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Hernando-Requejo O, Chen X, López M, Sánchez E, García J, García P, Alonso R, Montero A, Ciervide R, Álvarez B, Zucca D, García Aranda M, Valero J, Fernández Letón P, Rubio C. Real-world effectiveness and safety of stereotactic body radiotherapy for liver metastases with different respiratory motion management techniques. Strahlenther Onkol 2023; 199:1000-1010. [PMID: 37728734 DOI: 10.1007/s00066-023-02147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/13/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) has been firmly established as a treatment choice for patients with oligometastases, as it has demonstrated both safety and efficacy by consistently achieving high rates of local control. Moreover, it offers potential survival benefits for carefully selected patients in real-world clinical settings. METHODS Between January 2008 and May 2020, a total of 149 patients (with 414 liver metastases) received treatment. The Active Breathing Coordinator device was used for 68 patients, while respiratory gating was used for 65 and abdominal compression was used for 16 patients. The most common histological finding was colorectal adenocarcinoma, with 37.6% of patients having three or more metastases, and 18% having two metastases. The prescribed dose ranged from 36 to 60 Gy, delivered in 3-5 fractions. RESULTS Local control rates at 2 and 3 years were 76.1% and 61.2%, respectively, with no instances of local recurrence after 3 years. Factors negatively impacting local control included colorectal histology, lower prescribed dose, and the occurrence of new liver metastases. The median overall survival from SBRT was 32 months, with the presence of metastases outside the liver and the development of new liver metastases after SBRT affecting survival. The median disease-free survival was 10 months. No substantial differences in both local control and survival were observed between the respiratory motion control techniques employed. Treatment tolerance was excellent, with only one patient experiencing acute grade IV thrombocytopenia and two patients suffering from ≥ grade II chronic toxicity. CONCLUSION For radical management of single or multiple liver metastases, SBRT is an effective and well-tolerated treatment option. Regardless of the technology employed, experienced physicians can achieve similarly positive outcomes. However, additional studies are required to elucidate prognostic factors that can facilitate improved patient selection.
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Affiliation(s)
- O Hernando-Requejo
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain.
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain.
| | - X Chen
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sánchez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - P García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Álvarez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - M García Aranda
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernández Letón
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
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Liu G, Chen S, Hu Y, Cao S, Yang X, Zhou Y, Shi H. Respiratory-gated PET imaging with reduced acquisition time for suspect malignancies: the first experience in application of total-body PET/CT. Eur Radiol 2022; 33:3366-3376. [PMID: 36565352 DOI: 10.1007/s00330-022-09369-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/08/2022] [Accepted: 12/08/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study aimed to investigate the performance of respiratory-gating imaging with reduced acquisition time using the total-body positron emission tomography/computed tomography (PET/CT) scanner. METHODS Imaging data of 71 patients with suspect malignancies who underwent total-body 2-[18F]-fluoro-2-deoxy-D-glucose PET/CT for 15 min with respiration recorded were analyzed. For each examination, four reconstructions were performed: Ungated-15, using all coincidences; Ungated-5, using data of the first 5 min; Gated-15 using all coincidences but with respiratory gating; and Gated-6 using data of the first 6 min with respiratory gating. Lesions were quantified and image quality was evaluated; both were compared between the four image sets. RESULTS A total of 390 lesions were found in the thorax and upper abdomen. Lesion detectability was significantly higher in gated-15 (97.2%) than in ungated-15 (93.6%, p = 0.001) and ungated-5 (92.3%, p = 0.001), but comparable to Gated-6 (95.9%, p = 0.993). A total of 131 lesions were selected for quantitative analyses. Lesions in Gated-15 presented significantly larger standardized uptake values, tumor-to-liver ratio, and tumor-to-blood ratio, but smaller metabolic tumor volume, compared to those in Ungated-15 and Ungated-5 (all p < 0.001). These differences were more obvious in small lesions and in lesions from sites other than mediastinum/retroperitoneum. However, these indices were not significantly different between Gated-15 and Gated-6. Higher, but acceptable, image noise was identified in gated images than in ungated images. CONCLUSIONS Respiratory-gating imaging with reduced scanning time using the total-body PET/CT scanner is superior to ungated imaging and can be used in the clinic. KEY POINTS • In PET imaging, respiratory gating can improve lesion presentation and detectability but requires longer imaging time. • This single-center study showed that the total-body PET scanner allows respiratory-gated imaging with reduced and clinically acceptable scanning time.
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Affiliation(s)
- Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yan Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Shuangliang Cao
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Xinlan Yang
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China. .,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China. .,Shanghai Institute of Medical Imaging, Shanghai, 200032, China. .,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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3
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Faist D, Jreige M, Oreiller V, Nicod Lalonde M, Schaefer N, Depeursinge A, Prior JO. Reproducibility of lung cancer radiomics features extracted from data-driven respiratory gating and free-breathing flow imaging in [ 18F]-FDG PET/CT. Eur J Hybrid Imaging 2022; 6:33. [PMID: 36309636 PMCID: PMC9617997 DOI: 10.1186/s41824-022-00153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Quality and reproducibility of radiomics studies are essential requirements for the standardisation of radiomics models. As recent data-driven respiratory gating (DDG) [18F]-FDG has shown superior diagnostic performance in lung cancer, we evaluated the impact of DDG on the reproducibility of radiomics features derived from [18F]-FDG PET/CT in comparison to free-breathing flow (FB) imaging.
Methods Twenty four lung nodules from 20 patients were delineated. Radiomics features were derived on FB flow PET/CT and on the corresponding DDG reconstruction using the QuantImage v2 platform. Lin’s concordance factor (Cb) and the mean difference percentage (DIFF%) were calculated for each radiomics feature using the delineated nodules which were also classified by anatomical localisation and volume. Non-reproducible radiomics features were defined as having a bias correction factor Cb < 0.8 and/or a mean difference percentage DIFF% > 10.
Results In total 141 features were computed on each concordance analysis, 10 of which were non-reproducible on all pulmonary lesions. Those were first-order features from Laplacian of Gaussian (LoG)-filtered images (sigma = 1 mm): Energy, Kurtosis, Minimum, Range, Root Mean Squared, Skewness and Variance; Texture features from Gray Level Cooccurence Matrix (GLCM): Cluster Prominence and Difference Variance; First-order Standardised Uptake Value (SUV) feature: Kurtosis. Pulmonary lesions located in the superior lobes had only stable radiomics features, the ones from the lower parts had 25 non-reproducible radiomics features. Pulmonary lesions with a greater size (defined as long axis length > median) showed a higher reproducibility (9 non-reproducible features) than smaller ones (20 non-reproducible features).
Conclusion Calculated on all pulmonary lesions, 131 out of 141 radiomics features can be used interchangeably between DDG and FB PET/CT acquisitions. Radiomics features derived from pulmonary lesions located inferior to the superior lobes are subject to greater variability as well as pulmonary lesions of smaller size. Supplementary Information The online version contains supplementary material available at 10.1186/s41824-022-00153-2.
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Affiliation(s)
- Daphné Faist
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Valentin Oreiller
- Institute of Information Systems, University of Applied Sciences Western Switzerland, (HES-SO), Rue du Technopôle 3, CH-3960, Sierre, Switzerland
| | - Marie Nicod Lalonde
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland
| | - Adrien Depeursinge
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Institute of Information Systems, University of Applied Sciences Western Switzerland, (HES-SO), Rue du Technopôle 3, CH-3960, Sierre, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland. .,Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
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Bailly P, Bouzerar R, Galan R, Meyer ME. Phantom study of an in-house amplitude-gating respiratory method with silicon photomultiplier technology positron emission tomography/computed tomography. Comput Methods Programs Biomed 2022; 221:106907. [PMID: 35660941 DOI: 10.1016/j.cmpb.2022.106907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The objective of this phantom study was to determine whether breathing-synchronized, silicon photomultiplier (SiPM)-based PET/CT has a suitable acquisition time for routine clinical use. METHODS Acquisitions were performed in list mode on a 4-ring SiPM-based PET/CT system. The experimental setup consisted of an external respiratory tracking device placed on a commercial dynamic thorax phantom containing a sphere filled with [F-18]-fluorodeoxyglucose. Three-dimensional sinusoidal motion was imposed on the sphere. Data were processed using frequency binning and amplitude binning (the "DMI" and "OFFLINE" methods, respectively). PET sinograms were reconstructed with a Bayesian penalized likelihood algorithm. RESULTS Respiratory gating from a 150‑sec acquisition was successful. The DMI and OFFLINE methods gave similar activity profiles but both were slightly shifted in space; the latter profile was closest to the reference acquisition. CONCLUSION With SiPM PET/CT systems, the amplitude-based processing of breathing-synchronized data is likely to be feasible in routine clinical practice.
