H, McNair HA, Jakubowski K, Bamber JC, Tree AC, Harris EJ. Improving 3D ultrasound prostate localisation in radiotherapy through increased automation of interfraction matching. Radiother Oncol 2020; 149:134-141. [PMID: 32387546 PMCID: PMC7456791 DOI: 10.1016/j.radonc.2020.04.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 12/04/2022]
Abstract
BACKGROUND AND PURPOSE Daily image guidance is standard care for prostate radiotherapy. Innovations which improve the accuracy and efficiency of ultrasound guidance are needed, particularly with respect to reducing interobserver variation. This study explores automation tools for this purpose, demonstrated on the Elekta Clarity Autoscan®. The study was conducted as part of the Clarity-Pro trial (NCT02388308). MATERIALS AND METHODS Ultrasound scan volumes were collected from 32 patients. Prostate matches were performed using two proposed workflows and the results compared with Clarity's proprietary software. Gold standard matches derived from manually localised landmarks provided a reference. The two workflows incorporated a custom 3D image registration algorithm, which was benchmarked against a third-party application (Elastix). RESULTS Significant reductions in match errors were reported from both workflows compared to standard protocol. Median (IQR) absolute errors in the left-right, anteroposterior and craniocaudal axes were lowest for the Manually Initiated workflow: 0.7(1.0) mm, 0.7(0.9) mm, 0.6(0.9) mm compared to 1.0(1.7) mm, 0.9(1.4) mm, 0.9(1.2) mm for Clarity. Median interobserver variation was ≪0.01 mm in all axes for both workflows compared to 2.2 mm, 1.7 mm, 1.5 mm for Clarity in left-right, anteroposterior and craniocaudal axes. Mean matching times was also reduced to 43 s from 152 s for Clarity. Inexperienced users of the proposed workflows attained better match precision than experienced users on Clarity. CONCLUSION Automated image registration with effective input and verification steps should increase the efficacy of interfraction ultrasound guidance compared to the current commercially available tools.
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Affiliation(s)
- Alexander Grimwood
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital Trust, Sutton, UK
| | - Hassan Rivaz
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Canada
| | - Hang Zhou
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Canada
| | - Helen A McNair
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital Trust, Sutton, UK
| | | | - Jeffrey C Bamber
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital Trust, Sutton, UK
| | - Alison C Tree
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital Trust, Sutton, UK
| | - Emma J Harris
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital Trust, Sutton, UK.
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Iommi D, Hummel J, Figl ML. Evaluation of 3D ultrasound for image guidance. PLoS One 2020; 15:e0229441. [PMID: 32214326 PMCID: PMC7098612 DOI: 10.1371/journal.pone.0229441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 02/06/2020] [Indexed: 12/30/2022] Open
Abstract
PURPOSE In this paper we compared two different 3D ultrasound (US) modes (3D free-hand mode and 3D wobbler mode) to see which is more suitable to perform the 3D-US/3D-US registration for clinical guidance applications. The typical errors with respect to their impact on the final localization error were evaluated step by step. METHODS Multi-point target and Hand-eye calibration methods were used for 3D US calibration together with a newly designed multi-cone phantom. Pointer based and image based methods were used for 2D US calibration. The calibration target error was computed by using a different multi-cone phantom. An egg-shaped phantom was used as ground truth to compare distortions for both 3D modes along with the measurements of the volume. Finally, we compared 3D ultrasound images acquired by 3D wobbler mode and 3D free-hand mode with respect to their 3D-US/3D-US registration accuracy using both, phantom and patient data. A theoretical step by step error analysis was performed and compared to empirical data. RESULTS Target registration errors based on the calibration with the 3D Multi-point and 2D pointer/image method have been found to be comparable (∼1mm). They both outperformed the 3D Hand-eye method (error >2mm). Volume measurements with the 3D free-hand mode were closest to the ground truth (around 6% error compared to 9% with the 3D wobbler mode). Additional scans on phantoms showed a 3D-US/3D-US registration error below 1 mm for both, the 3D free-hand mode and the 3D wobbler mode, respectively. Results with patient data showed greater error with the 3D free-hand mode (6.50mm - 13.37mm) than with the 3D wobbler mode (2.99 ± 1.54 mm). All the measured errors were found to be in accordance to their theoretical upper bounds. CONCLUSION While both 3D volume methods showed comparable results with respect to 3D-US/3D-US registration for phantom images, for patient data registrations the 3D wobbler mode is superior to the 3D free-hand mode. The effect of all error sources could be estimated by theoretical derivations.