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Affiliation(s)
- Pascal Bailly
- Nuclear Medicine Department, Amiens University Medical Center, Amiens, France; Department of Nuclear Medicine, Amiens University Hospital, Amiens, France.
| | - Roger Bouzerar
- Nuclear Medicine Department, Amiens University Medical Center, Amiens, France; Department of Nuclear Medicine, Amiens University Hospital, Amiens, France
| | - Romain Galan
- Nuclear Medicine Department, Amiens University Medical Center, Amiens, France; Jules Verne University of Picardie, Amiens, France; Department of Nuclear Medicine, Amiens University Hospital, Amiens, France
| | - Marc-Etienne Meyer
- Nuclear Medicine Department, Amiens University Medical Center, Amiens, France; Jules Verne University of Picardie, Amiens, France; Department of Nuclear Medicine, Amiens University Hospital, Amiens, France
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5
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Abstract
Herein are presented the recommendations from the Société française de radiothérapie oncologique regarding indications and modalities of lung cancer radiotherapy. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Affiliation(s)
- J Khalifa
- Département de radiothérapie, Institut universitaire du cancer de Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - D Lerouge
- Département de radiothérapie, centre François-Baclesse, 3, avenue du General-Harris, 14076 Caen, France
| | - C Le Péchoux
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - N Pourel
- Département de radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, CS80005, 84918 Avignon cedex 9, France
| | - J Darréon
- Service de physique médicale, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - F Mornex
- Service de radiothérapie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
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Gut P, Krieger M, Lomax T, Weber DC, Hrbacek J. Combining rescanning and gating for a time-efficient treatment of mobile tumors using pencil beam scanning proton therapy. Radiother Oncol 2021; 160:82-89. [PMID: 33839206 DOI: 10.1016/j.radonc.2021.03.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/04/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Respiratory motion during proton therapy can severely degrade dose distributions, particularly due to interplay effects when using pencil beam scanning. Combined rescanning and gating treatments for moving tumors mitigates dose degradation, but at the cost of increased treatment delivery time. The objective of this study was to identify the time efficiency of these dose degradation-motion mitigation strategies for different range of motions. MATERIALS AND METHODS Seventeen patients with thoracic or abdominal tumors were studied. Tumor motion amplitudes ranged from 2-30 mm. Deliveries using different combinations of rescanning and gating were simulated with a dense dose spot grid (4 × 4 × 2.5 mm3) for all patients and a sparse dose spot grid (8 × 8 × 5 mm3) for six patients with larger tumor movements (>8 mm). The resulting plans were evaluated in terms of CTV coverage and time efficiency. RESULTS Based on the studied patient cohort, it has been shown that for amplitudes up to 5 mm, no motion mitigation is required with a dense spot grid. For amplitudes between 5 and 10 mm, volumetric rescanning should be applied while maintaining a 100% duty cycle when using a dense spot grid. Although gating could be envisaged to reduce the target volume for intermediate motion, it has been shown that the dose to normal tissues would only be reduced marginally. Moreover, the treatment time would increase. Finally, for larger motion amplitudes, both volumetric rescanning and respiratory gating should be applied with both spot grids. In addition, it has been shown that a dense spot grid delivers better CTV dose coverage than a sparse dose grid. CONCLUSION Volumetric rescanning and/or respiratory gating can be used in order to effectively and efficiently mitigate dose degradation due to tumor movement.
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Affiliation(s)
- Pauline Gut
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Miriam Krieger
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Tony Lomax
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland; Department of Radiation Oncology, University Hospital of Zurich, Zurich, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Jan Hrbacek
- Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland.
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Sigfridsson J, Lindström E, Iyer V, Holstensson M, Velikyan I, Sundin A, Lubberink M. Prospective data-driven respiratory gating of [ 68Ga]Ga-DOTATOC PET/CT. EJNMMI Res 2021; 11:33. [PMID: 33788025 PMCID: PMC8012445 DOI: 10.1186/s13550-021-00775-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022] Open
Abstract
Aim The aim of this prospective study was to evaluate a data-driven gating software’s performance, in terms of identifying the respiratory signal, comparing [68Ga]Ga-DOTATOC and [18F]FDG examinations. In addition, for the [68Ga]Ga-DOTATOC examinations, tracer uptake quantitation and liver lesion detectability were assessed. Methods Twenty-four patients with confirmed or suspected neuroendocrine tumours underwent whole-body [68Ga]Ga-DOTATOC PET/CT examinations. Prospective DDG was applied on all bed positions and respiratory motion correction was triggered automatically when the detected respiratory signal exceeded a certain threshold (R value ≥ 15), at which point the scan time for that bed position was doubled. These bed positions were reconstructed with quiescent period gating (QPG), retaining 50% of the total coincidences. A respiratory signal evaluation regarding the software’s efficacy in detecting respiratory motion for [68Ga]Ga-DOTATOC was conducted and compared to [18F]FDG data. Measurements of SUVmax, SUVmean, and tumour volume were performed on [68Ga]Ga-DOTATOC PET and compared between gated and non-gated images. Results The threshold of R ≥ 15 was exceeded and gating triggered on mean 2.1 bed positions per examination for [68Ga]Ga-DOTATOC as compared to 1.4 for [18F]FDG. In total, 34 tumours were evaluated in a quantitative analysis. An increase of 25.3% and 28.1%, respectively, for SUVmax (P < 0.0001) and SUVmean (P < 0.0001), and decrease of 21.1% in tumour volume (P < 0.0001) was found when DDG was applied. Conclusions High respiratory signal was exclusively detected in bed positions where respiratory motion was expected, indicating reliable performance of the DDG software on [68Ga]Ga-DOTATOC PET/CT. DDG yielded significantly higher SUVmax and SUVmean values and smaller tumour volumes, as compared to non-gated images.
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Affiliation(s)
- Jonathan Sigfridsson
- PET Centre, Uppsala University Hospital, Uppsala, Sweden. .,Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Elin Lindström
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden.,Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Victor Iyer
- PET Centre, Uppsala University Hospital, Uppsala, Sweden.,Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Holstensson
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Functional Imaging and Technology, Karolinska Institute, Stockholm, Sweden
| | - Irina Velikyan
- PET Centre, Uppsala University Hospital, Uppsala, Sweden.,Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anders Sundin
- PET Centre, Uppsala University Hospital, Uppsala, Sweden.,Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mark Lubberink
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden.,Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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8
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Kvernby S, Hult NK, Lindström E, Sigfridsson J, Linder G, Hedberg J, Ahlström H, Bjerner T, Lubberink M. Quantitative comparison of data-driven gating and external hardware gating for 18F-FDG PET-MRI in patients with esophageal tumors. Eur J Hybrid Imaging 2021; 5:5. [PMID: 34181124 DOI: 10.1186/s41824-021-00099-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/07/2021] [Indexed: 12/16/2022] Open
Abstract
Background Respiratory motion during PET imaging reduces image quality. Data-driven gating (DDG) based on principal component analysis (PCA) can be used to identify respiratory signals. The use of DDG, without need for external devices, would greatly increase the feasibility of using respiratory gating in a routine clinical setting. The objective of this study was to evaluate data-driven gating in relation to external hardware gating and regular static image acquisition on PET-MRI data with respect to SUVmax and lesion volumes. Methods Sixteen patients with esophageal or gastroesophageal cancer (Siewert I and II) underwent a 6-min PET scan on a Signa PET-MRI system (GE Healthcare) 1.5–2 h after injection of 4 MBq/kg 18F-FDG. External hardware gating was done using a respiratory bellow device, and DDG was performed using MotionFree (GE Healthcare). The DDG raw data files and the external hardware-gating raw files were created on a Matlab-based toolbox from the whole 6-min scan LIST-file. For comparison, two 3-min static raw files were created for each patient. Images were reconstructed using TF-OSEM with resolution recovery with 2 iterations, 28 subsets, and 3-mm post filter. SUVmax and lesion volume were measured in all visible lesions, and noise level was measured in the liver. Paired t-test, linear regression, Pearson correlation, and Bland-Altman analysis were used to investigate difference, correlation, and agreement between the methods. Results A total number of 30 lesions were included in the study. No significant differences between DDG and external hardware-gating SUVmax or lesion volumes were found, but the noise level was significantly reduced in the DDG images. Both DDG and external hardware gating demonstrated significantly higher SUVmax (9.4% for DDG, 10.3% for external hardware gating) and smaller lesion volume (− 5.4% for DDG, − 6.6% for external gating) in comparison with non-gated static images. Conclusions Data-driven gating with MotionFree for PET-MRI performed similar to external device gating for esophageal lesions with respect to SUVmax and lesion volume. Both gating methods significantly increased the SUVmax and reduced the lesion volume in comparison with non-gated static acquisition. DDG resulted in reduced image noise compared to external device gating and static images.
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9
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Walker MD, Bradley KM, McGowan DR. Data-Driven Respiratory Motion Correction in Clinical PET - A Turning Point. J Nucl Med 2020; 62:jnumed.120.257022. [PMID: 33443091 DOI: 10.2967/jnumed.120.257022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/17/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Matthew D Walker
- Oxford University Hospitals NHS Foundation Trust, United Kingdom
| | | | - Daniel R McGowan
- Oxford University Hospitals NHS Foundation Trust, United Kingdom
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10
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Lassen ML, Beyer T, Berger A, Beitzke D, Rasul S, Büther F, Hacker M, Cal-González J. Data-driven, projection-based respiratory motion compensation of PET data for cardiac PET/CT and PET/MR imaging. J Nucl Cardiol 2020; 27:2216-2230. [PMID: 30761482 DOI: 10.1007/s12350-019-01613-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 01/06/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Respiratory patient motion causes blurring of the PET images that may impact accurate quantification of perfusion and infarction extents in PET myocardial viability studies. In this study, we investigate the feasibility of correcting for respiratory motion directly in the PET-listmode data prior to image reconstruction using a data-driven, projection-based, respiratory motion compensation (DPR-MoCo) technique. METHODS The DPR-MoCo method was validated using simulations of a XCAT phantom (Biograph mMR PET/MR) as well as experimental phantom acquisitions (Biograph mCT PET/CT). Seven patient studies following a dual-tracer (18F-FDG/13N-NH3) imaging-protocol using a PET/MR-system were also evaluated. The performance of the DPR-MoCo method was compared against reconstructions of the acquired data (No-MoCo), a reference gate method (gated) and an image-based MoCo method using the standard reconstruction-transform-average (RTA-MoCo) approach. The target-to-background ratio (TBRLV) in the myocardium and the noise in the liver (CoVliver) were evaluated for all acquisitions. For all patients, the clinical effect of the DPR-MoCo was assessed based on the end-systolic (ESV), the end-diastolic volumes (EDV) and the left ventricular ejection fraction (EF) which were compared to functional values obtained from the cardiac MR. RESULTS The DPR-MoCo and the No-MoCo images presented with similar noise-properties (CoV) (P = .12), while the RTA-MoCo and reference-gate images showed increased noise levels (P = .05). TBRLV values increased for the motion limited reconstructions when compared to the No-MoCo reconstructions (P > .05). DPR-MoCo results showed higher correlation with the functional values obtained from the cardiac MR than the No-MoCo results, though non-significant (P > .05). CONCLUSION The projection-based DPR-MoCo method helps to improve PET image quality of the myocardium without the need for external devices for motion tracking.
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Affiliation(s)
- Martin Lyngby Lassen
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
- Artificial Intelligence in Medicine program, Cedars-Sinai Medical Center, Los Angeles, California, USA.
| | - Thomas Beyer
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Alexander Berger
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Dietrich Beitzke
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Engineering and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Sazan Rasul
- Division of Nuclear Medicine, Department of Biomedical Engineering and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Florian Büther
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Engineering and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Jacobo Cal-González
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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11
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Abreu M, Fred A, Valente J, Wang C, Plácido da Silva H. Morphological autoencoders for apnea detection in respiratory gating radiotherapy. Comput Methods Programs Biomed 2020; 195:105675. [PMID: 32750630 DOI: 10.1016/j.cmpb.2020.105675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Respiratory gating training is a common technique to increase patient proprioception, with the goal of (e.g.) minimizing the effects of organ motion during radiotherapy. In this work, we devise a system based on autoencoders for classification of regular, apnea and unconstrained breathing patterns (i.e. multiclass). METHODS Our approach is based on morphological analysis of the respiratory signals, using an autoencoder trained on regular breathing. The correlation between the input and output of the autoencoder is used to train and test several classifiers in order to select the best. Our approach is evaluated in a novel real-world respiratory gating biofeedback training dataset and on the Apnea-ECG reference dataset. RESULTS Accuracies of 95 ± 3.5% and 87 ± 6.6% were obtained for two different datasets, in the classification of breathing and apnea. These results suggest the viability of a generalised model to characterise the breathing patterns under study. CONCLUSIONS Using autoencoders to learn respiratory gating training patterns allows a data-driven approach to feature extraction, by focusing only on the signal's morphology. The proposed system is prone to be used in real-time and could potentially be transferred to other domains.
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Affiliation(s)
- Mariana Abreu
- Instituto Superior Técnico, 1049-001, Lisboa, Portugal; Instituto de Telecomunicações, Lisboa, 1049-001, Portugal.
| | - Ana Fred
- Instituto Superior Técnico, 1049-001, Lisboa, Portugal; Instituto de Telecomunicações, Lisboa, 1049-001, Portugal.
| | - João Valente
- Instituto Politécnico de Castelo Branco, Castelo Branco, 6000-084, Portugal.
| | | | - Hugo Plácido da Silva
- Instituto Superior Técnico, 1049-001, Lisboa, Portugal; Instituto de Telecomunicações, Lisboa, 1049-001, Portugal.
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12
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Fattori G, Hrbacek J, Regele H, Bula C, Mayor A, Danuser S, Oxley DC, Rechsteiner U, Grossmann M, Via R, Böhlen TT, Bolsi A, Walser M, Togno M, Colvill E, Lempen D, Weber DC, Lomax AJ, Safai S. Commissioning and quality assurance of a novel solution for respiratory-gated PBS proton therapy based on optical tracking of surface markers. Z Med Phys 2020; 32:52-62. [PMID: 32830006 PMCID: PMC9948868 DOI: 10.1016/j.zemedi.2020.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/01/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022]
Abstract
We present the commissioning and quality assurance of our clinical protocol for respiratory gating in pencil beam scanning proton therapy for cancer patients with moving targets. In a novel approach, optical tracking has been integrated in the therapy workflow and used to monitor respiratory motion from multiple surrogates, applied on the patients' chest. The gating system was tested under a variety of experimental conditions, specific to proton therapy, to evaluate reaction time and reproducibility of dose delivery control. The system proved to be precise in the application of beam gating and allowed the mitigation of dose distortions even for large (1.4cm) motion amplitudes, provided that adequate treatment windows were selected. The total delivered dose was not affected by the use of gating, with measured integral error within 0.15cGy. Analysing high-resolution images of proton transmission, we observed negligible discrepancies in the geometric location of the dose as a function of the treatment window, with gamma pass rate greater than 95% (2%/2mm) compared to stationary conditions. Similarly, pass rate for the latter metric at the 3%/3mm level was observed above 97% for clinical treatment fields, limiting residual movement to 3mm at end-exhale. These results were confirmed in realistic clinical conditions using an anthropomorphic breathing phantom, reporting a similarly high 3%/3mm pass rate, above 98% and 94%, for regular and irregular breathing, respectively. Finally, early results from periodic QA tests of the optical tracker have shown a reliable system, with small variance observed in static and dynamic measurements.
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Affiliation(s)
- Giovanni Fattori
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland.
| | - Jan Hrbacek
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Harald Regele
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Christian Bula
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Alexandre Mayor
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Stefan Danuser
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - David C. Oxley
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Urs Rechsteiner
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Martin Grossmann
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Riccardo Via
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Till T. Böhlen
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Alessandra Bolsi
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Marc Walser
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Michele Togno
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Emma Colvill
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Daniel Lempen
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Damien C. Weber
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland,Department of Radiation Oncology, University Hospital Zurich, 8091 Zurich, Switzerland,Department of Radiation Oncology, University Hospital Bern, 3000 Bern, Switzerland
| | - Antony J. Lomax
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland,Department of Physics, ETH Zurich, 8092 Zurich, Switzerland
| | - Sairos Safai
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen, Switzerland
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13
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Zhang D, Pretorius PH, Ghaly M, Zhang Q, King MA, Mok GSP. Evaluation of different respiratory gating schemes for cardiac SPECT. J Nucl Cardiol 2020; 27:634-647. [PMID: 30088195 DOI: 10.1007/s12350-018-1392-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/17/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Respiratory gating reduces motion blurring in cardiac SPECT. Here we aim to evaluate the performance of three respiratory gating strategies using a population of digital phantoms with known truth and clinical data. METHODS We analytically simulated 60 projections for 10 XCAT phantoms with 99mTc-sestamibi distributions using three gating schemes: equal amplitude gating (AG), equal count gating (CG), and equal time gating (TG). Clinical list-mode data for 10 patients who underwent 99mTc-sestamibi scans were also processed using the 3 gating schemes. Reconstructed images in each gate were registered to a reference gate, averaged and reoriented to generate the polar plots. For simulations, image noise, relative difference (RD) of averaged count for each of the 17 segment, and relative defect size difference (RSD) were analyzed. For clinical data, image intensity profile and FWHM were measured across the left ventricle wall. RESULTS For simulations, AG and CG methods showed significantly lower RD and RSD compared to TG, while noise variation was more non-uniform through different gates for AG. In the clinical study, AG and CG had smaller FWHM than TG. CONCLUSIONS AG and CG methods show better performance for motion reduction and are recommended for clinical respiratory gating SPECT implementation.