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Affiliation(s)
- David Iommi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Johann Hummel
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Michael Lutz Figl
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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Zhao W, Han B, Yang Y, Buyyounouski M, Hancock SL, Bagshaw H, Xing L. Incorporating imaging information from deep neural network layers into image guided radiation therapy (IGRT). Radiother Oncol 2019; 140:167-174. [PMID: 31302347 DOI: 10.1016/j.radonc.2019.06.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/06/2019] [Accepted: 06/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE To investigate a novel markerless prostate localization strategy using a pre-trained deep learning model to interpret routine projection kilovoltage (kV) X-ray images in image-guided radiation therapy (IGRT). MATERIALS AND METHODS We developed a personalized region-based convolutional neural network to localize the prostate treatment target without implanted fiducials. To train the deep neural network (DNN), we used the patient's planning computed tomography (pCT) images with pre-delineated prostate target to generate a large amount of synthetic kV projection X-ray images in the geometry of onboard imager (OBI) system. The DNN model was evaluated by retrospectively studying 10 patients who underwent prostate IGRT. Three out of the ten patients who had implanted fiducials and the fiducials' positions in the OBI images acquired for treatment setup were examined to show the potential of the proposed method for prostate IGRT. Statistical analysis using Lin's concordance correlation coefficient was calculated to assess the results along with the difference between the digitally reconstructed radiographs (DRR) derived and DNN predicted locations of the prostate. RESULTS Differences between the predicted target positions using DNN and their actual positions are (mean ± standard deviation) 1.58 ± 0.43 mm, 1.64 ± 0.43 mm, and 1.67 ± 0.36 mm in anterior-posterior, lateral, and oblique directions, respectively. Prostate position identified on the OBI kV images is also found to be consistent with that derived from the implanted fiducials. CONCLUSIONS Highly accurate, markerless prostate localization based on deep learning is achievable. The proposed method is useful for daily patient positioning and real-time target tracking during prostate radiotherapy.
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Affiliation(s)
- Wei Zhao
- Stanford University, Department of Radiation Oncology, Stanford, USA.
| | - Bin Han
- Stanford University, Department of Radiation Oncology, Stanford, USA.
| | - Yong Yang
- Stanford University, Department of Radiation Oncology, Stanford, USA.
| | - Mark Buyyounouski
- Stanford University, Department of Radiation Oncology, Stanford, USA.
| | - Steven L Hancock
- Stanford University, Department of Radiation Oncology, Stanford, USA.
| | - Hilary Bagshaw
- Stanford University, Department of Radiation Oncology, Stanford, USA.
| | - Lei Xing
- Stanford University, Department of Radiation Oncology, Stanford, USA.
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Figl M, Hoffmann R, Kaar M, Hummel J. Deformable registration of 3D ultrasound volumes using automatic landmark generation. PLoS One 2019; 14:e0213004. [PMID: 30875379 PMCID: PMC6420033 DOI: 10.1371/journal.pone.0213004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 02/13/2019] [Indexed: 11/18/2022] Open
Abstract
US image registration is an important task e.g. in Computer Aided Surgery. Due to tissue deformation occurring between pre-operative and interventional images often deformable registration is necessary. We present a registration method focused on surface structures (i.e. saliencies) of soft tissues like organ capsules or vessels. The main concept follows the idea of representative landmarks (so called leading points). These landmarks represent saliencies in each image in a certain region of interest. The determination of deformation was based on a geometric model assuming that saliencies could locally be described by planes. These planes were calculated from the landmarks using two dimensional linear regression. Once corresponding regions in both images were found, a displacement vector field representing the local deformation was computed. Finally, the deformed image was warped to match the pre-operative image. For error calculation we used a phantom representing the urinary bladder and the prostate. The phantom could be deformed to mimic tissue deformation. Error calculation was done using corresponding landmarks in both images. The resulting target registration error of this procedure amounted to 1.63 mm. With respect to patient data a full deformable registration was performed on two 3D-US images of the abdomen. The resulting mean distance error was 2.10 ± 0.66 mm compared to an error of 2.75 ± 0.57 mm from a simple rigid registration. A two-sided paired t-test showed a p-value < 0.001. We conclude that the method improves the results of the rigid registration considerably. Provided an appropriate choice of the filter there are many possible fields of applications.