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Affiliation(s)
- Duo Zhang
- Biomedical Imaging Laboratory (BIG), Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau SAR, China
- Department of Radiology, University of Massachusetts Medical School, Worcester, USA
| | - P Hendrik Pretorius
- Department of Radiology, University of Massachusetts Medical School, Worcester, USA
| | - Michael Ghaly
- The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
- Radiopharmaceutical Imaging and Dosimetry (RAPID), LLC, Baltimore, MD, USA
| | - Qi Zhang
- Biomedical Imaging Laboratory (BIG), Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau SAR, China
| | - Michael A King
- Department of Radiology, University of Massachusetts Medical School, Worcester, USA
| | - Greta S P Mok
- Biomedical Imaging Laboratory (BIG), Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau SAR, China.
- Department of Radiology, University of Massachusetts Medical School, Worcester, USA.
- Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.
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14
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Heard VD, Bolookat ER, Rauschenbach B, Martin K, Gomez J, Singh AK, Malhotra H. Dosimetric Implications of Number of Breathing Phases Used in the Definition of Internal Target Volume [ITV] in the Treatment of Non-Small Cell Lung Cancers Using Stereotactic Body Radiation Therapy (SBRT). Ann Lung Cancer 2019; 3:75-83. [PMID: 31942567 PMCID: PMC6961841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Determination of intrafraction motion in stereotactic body radiation therapy (SBRT) of non-small-cell lung cancer (NSCLC) usually involves generating an internal target volume (ITV) based on target segmentation in every one of the 10 phases of a 4-dimensional computed tomography (4DCT) dataset which increases dosimetry work load substantially. This study explores the feasibility of using a smaller number of phases to compile an ITV to get equivalent results. Twenty-five lung cancer patients treated with SBRT were retrospectively assessed. Patients were categorized by the anatomic location of the GTV within different lobes of the lungs, 5 in each lobe. Ten GTVs were contoured by the radiation oncologist in 10 different phases of one complete respiratory cycle. Five samples (Sample 1-5) were created using (0%, 20%, 40%, 60%, 80% i.e. taking every other phase), (0%, 30%, 60%, 90% i.e. skipping two successive phases), (0%, 20%, 30%, 50% i.e. essentially taking inhale, exhale & a phase in between), (0%, 30%, 60%), (0%, 50% i.e. using completely inhale and exhale phase only) phase GTVs, 0% is designated as the most inhaled phase and 50% as the most exhaled phase. Appropriate sample ITVs and PTVs were created in the same manner as the clinical plan which was then adapted to each sample set with minimal modification. Sample plans were compared for equivalent dose coverage, center of mass, and ITV/PTV volume differences against the clinical treatment plan. The average % ITV underestimation against the clinical ITV increased from a minimum of 7.3% in sample 1 (0%, 20%, 40%, 60%, 80%) to a maximum of 24.5% in sample 5 (0% & 50%) under the conditions of controlled breathing. A similar trend was seen in other samples with the underestimation in the ITV/PTV volume increasing with the decrease in the number of phases irrespective of the tumor location. The average variation in the center of mass of the ITV was minimal (0.43 ± 0.11 mm). Use of ITV/PTV combination derived from using less than all 10 phases resulted in the maximum clinical PTV under-dosage of 5.9% for sample 1 and 12.3% for sample 5, respectively. If fewer phases in the generation of ITV are used, a larger ITV-to-PTV margin might be necessary to get equivalent PTV coverage.
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Affiliation(s)
- Von Darius Heard
- Department of Radiation Medicine, Roswell Park Cancer Institute, USA
| | | | | | - Kate Martin
- Department of Radiation Medicine, Roswell Park Cancer Institute, USA
| | - Jorge Gomez
- Department of Radiation Medicine, Roswell Park Cancer Institute, USA
| | - Anurag K Singh
- Department of Radiation Medicine, Roswell Park Cancer Institute, USA
| | - Harish Malhotra
- Department of Radiation Medicine, Roswell Park Cancer Institute, USA
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15
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Santos AMC, Shepherd J. An affordable custom phantom for measurement of linac time delay in gated treatments with irregular breathing. Australas Phys Eng Sci Med 2019; 42:863-869. [PMID: 31396857 DOI: 10.1007/s13246-019-00785-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Abstract
Respiratory gated treatments are now common in order to reduce tumour motion uncertainties due to breathing. One issue associated with gated treatments is the time delay between the gating system and the linear accelerator. In this study we develop and characterise an affordable phantom to be used in routine and patient specific quality assurance (QA) of the Varian Real-Time Position Management™ (RPM) system. A photodiode has been incorporated into the phantom in order to estimate the time delay. A commercial Quasar phantom was customised to incorporate two stepper motors which independently control an anterior-posterior abdomen/thorax moving plate, and an inferior-superior moving lung insert. A photodiode placed in the path of the radiation is used to measure when beam on/off occurs. Two Arduino microcontroller boards have been utilised to control the motors, read the photodiode and write to an SD card. The measured beam on/off, correlated to the known positions of the phantom is compared to the gate window for RPM. The time delay was measured for sinusoidal movements with a period of 7.50 s and 3.75 s, and for three patient breathing traces. For the sinusoidal movements, time delays of 150 ± 34 ms and 39 ± 34 ms were measured, for 7.50 s and 3.75 s periods, respectively. In the case of the patients' breathing traces time delays of 135 ± 26 ms, 137 ± 34 ms and 129 ± 28 ms were measured. An affordable motion phantom has been developed for routine and patient specific QA of respiratory gating systems. It is capable of reproducing a patient's breathing waveform and performing time delay measurements with a photodiode. Results indicate a time delay of the order of 0.1-0.2 s for the RPM system.
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Affiliation(s)
- Alexandre M Caraça Santos
- Department of Medical Physics, Royal Adelaide Hospital, Adelaide, Australia. .,School of Physical Sciences, University of Adelaide, Adelaide, Australia.
| | - Justin Shepherd
- Department of Medical Physics, Royal Adelaide Hospital, Adelaide, Australia
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16
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Abstract
Cardiac PET provides high sensitivity and high negative predictive value in the diagnosis of coronary artery disease and cardiomyopathies. Cardiac, respiratory as well as bulk patient motion have detrimental effects on thoracic PET imaging, in particular on cardiovascular PET imaging where the motion can affect the PET images quantitatively as well as qualitatively. Gating can ameliorate the unfavorable impact of motion additionally enabling evaluation of left ventricular systolic function. In this article, the authors review the recent advances in gating approaches and highlight the advances in data-driven approaches, which hold promise in motion detection without the need for complex hardware setup.
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Affiliation(s)
| | - Jacek Kwiecinski
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA; British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Piotr J Slomka
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.
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17
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Walker MD, Morgan AJ, Bradley KM, McGowan DR. Evaluation of data-driven respiratory gating waveforms for clinical PET imaging. EJNMMI Res 2019; 9:1. [PMID: 30607651 PMCID: PMC6318161 DOI: 10.1186/s13550-018-0470-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to evaluate the clinical robustness of a commercially developed data-driven respiratory gating algorithm based on principal component analysis, for use in routine PET imaging. METHODS One hundred fifty-seven adult FDG PET examinations comprising a total of 1149 acquired bed positions were used for the assessment. These data are representative of FDG scans currently performed at our institution. Data were acquired for 4 min/bed position (3 min/bed for legs). The data-driven gating (DDG) algorithm was applied to each bed position, including those where minimal respiratory motion was expected. The algorithm provided a signal-to-noise measure of respiratory-like frequencies within the data, denoted as R. Qualitative evaluation was performed by visual examination of the waveforms, with each waveform scored on a 3-point scale by two readers and then averaged (score S of 0 = no respiratory signal, 1 = some respiratory-like signal but indeterminate, 2 = acceptable signal considered to be respiratory). Images were reconstructed using quiescent period gating and compared with non-gated images reconstructed with a matched number of coincidences. If present, the SUVmax of a well-defined lesion in the thorax or abdomen was measured and compared between the two reconstructions. RESULTS There was a strong (r = 0.86) and significant correlation between R and scores S. Eighty-six percent of waveforms with R ≥ 15 were scored as acceptable for respiratory gating. On average, there were 1.2 bed positions per patient examination with R ≥ 15. Waveforms with high R and S were found to originate from bed positions corresponding to the thorax and abdomen: 90% of waveforms with R ≥ 15 had bed centres in the range 5.6 cm superior to 27 cm inferior from the dome of the liver. For regions where respiratory motion was expected to be minimal, R tended to be < 6 and S tended to be 0. The use of DDG significantly increased the SUVmax of focal lesions, by an average of 11% when considering lesions in bed positions with R ≥ 15. CONCLUSIONS The majority of waveforms with high R corresponded to the part of the patient where respiratory motion was expected. The waveforms were deemed suitable for respiratory gating when assessed visually, and when used were found to increase SUVmax in focal lesions.
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Affiliation(s)
- Matthew D Walker
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK.
| | - Andrew J Morgan
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Kevin M Bradley
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Daniel R McGowan
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK.,Department of Oncology, Old Road Campus Research Building, University of Oxford, Oxford, UK
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18
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Daou D, Sabbah R, Coaguila C, Boulahdour H. Impact of data-driven cardiac respiratory motion correction on the extent and severity of myocardial perfusion defects with free-breathing CZT SPECT. J Nucl Cardiol 2018; 25:1299-1309. [PMID: 28160264 DOI: 10.1007/s12350-017-0806-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/24/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND We previously reported the clinical feasibility and positive impact on image characteristics of a data-driven cardiac respiratory motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). Here, we evaluate its impact on the extent and severity of myocardial perfusion defects (MPD). METHODS We included 25 patients having a 1-day 99mTc-Tetrofosmin stress/rest MPI acquired with multi-pinhole CZT SPECT. Acquisitions were processed with REGAT to generate mean RM gated SPECT. These were summed either after (R-SPECT) or without realignment (NR-SPECT). We noted the maximal cardiac RM shift in the 3 axes of the left ventricle (LV). Both visual and semi-quantitative analyses of myocardial tracer uptake were realized. Studies were classified as having an impact on the extent/severity of MPD with REGAT if ≥1 segment presented a severity score changing by ≥1 level between NR-SPECT and R-SPECT. An impact on the extent of MPD was considered present if at least 1 segment shifted from normal (score = 0) to abnormal (score different from 0) or inversely. RESULTS Cardiac RM was >10 mm in 55% of studies. With visual and semi-quantitative analyses, an impact on the extent/severity MPD was observed in 14% of all studies (7/49) and 60% of studies with cardiac RM >15 mm. An impact on the extent of MPD was observed in 5 of the 7 upper listed studies. All studies presenting an impact on MPD had RM in the anterior to inferior LV axis >10 mm. CONCLUSIONS A substantial number of MPI studies presented significant cardiac RM. Cardiac RM compensation showed a frequent impact on the extent/severity of MPD.
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Affiliation(s)
- Doumit Daou
- EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.
- Nuclear Medicine Department, Cochin University Hospital, AP-HP, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France.
| | - Rémy Sabbah
- Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France
| | - Carlos Coaguila
- Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France
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19
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Dasu A, Flejmer AM, Edvardsson A, Witt Nyström P. Normal tissue sparing potential of scanned proton beams with and without respiratory gating for the treatment of internal mammary nodes in breast cancer radiotherapy. Phys Med 2018; 52:81-5. [PMID: 30139613 DOI: 10.1016/j.ejmp.2018.06.639] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 06/26/2018] [Accepted: 06/29/2018] [Indexed: 01/26/2023] Open
Abstract
Proton therapy has shown potential for reducing doses to normal tissues in breast cancer radiotherapy. However data on the impact of protons when including internal mammary nodes (IMN) in the target for breast radiotherapy is comparatively scarce. This study aimed to evaluate normal tissue doses when including the IMN in regional RT with scanned proton beams, with and without respiratory gating. The study cohort was composed of ten left-sided breast patients CT-scanned during enhanced inspiration gating (EIG) and free-breathing (FB). Proton plans were designed for the target including or excluding the IMN. Targets and organs-at-risk were delineated according to RTOG guidelines. Comparison was performed between dosimetric parameters characterizing target coverage and OAR radiation burden. Statistical significance of differences was tested using a paired, two-tailed Student's t-test. Inclusion of the IMN in the target volume led to a small increase of the cardiopulmonary burden. The largest differences were seen for the ipsilateral lung where the mean dose increased from 6.1 to 6.6 Gy (RBE) (P < 0.0001) in FB plans and from 6.9 to 7.4 Gy (RBE) (P = 0.003) in EIG plans. Target coverage parameters were very little affected by the inclusion of IMN into the treatment target. Radiotherapy with scanned proton beams has the potential of maintaining low cardiovascular burden when including the IMN into the target, irrespective of whether respiratory gating is used or not.
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20
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Farias AR, Medeiros DDC, Magalhães HA, Moraes MFD, Mendes EMAM. A novel approach for accelerating mouse abdominal MRI by combining respiratory gating and compressed sensing. Magn Reson Imaging 2018. [PMID: 29526644 DOI: 10.1016/j.mri.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To combine the technique of respiratory gating and compressed sensing (CS) with the objective of accelerating mouse abdominal magnetic resonance imaging (MRI). MATERIALS AND METHODS To obtain the maximum acceleration, phase-encoding data from a phantom and mouse were obtained on a 4.7 Tesla scanner using the respiratory gating technique. The fully sampled data (FSD) were used to construct reference images and to provide samples to simulate retrospective undersampled data (UD) acquisition using respiratory gating. The UD and 95% of the UD on acceleration 2-5 rates were acquired and used for image reconstruction by CS. Quantitative assessment of reconstructed images was performed by structural similarity index (SSIM), peak signal-to-noise ratio (PSNR) and root mean square error (RMSE). RESULTS The proposed method can accelerate phantom and mouse abdominal MRI acquisition between 2 and 4 rates by reducing the amount of FSD. For phantom UD acquisition, the mean time was reduced in 45.9% and for the acquisition of 95% of UD in 67.8%. For mouse abdominal image UD acquisition, the mean time was reduced in 44.6% and for the acquisition of 95% of UD in 62.5%. The metrics results show that the reconstructed image from UD and 95% of UD by using CS maintains an optimal agreement with their reference images (similarity above 0.88 for phantom and 0.93 for mouse). CONCLUSION This study presents a novel approach to accelerate mouse abdominal MRI combining respiratory gating technique and CS without the use of expensive hardware and capable of achieving up to 4 acceleration rate without image degradation.
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Affiliation(s)
- Alexandre Rodrigues Farias
- Center for Technological and Research in Magneto-Resonance (CTPMag), Electrical Engineering Graduate Program, Federal University of Minas Gerais - UFMG, Brazil; Department of Electronic and Biomedical Equipment, Federal Centre of Technological Education of Minas Gerais - CEFET-MG, Brazil
| | - Daniel de Castro Medeiros
- Center for Technological and Research in Magneto-Resonance (CTPMag), Electrical Engineering Graduate Program, Federal University of Minas Gerais - UFMG, Brazil; Department of Physiology and Biophisics, Institute of Biological Sciences, Federal University of Minas Gerais, Brazil
| | - Hermes Aguiar Magalhães
- Center for Technological and Research in Magneto-Resonance (CTPMag), Electrical Engineering Graduate Program, Federal University of Minas Gerais - UFMG, Brazil
| | - Márcio Flávio Dutra Moraes
- Center for Technological and Research in Magneto-Resonance (CTPMag), Electrical Engineering Graduate Program, Federal University of Minas Gerais - UFMG, Brazil; Department of Physiology and Biophisics, Institute of Biological Sciences, Federal University of Minas Gerais, Brazil
| | - Eduardo M A M Mendes
- Center for Technological and Research in Magneto-Resonance (CTPMag), Electrical Engineering Graduate Program, Federal University of Minas Gerais - UFMG, Brazil.
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Guerra L, Ponti ED, Morzenti S, Spadavecchia C, Crivellaro C. Respiratory Motion Management in PET/CT: Applications and Clinical Usefulness. Curr Radiopharm 2018; 10:85-92. [PMID: 28530533 DOI: 10.2174/1874471010666170519165918] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Breathing movement can introduce heavy bias in both image quality and quantitation in PET/CT. The aim of this paper is a review of the literature to evaluate the benefit of respiratory gating in terms of image quality, quantification and lesion detectability. METHODS A review of the literature published in the last 10 years and dealing with gated PET/CT technique has been performed, focusing on improvement in quantification, lesion detectability and diagnostic accuracy in neoplastic lesion. In addition, the improvement in the definition of radiotherapy planning has been evaluated. RESULTS There is a consistent increase of the Standardized Uptake Value (SUV) in gated PET images when compared to ungated ones, particularly for lesions located in liver and in lung. Respiratory gating can also increase sensitivity, specificity and accuracy of PET/CT. Gated PET/CT can be used for radiation therapy planning, reducing the uncertainty in target definition, optimizing the volume to be treated and reducing the possibility of "missing" during the dose delivery. Moreover, new technologies, able to define the movement of lesions and organs directly from the PET sinogram, can solve some problems that currently are limiting the clinical use of gated PET/CT (i.e.: extended acquisition time, radiation exposure). CONCLUSION The published literature demonstrated that respiratory gating PET/CT is a valid technique to improve quantification, lesion detectability of lung and liver tumors and can better define the radiotherapy planning of moving lesions and organs. If new technical improvements for motion compensation will be clinically validated, gated technique could be applied routinely in any PET/CT scan.