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Affiliation(s)
- Michael Figl
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Rainer Hoffmann
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Marcus Kaar
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Johann Hummel
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- * E-mail:
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Pang EPP, Knight K, Baird M, Loh JMQ, Boo AHS, Tuan JKL. A comparison of interfraction setup error, patient comfort, and therapist acceptance for 2 different prostate radiation therapy immobilization devices. Adv Radiat Oncol 2017; 2:125-131. [PMID: 28740923 PMCID: PMC5514259 DOI: 10.1016/j.adro.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/12/2016] [Accepted: 02/08/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Our purpose was to investigate interfraction setup error of the immobilization device required to implement transperineal ultrasound compared with the current, standard immobilization device. Patient comfort and radiation therapist (RT) satisfaction were also assessed. METHODS AND MATERIALS Cone beam computed tomography images were acquired before 4069 fractions from 111 patients (control group, n = 56; intervention group, n = 55) were analyzed. The intervention group was immobilized using the Clarity Immobilization System (CIS), comprising a knee rest with autoscan probe kit and transperineal ultrasound probe (n = 55), and control group using a leg immobilizer (LI) (n = 56). Interfraction setup errors were compared for both groups. Weekly questionnaires using a 10-point visual analog scale were administered to both patient groups to measure and compare patient comfort. RT acceptance for both devices was also compared using a survey. RESULTS There was no significant difference in the magnitude of interfraction cone beam computed tomography-derived setup shifts in the lateral and anteroposterior direction between the LI and CIS (P = .878 and .690, respectively). However, a significant difference (P = .003) was observed in the superoinferior direction between the 2 groups of patients. Patient-reported level of comfort and stability demonstrated no significant difference between groups (P = .994 and .132). RT user acceptance measures for the LI and CIS were ease of handling (100% vs 53.7%), storage (100% vs 61.1%), and cleaning of the devices (100% vs 64.8%), respectively. CONCLUSIONS The CIS demonstrated stability and reproducibility in prostate treatment setup comparable to LI. The CIS device had no impact on patient comfort; however, RTs indicated a preference for LI over the CIS mainly because of its weight and bulkiness.
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Affiliation(s)
- Eric Pei Ping Pang
- Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Corresponding author. Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore.Division of Radiation OncologyNational Cancer Centre Singapore11 Hospital DriveSingapore
| | - Kellie Knight
- Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Marilyn Baird
- Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia
| | | | | | - Jeffrey Kit Loong Tuan
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore
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Matsopoulos GK, Asvestas PA, Markaki V, Platoni K, Kouloulias V. Isocenter Verification in Radiotherapy Clinical Practice Using Virtual Simulation. Oncology 2017. [DOI: 10.4018/978-1-5225-0549-5.ch026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This chapter presents an overview of the procedures that are used for the verification of the patient position during radiotherapy. Furthermore, a method for the verification of the radiotherapy isocenter prior to treatment delivery is proposed. The method is based on the alignment of two Computed Tomography (CT) scans: a scan, which is acquired for treatment planning, and an additional verification scan, which is acquired prior to the treatment delivery. The proposed method was applied to CT scans, acquired from 20 patients with abdominal tumors and 20 patients with breast/lung cancer. The results of the proposed method were compared with the ones obtained using conventional methods, indicating that the estimated isocenter displacement can be translated into patient setup error inside the treatment room.