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Affiliation(s)
- Luca Guerra
- Nuclear Medicine Department, San Gerardo Hospital - ASST Monza, University of Milano-Bicocca, Via Pergolesi 33, Monza, 20900. Italy
| | - Elena De Ponti
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Monza. Italy
| | - Sabrina Morzenti
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Monza. Italy
| | | | - Cinzia Crivellaro
- Nuclear Medicine Department, San Gerardo Hospital, ASST-Monza, Monza. Italy
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Lassen ML, Rasmussen T, Christensen TE, Kjær A, Hasbak P. Respiratory gating in cardiac PET: Effects of adenosine and dipyridamole. J Nucl Cardiol 2017; 24:1941-1949. [PMID: 27604107 DOI: 10.1007/s12350-016-0631-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 07/26/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim of our study was to compare the resulting imaging quality by the use of a time-based respiratory gating system in two groups administered either adenosine or dipyridamole as the pharmacological stress agent. METHODS AND RESULTS Forty-eight patients were randomized to adenosine or dipyridamole cardiac stress 82RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4.7) min-1, P < .001] and tended to have a lower frequency of successful respiratory gating compared to dipyridamole (47% vs 71%, P = .12). As a result, imaging quality was superior in the dipyridamole group compared to adenosine. CONCLUSIONS If respiratory gating is considered for use in cardiac PET, a dipyridamole stress protocol is recommended as it, compared to adenosine, causes a more uniform respiration and results in a higher frequency of successful respiratory gating and thereby superior imaging quality.
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Affiliation(s)
- Martin Lyngby Lassen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Section 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Thomas Rasmussen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Section 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Thomas E Christensen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Section 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Section 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Philip Hasbak
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Section 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Crivellaro C, De Ponti E, Elisei F, Morzenti S, Picchio M, Bettinardi V, Versari A, Fioroni F, Dziuk M, Tkaczewski K, Ahond-Vionnet R, Nodari G, Todde S, Landoni C, Guerra L. Added diagnostic value of respiratory-gated 4D 18F-FDG PET/CT in the detection of liver lesions: a multicenter study. Eur J Nucl Med Mol Imaging 2017; 45:102-109. [PMID: 28825125 DOI: 10.1007/s00259-017-3795-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/26/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18F-FDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. METHODS Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3D-PET/CT and liver 4D-PET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4D-PET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4D-PET/CT. RESULTS Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3D-PET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4D-PET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4D-PET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4D-PET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4D-PET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3D-PET (mean ± SD, 5.2 ± 2.3). CONCLUSIONS Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic accuracy, and confidence in reporting. 4D-PET/CT also improved the quantification of SUVmax of liver lesions.
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Affiliation(s)
- Cinzia Crivellaro
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy. .,University of Milan-Bicocca, Milan, Italy.
| | | | | | | | - Maria Picchio
- Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Annibale Versari
- Nuclear Medicine, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | - Federica Fioroni
- Medical Physics, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | | | | | - Renée Ahond-Vionnet
- Service de Médecine Nucléaire, Hôpital Pierre Beregovoy, Cedex, Nevers, France
| | - Guillaume Nodari
- Service de Médecine Nucléaire, Hôpital Pierre Beregovoy, Cedex, Nevers, France
| | - Sergio Todde
- Tecnomed Foundation, University of Milan-Bicocca, Monza, Italy
| | - Claudio Landoni
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy.,University of Milan-Bicocca, Milan, Italy
| | - Luca Guerra
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy.,University of Milan-Bicocca, Milan, Italy
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Campbell WG, Jones BL, Schefter T, Goodman KA, Miften M. An evaluation of motion mitigation techniques for pancreatic SBRT. Radiother Oncol 2017; 124:168-173. [PMID: 28571887 DOI: 10.1016/j.radonc.2017.05.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/20/2017] [Accepted: 05/15/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Ablative radiation therapy can be beneficial for pancreatic cancer, and motion mitigation helps to reduce dose to nearby organs-at-risk. Here, we compared two competing methods of motion mitigation-abdominal compression and respiratory gating. MATERIALS AND METHODS CBCT scans of 19 pancreatic cancer patients receiving stereotactic body radiation therapy were acquired with and without abdominal compression, and 3D target motion was reconstructed from CBCT projection images. Daily target motion without mitigation was compared against motion with compression and with simulated respiratory gating. Gating was free-breathing and based on an external surrogate. Target coverage was also evaluated for each scenario by simulating reduced target margins. RESULTS Without mitigation, average daily target motion in LR/AP/SI directions was 5.3, 7.3, and 13.9mm, respectively. With abdominal compression, these values were 5.2, 5.3, and 8.5mm, and with respiratory gating they were 3.2, 3.9, and 5.5mm, respectively. Reductions with compression were significant in AP/SI directions, while reductions with gating were significant in all directions. Respiratory gating also demonstrated better coverage in the reduced margins scenario. CONCLUSION Respiratory gating is the most effective strategy for reducing motion in pancreatic SBRT, and may allow for dose escalation through a reduction in target margin.
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Affiliation(s)
- Warren G Campbell
- Department of Radiation Oncology, University of Colorado School of Medicine, USA.
| | - Bernard L Jones
- Department of Radiation Oncology, University of Colorado School of Medicine, USA
| | - Tracey Schefter
- Department of Radiation Oncology, University of Colorado School of Medicine, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, University of Colorado School of Medicine, USA
| | - Moyed Miften
- Department of Radiation Oncology, University of Colorado School of Medicine, USA
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Kitamura Y, Baba S, Isoda T, Maruoka Y, Kawanami S, Himuro K, Sasaki M, Honda H. The Efficiency of Respiratory-gated 18F-FDG PET/CT in Lung Adenocarcinoma: Amplitude-gating Versus Phase-gating Methods. Asia Ocean J Nucl Med Biol 2017; 5:30-36. [PMID: 28840136 PMCID: PMC5221683 DOI: 10.22038/aojnmb.2016.7747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 07/06/2016] [Accepted: 07/25/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In positron emission tomography (PET) studies, thoracic movement under free-breathing conditions is a cause of image degradation. Respiratory gating (RG) is commonly used to solve this problem. Two different methods, i.e., phase-gating (PG) and amplitude-gating (AG) PET, are available for respiratory gating. It is important to know the strengths and weaknesses of both methods when selecting an RG method for a given patient. We conducted this study to clarify whether AG or PG is preferable for measuring fluorodeoxyglucose (FDG) accumulation in lung adenocarcinoma and to investigate patient conditions which are most suitable for AG and PG methods. METHODS A total of 31 patients (11 males, 20 females; average age: 70.1±11.6 yrs) with 44 lung lesions, diagnosed as lung adenocarcinoma between April 2012 and March 2013, were investigated. Whole-body FDG-PET/CT scan was performed with both PG and AG methods in all patients. The maximum standardized uptake value (SUVmax) of PG, AG, and the control data of these two methods were measured, and the increase ratio (IR), calculated as IR(%)= (Post - Pre)/Pre × 100, was calculated. The diameter and position of lung lesions were also analyzed. We defined an 'effective lesion' of PG (or AG) as a lesion which showed a higher IR compared to AG (or PG). 8 (25.8%). RESULTS The average SUVmax and average IR were 8.99±7.94 and %21.4±25.6 in PG and 7.60±6.70 and %4.0±14.4 in AG, respectively. Although there was no significant difference between the average SUVmax of PG and AG (P=0.09), the average IR of PG was significantly higher than that of AG (P<0.01). The number of PG- and AG-effective lesions was 32 (72.7%) and 12 (28.3%), respectively. There was no significant difference in the average diameter or position of the lesions between the PG- and AG-effective lesions. There were 23 (74.2%) PG-effective and 8 (25.8%) AG-effective patients. No significant difference was observed in sex or age between PG- and AG-effective patients. CONCLUSION The PG method was more effective for measuring FDG accumulation of lung lesions under free-breathing conditions in comparison with the AG method.
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Affiliation(s)
- Yoshiyuki Kitamura
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shingo Baba
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuro Isoda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiro Maruoka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Kawanami
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuhiko Himuro
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Sasaki
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Bedos L, Riou O, Aillères N, Braccini A, Molinier J, Moscardo CL, Azria D, Fenoglietto P. Evaluation of reproducibility of tumor repositioning during multiple breathing cycles for liver stereotactic body radiotherapy treatment. Rep Pract Oncol Radiother 2016; 22:132-140. [PMID: 28490984 DOI: 10.1016/j.rpor.2016.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/15/2016] [Accepted: 07/23/2016] [Indexed: 12/25/2022] Open
Abstract
AIM To evaluate the tumor repositioning during gated volumetric modulated arc therapy (VMAT) for liver stereotactic body radiotherapy(SBRT) treatment using implanted fiducial markers and intrafraction kilovoltage (kV) images acquired during dose delivery. MATERIALS AND METHODS Since 2012, 47 liver cancer patients with implanted fiducial markers were treated using the gated VMAT technique with a Varian Truebeam STx linear accelerator. The fiducial markers were implanted inside or close to the tumor target before treatment simulation. They were defined at the maximum inhalation and exhalation phases on a 4-dimensionnal computed tomography (4DCT) acquisition. During the treatment, kV images were acquired just before the beam-on at each breathing cycle at maximum exhalation and inhalation phases to verify the fiducial markers positions. For the five first fractions of treatment in the first ten consecutive patients, a total of 2705 intrafraction kV images were retrospectively analyzed to assess the differences between expected and actual positions of the fiducial markers along the cranio-caudal (CC) direction during the exhalation phase. RESULTS The mean absolute intrafractional fiducial marker deviation along the CC direction was 1.0 mm at the maximum exhalation phase. In 99%, 95% and 90% cases, the fiducial marker deviations were ≤4.5 mm, 2.8 mm and 2.2 mm, respectively. CONCLUSION Intrafraction kV images allowed us to ensure the consistency of tumor repositioning during treatment. In 99% cases, the fiducial marker deviations were ≤4.5 mm corresponding to our 5 mm treatment margin. This margin seems to be well-adapted to the gated VMAT SBRT treatment in liver disease.
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Affiliation(s)
- Ludovic Bedos
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - Olivier Riou
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - Norbert Aillères
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - Antoine Braccini
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - Jessica Molinier
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - Carmen Llacer Moscardo
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - David Azria
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
| | - Pascal Fenoglietto
- Radiation Oncology Department, Institut régional du Cancer de Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, 34298 Montpellier cedex 5, France
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Suzawa N, Ichikawa Y, Ishida M, Tomita Y, Nakayama R, Sakuma H. Respiratory-gated time-of-flight PET/CT during whole-body scan for lung lesions: feasibility in a routine clinical setting and quantitative analysis. Ann Nucl Med 2016; 30:722-30. [PMID: 27566685 DOI: 10.1007/s12149-016-1118-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To demonstrate the feasibility of respiratory gating during whole-body scan for lung lesions in routine 18F-FDG PET/CT examinations using a time-of-flight (TOF)-capable scanner to determine the effect of respiratory gating on reduction of both misregistration (between CT and PET) and image blurring, and on improvement of the maximum standardized uptake value (SUVmax). MATERIALS AND METHODS Patients with lung lesions who received FDG PET/CT were prospectively studied. Misregistration, volume of PET (Vp), and SUVmax were compared between ungated and gated images. The difference in respiratory gating effects was compared between lesions located in the upper or middle lobes (UML) and the lower lobe (LL). The correlation between three parameters (% change in misregistration, % change in Vp, and lesion size) and % change in SUVmax was analyzed. RESULTS The study population consisted of 60 patients (37 males, 23 females; age 68 ± 12 years) with lung lesions (2.5 ± 1.7 cm). Fifty-eight out of sixty respiratory gating studies were successfully completed with a total scan time of 20.9 ± 1.9 min. Eight patients' data were not suitable for analysis, while the remaining 50 patients' data were analyzed. Respiratory gating reduced both misregistration by 21.4 % (p < 0.001) and Vp by 14.2 % (p < 0.001). The SUVmax of gated images improved by 14.8 % (p < 0.001). The % change in misregistration, Vp, and SUVmax by respiratory gating tended to be larger in LL lesions than in UML lesions. The correlation with % change in SUVmax was stronger in % change in Vp (r = 0.57) than % change in misregistration (r = 0.35). There was no statistically significant correlation between lesion size and % change in SUVmax (r = -0.20). CONCLUSIONS Respiratory gating during whole-body scan in routine TOF PET/CT examinations is feasible and can reduce both misregistration and PET image blurring, and improve the SUVmax of lung lesions located primarily in the LL.
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Vauclin S, Michel C, Buvat I, Doyeux K, Edet-Sanson A, Vera P, Gardin I, Hapdey S. Monte-Carlo simulations of clinically realistic respiratory gated (18)F-FDG PET: application to lesion detectability and volume measurements. Comput Methods Programs Biomed 2015; 118:84-93. [PMID: 25459525 DOI: 10.1016/j.cmpb.2014.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 10/02/2014] [Accepted: 10/03/2014] [Indexed: 06/04/2023]
Abstract
In PET/CT thoracic imaging, respiratory motion reduces image quality. A solution consists in performing respiratory gated PET acquisitions. The aim of this study was to generate clinically realistic Monte-Carlo respiratory PET data, obtained using the 4D-NCAT numerical phantom and the GATE simulation tool, to assess the impact of respiratory motion and respiratory-motion compensation in PET on lesion detection and volume measurement. To obtain reconstructed images as close as possible to those obtained in clinical conditions, a particular attention was paid to apply to the simulated data the same correction and reconstruction processes as those applied to real clinical data. The simulations required 140,000h (CPU) generating 1.5 To of data (98 respiratory gated and 49 ungated scans). Calibration phantom and patient reconstructed images from the simulated data were visually and quantitatively very similar to those obtained in clinical studies. The lesion detectability was higher when the better trade-off between lesion movement limitation (compared to ungated acquisitions) and image statistic preservation is considered (respiratory cycle sampling in 3 frames). We then compared the lesion volumes measured on conventional PET acquisitions versus respiratory gated acquisitions, using an automatic segmentation method and a 40%-threshold approach. A time consuming initial manual exclusion of noisy structures needed with the 40%-threshold was not necessary when the automatic method was used. The lesion detectability along with the accuracy of tumor volume estimates was largely improved with the gated compared to ungated PET images.
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Affiliation(s)
- S Vauclin
- QuantIF-Litis, EA4108 - FR CNRS 3638, Rouen University, Rouen, France; Siemens Medical, Saint-Denis, France
| | - C Michel
- Siemens Medical, Knoxville, TN, USA
| | - I Buvat
- IMNC, UMR 8165 CNRS, Universités Paris 7 & 11, Orsay, France
| | - K Doyeux
- QuantIF-Litis, EA4108 - FR CNRS 3638, Rouen University, Rouen, France; Radiotherapy Department, Henri Becquerel Center, Rouen, France
| | - A Edet-Sanson
- QuantIF-Litis, EA4108 - FR CNRS 3638, Rouen University, Rouen, France; Nuclear Medicine Department, Henri Becquerel Center, Rouen, France; Rouen University Hospital, Rouen, France
| | - P Vera
- QuantIF-Litis, EA4108 - FR CNRS 3638, Rouen University, Rouen, France; Nuclear Medicine Department, Henri Becquerel Center, Rouen, France; Rouen University Hospital, Rouen, France
| | - I Gardin
- QuantIF-Litis, EA4108 - FR CNRS 3638, Rouen University, Rouen, France; Nuclear Medicine Department, Henri Becquerel Center, Rouen, France; Rouen University Hospital, Rouen, France
| | - S Hapdey
- QuantIF-Litis, EA4108 - FR CNRS 3638, Rouen University, Rouen, France; Nuclear Medicine Department, Henri Becquerel Center, Rouen, France; Rouen University Hospital, Rouen, France.
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Wu J, Gogna A, Tan BS, Ooi LL, Tian Q, Liu F, Liu J. A manifold learning method to detect respiratory signal from liver ultrasound images. Comput Med Imaging Graph 2015; 40:194-204. [PMID: 25499961 DOI: 10.1016/j.compmedimag.2014.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 10/11/2014] [Accepted: 11/20/2014] [Indexed: 11/22/2022]
Abstract
Respiratory gating has been widely applied for respiratory correction or compensation in image acquisition and image-guided interventions. A novel image-based method is proposed to extract respiratory signal directly from 2D ultrasound liver images. The proposed method utilizes a typical manifold learning method, based on local tangent space alignment based technique, to detect principal respiratory motion from a sequence of ultrasound images. This technique assumes all the images lying on a low-dimensional manifold embedding into the high-dimensional image space, constructs an approximate tangent space of each point to represent its local geometry on the manifold, and then aligns the local tangent spaces to form the global coordinate system, where the respiratory signal is extracted. The experimental results show that the proposed method can detect relatively accurate respiratory signal with high correlation coefficient (0.9775) with respect to the ground-truth signal by tracking external markers, and achieve satisfactory computing performance (2.3s for an image sequence of 256 frames). The proposed method is also used to create breathing-corrected 3D ultrasound images to demonstrate its potential application values.