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Intraoperative image-guided navigation system: development and applicability in 65 patients undergoing liver surgery. Langenbecks Arch Surg 2016; 401:495-502. [PMID: 27122364 DOI: 10.1007/s00423-016-1417-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/30/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Image-guided systems have recently been introduced for their application in liver surgery. We aimed to identify and propose suitable indications for image-guided navigation systems in the domain of open oncologic liver surgery and, more specifically, in the setting of liver resection with and without microwave ablation. METHOD Retrospective analysis was conducted in patients undergoing liver resection with and without microwave ablation using an intraoperative image-guided stereotactic system during three stages of technological development (accuracy: 8.4 ± 4.4 mm in phase I and 8.4 ± 6.5 mm in phase II versus 4.5 ± 3.6 mm in phase III). It was evaluated, in which indications image-guided surgery was used according to the different stages of technical development. RESULTS Between 2009 and 2013, 65 patients underwent image-guided surgical treatment, resection alone (n = 38), ablation alone (n = 11), or a combination thereof (n = 16). With increasing accuracy of the system, image guidance was progressively used for atypical resections and combined microwave ablation and resection instead of formal liver resection (p < 0.0001). CONCLUSION Clinical application of image guidance is feasible, while its efficacy is subject to accuracy. The concept of image guidance has been shown to be increasingly efficient for selected indications in liver surgery. While accuracy of available technology is increasing pertaining to technological advancements, more and more previously untreatable scenarios such as multiple small, bilobar lesions and so-called vanishing lesions come within reach.
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Hess CB, Thompson HM, Benedict SH, Seibert JA, Wong K, Vaughan AT, Chen AM. Exposure Risks Among Children Undergoing Radiation Therapy: Considerations in the Era of Image Guided Radiation Therapy. Int J Radiat Oncol Biol Phys 2016; 94:978-92. [PMID: 27026304 DOI: 10.1016/j.ijrobp.2015.12.372] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 11/30/2015] [Accepted: 12/22/2015] [Indexed: 12/14/2022]
Abstract
Recent improvements in toxicity profiles of pediatric oncology patients are attributable, in part, to advances in the field of radiation oncology such as intensity modulated radiation (IMRT) and proton therapy (IMPT). While IMRT and IMPT deliver highly conformal dose to targeted volumes, they commonly demand the addition of 2- or 3-dimensional imaging for precise positioning--a technique known as image guided radiation therapy (IGRT). In this manuscript we address strategies to further minimize exposure risk in children by reducing effective IGRT dose. Portal X rays and cone beam computed tomography (CBCT) are commonly used to verify patient position during IGRT and, because their relative radiation exposure is far less than the radiation absorbed from therapeutic treatment beams, their sometimes significant contribution to cumulative risk can be easily overlooked. Optimizing the conformality of IMRT/IMPT while simultaneously ignoring IGRT dose may result in organs at risk being exposed to a greater proportion of radiation from IGRT than from therapeutic beams. Over a treatment course, cumulative central-axis CBCT effective dose can approach or supersede the amount of radiation absorbed from a single treatment fraction, a theoretical increase of 3% to 5% in mutagenic risk. In select scenarios, this may result in the underprediction of acute and late toxicity risk (such as azoospermia, ovarian dysfunction, or increased lifetime mutagenic risk) in radiation-sensitive organs and patients. Although dependent on variables such as patient age, gender, weight, body habitus, anatomic location, and dose-toxicity thresholds, modifying IGRT use and acquisition parameters such as frequency, imaging modality, beam energy, current, voltage, rotational degree, collimation, field size, reconstruction algorithm, and documentation can reduce exposure, avoid unnecessary toxicity, and achieve doses as low as reasonably achievable, promoting a culture and practice of "gentle IGRT."
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Affiliation(s)
- Clayton B Hess
- Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California
| | - Holly M Thompson
- Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California
| | - Stanley H Benedict
- Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California
| | - J Anthony Seibert
- Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California
| | - Kenneth Wong
- Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California
| | - Andrew T Vaughan
- Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California
| | - Allen M Chen
- Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California.
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Banerjee J, Klink C, Niessen WJ, Moelker A, van Walsum T. 4D Ultrasound Tracking of Liver and its Verification for TIPS Guidance. IEEE TRANSACTIONS ON MEDICAL IMAGING 2016; 35:52-62. [PMID: 26168435 DOI: 10.1109/tmi.2015.2454056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In this work we describe a 4D registration method for on the fly stabilization of ultrasound volumes for improving image guidance for transjugular intrahepatic portosystemic shunt (TIPS) interventions. The purpose of the method is to enable a continuous visualization of the relevant anatomical planes (determined in a planning stage) in a free breathing patient during the intervention. This requires registration of the planning information to the interventional images, which is achieved in two steps. In the first step tracking is performed across the streaming input. An approximate transformation between the reference image and the incoming image is estimated by composing the intermediate transformations obtained from the tracking. In the second step a subsequent registration is performed between the reference image and the approximately transformed incoming image to account for the accumulation of error. The two step approach helps in reducing the search range and is robust under rotation. We additionally present an approach to initialize and verify the registration. Verification is required when the reference image (containing planning information) is acquired in the past and is not part of the (interventional) 4D ultrasound sequence. The verification score will help in invalidating the registration outcome, for instance, in the case of insufficient overlap or information between the registering images due to probe motion or loss of contact, respectively. We evaluate the method over thirteen 4D US sequences acquired from eight subjects. A graphics processing unit implementation runs the 4D tracking at 9 Hz with a mean registration error of 1.7 mm.
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Fontanarosa D, van der Meer S, Bamber J, Harris E, O'Shea T, Verhaegen F. Review of ultrasound image guidance in external beam radiotherapy: I. Treatment planning and inter-fraction motion management. Phys Med Biol 2015; 60:R77-114. [PMID: 25592664 DOI: 10.1088/0031-9155/60/3/r77] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In modern radiotherapy, verification of the treatment to ensure the target receives the prescribed dose and normal tissues are optimally spared has become essential. Several forms of image guidance are available for this purpose. The most commonly used forms of image guidance are based on kilovolt or megavolt x-ray imaging. Image guidance can also be performed with non-harmful ultrasound (US) waves. This increasingly used technique has the potential to offer both anatomical and functional information.This review presents an overview of the historical and current use of two-dimensional and three-dimensional US imaging for treatment verification in radiotherapy. The US technology and the implementation in the radiotherapy workflow are described. The use of US guidance in the treatment planning process is discussed. The role of US technology in inter-fraction motion monitoring and management is explained, and clinical studies of applications in areas such as the pelvis, abdomen and breast are reviewed. A companion review paper (O'Shea et al 2015 Phys. Med. Biol. submitted) will extensively discuss the use of US imaging for intra-fraction motion quantification and novel applications of US technology to RT.
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Affiliation(s)
- Davide Fontanarosa
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN, the Netherlands. Oncology Solutions Department, Philips Research, High Tech Campus 34, Eindhoven 5656 AE, the Netherlands
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Banerjee J, Klink C, Peters ED, Niessen WJ, Moelker A, van Walsum T. Fast and robust 3D ultrasound registration – Block and game theoretic matching. Med Image Anal 2015; 20:173-83. [DOI: 10.1016/j.media.2014.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 11/03/2014] [Accepted: 11/08/2014] [Indexed: 11/30/2022]
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Presles B, Fargier-Voiron M, Biston MC, Lynch R, Munoz A, Liebgott H, Pommier P, Rit S, Sarrut D. Semiautomatic registration of 3D transabdominal ultrasound images for patient repositioning during postprostatectomy radiotherapy. Med Phys 2014; 41:122903. [DOI: 10.1118/1.4901642] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Hoffmann R, Kaar M, Bathia A, Bathia A, Lampret A, Birkfellner W, Hummel J, Figl M. A navigation system for flexible endoscopes using abdominal 3D ultrasound. Phys Med Biol 2014; 59:5545-58. [PMID: 25170913 DOI: 10.1088/0031-9155/59/18/5545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Impact of probe pressure variability on prostate localization for ultrasound-based image-guided radiotherapy. Radiother Oncol 2014; 111:132-7. [DOI: 10.1016/j.radonc.2014.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 01/24/2014] [Accepted: 02/15/2014] [Indexed: 11/17/2022]
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Hummel J. Erratum: “Automatic patient alignment system using 3D ultrasound” [Med. Phys. 40(4), 041714 (7pp.) (2013)]. Med Phys 2013; 40. [DOI: 10.1118/1.4804050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 04/22/2013] [Indexed: 11/07/2022] Open
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