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Y W, Mb W, C S, G S, Mt B, Kd W. Applications of a Capacitor-Based Respiratory Position Sensing Device: Implications for Radiation Therapy. Austin J Med Oncol 2014; 1:1009. [PMID: 31934681 PMCID: PMC6956860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Respiratory motion may significantly affect the outcome in a number of medical imaging techniques and some radiation therapy applications. 4-dimensional computed tomography (4DCT) and respiratory gating technology, which account for the dynamics of respiration, are expensive and often unavailable in smaller radiation treatment centers. Here we evaluate the ability of an inexpensive, technology comprised of two capacitors placed next to the skin to provide real-time respiratory phase information. Three subjects were simultaneously monitored by the new capacitor-based device (CBD) and a commercially available Real time Position Management (RPM) system by Varian. All respiratory phases detected by the RPM system were also detected by the CBD. Automatically detected peaks were not significantly different in timing when comparing RPM and CBD-derived respiratory amplitudes. The anatomic locations of the CBD were varied to evaluate the change in signal quality across the abdomen and thorax. CBD signals were reliable on the abdomen and lower thorax but degraded when recorded from the upper thorax. We also used computed tomography (CT) to assess the imaging characteristics of CBD and found that there were minimal artifacts. We therefore conclude that CBD respiratory amplitude measurements may be useful for tracking respiratory movements as part of a number of advanced radiation therapy technologies including 4DCT image resorting, adaptive radiation therapy and gated radiation therapy.
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Affiliation(s)
- Weng Y
- UT Southwestern Medical School, Dallas, TX, USA
| | - Westover Mb
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Speier C
- Division of Radiation Physics, Department of Radiation Oncology, Massachustets General Hospital, Boston, MA, USA
| | - Sharp G
- Division of Radiation Physics, Department of Radiation Oncology, Massachustets General Hospital, Boston, MA, USA
| | - Bianchi Mt
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Westover Kd
- Department of Radiation Oncology, UT Southwestern Medical School, Dallas, TX, USA
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Kesner AL, Schleyer PJ, Büther F, Walter MA, Schäfers KP, Koo PJ. On transcending the impasse of respiratory motion correction applications in routine clinical imaging - a consideration of a fully automated data driven motion control framework. EJNMMI Phys 2014; 1:8. [PMID: 26501450 PMCID: PMC4673082 DOI: 10.1186/2197-7364-1-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/23/2014] [Indexed: 12/21/2022] Open
Abstract
Positron emission tomography (PET) is increasingly used for the detection, characterization, and follow-up of tumors located in the thorax. However, patient respiratory motion presents a unique limitation that hinders the application of high-resolution PET technology for this type of imaging. Efforts to transcend this limitation have been underway for more than a decade, yet PET remains for practical considerations a modality vulnerable to motion-induced image degradation. Respiratory motion control is not employed in routine clinical operations. In this article, we take an opportunity to highlight some of the recent advancements in data-driven motion control strategies and how they may form an underpinning for what we are presenting as a fully automated data-driven motion control framework. This framework represents an alternative direction for future endeavors in motion control and can conceptually connect individual focused studies with a strategy for addressing big picture challenges and goals.
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Affiliation(s)
- Adam L Kesner
- Division of Nuclear Medicine, Department of Radiology, Anschutz Medical Campus, University of Colorado Denver, 12700 E 19th Ave, Box C-278, Aurora, CO, 80045, USA.
| | - Paul J Schleyer
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, WC2R 2LS, UK.
| | - Florian Büther
- European Institute for Molecular Imaging, University of Münster, Münster, 48149, Germany.
| | - Martin A Walter
- Institute of Nuclear Medicine and Department of Clinical Research, University Hospital Bern, Bern, 3010, Switzerland.
| | - Klaus P Schäfers
- European Institute for Molecular Imaging, University of Münster, Münster, 48149, Germany.
| | - Phillip J Koo
- Division of Nuclear Medicine, Department of Radiology, Anschutz Medical Campus, University of Colorado Denver, 12700 E 19th Ave, Box C-278, Aurora, CO, 80045, USA.
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Shah C, Badiyan S, Berry S, Khan AJ, Goyal S, Schulte K, Nanavati A, Lynch M, Vicini FA. Cardiac dose sparing and avoidance techniques in breast cancer radiotherapy. Radiother Oncol 2014; 112:9-16. [PMID: 24813095 DOI: 10.1016/j.radonc.2014.04.009] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 04/06/2014] [Accepted: 04/18/2014] [Indexed: 12/12/2022]
Abstract
Breast cancer radiotherapy represents an essential component in the overall management of both early stage and locally advanced breast cancer. As the number of breast cancer survivors has increased, chronic sequelae of breast cancer radiotherapy become more important. While recently published data suggest a potential for an increase in cardiac events with radiotherapy, these studies do not consider the impact of newer radiotherapy techniques commonly utilized. Therefore, the purpose of this review is to evaluate cardiac dose sparing techniques in breast cancer radiotherapy. Current options for cardiac protection/avoidance include (1) maneuvers that displace the heart from the field such as coordinating the breathing cycle or through prone patient positioning, (2) technological advances such as intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT), and (3) techniques that treat a smaller volume around the lumpectomy cavity such as accelerated partial breast irradiation (APBI), or intraoperative radiotherapy (IORT). While these techniques have shown promise dosimetrically, limited data on late cardiac events exist due to the difficulties of long-term follow up. Future studies are required to validate the efficacy of cardiac dose sparing techniques and may use surrogates for cardiac events such as biomarkers or perfusion imaging.
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Affiliation(s)
- Chirag Shah
- Department of Radiation Oncology, Summa Health System, Akron, United States
| | - Shahed Badiyan
- Department of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States
| | - Sameer Berry
- Department of Radiation Oncology, Summa Health System, Akron, United States
| | - Atif J Khan
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey & Rutgers Robert Wood Johnson Medical School, New Brunswick, United States
| | - Sharad Goyal
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey & Rutgers Robert Wood Johnson Medical School, New Brunswick, United States
| | - Kevin Schulte
- Department of Radiation Oncology, Summa Health System, Akron, United States
| | - Anish Nanavati
- Department of Oncology, Georgetown University School of Medicine, Washington DC United States
| | - Melanie Lynch
- Department of Radiation Oncology, Summa Health System, Akron, United States
| | - Frank A Vicini
- Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, United States.
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Henni M, Fabre E, Abane R, Housset M. [New techniques in thoracic radiation therapy]. Rev Pneumol Clin 2014; 70:63-68. [PMID: 24566032 DOI: 10.1016/j.pneumo.2013.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/10/2013] [Accepted: 10/25/2013] [Indexed: 06/03/2023]
Abstract
Advanced technologies have led to an improvement of target volume delineation and a higher accuracy in dose delivery. Stereotactic body radiotherapy, intensity-modulated radiotherapy and respiratory gating allow new therapeutic perspectives along with an improvement of the therapeutic ratio. Ongoing trials aim to show the magnitude of gains in patient care with technical improvements.
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Affiliation(s)
- M Henni
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| | - E Fabre
- Service d'oncologie médicale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - R Abane
- Unité CNRS UMR 7216, université Paris Diderot, 35, rue Hélène-Brion, 75013 Paris, France
| | - M Housset
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Aristizábal O, Mamou J, Ketterling JA, Turnbull DH. High-throughput, high-frequency 3-D ultrasound for in utero analysis of embryonic mouse brain development. Ultrasound Med Biol 2013; 39:2321-32. [PMID: 24035625 PMCID: PMC3834109 DOI: 10.1016/j.ultrasmedbio.2013.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/21/2013] [Accepted: 06/30/2013] [Indexed: 05/05/2023]
Abstract
With the emergence of the mouse as the predominant model system for studying mammalian brain development, in utero imaging methods are urgently required to analyze the dynamics of brain growth and patterning in mouse embryos. To address this need, we combined synthetic focusing with a high-frequency (38-MHz) annular-array ultrasound imaging system for extended depth-of-field, coded excitation for improved penetration and respiratory-gated transmit/receive. This combination allowed non-invasive in utero acquisition of motion-free 3-D data from individual embryos in approximately 2 min, and data from four or more embryos in a pregnant mouse in less than 30 min. Data were acquired from 148 embryos spanning 5 d of early to mid-gestational stages of brain development. The results indicated that brain anatomy and cerebral vasculature can be imaged with this system and that quantitative analyses of segmented cerebral ventricles can be used to characterize volumetric changes associated with mouse brain development.
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Affiliation(s)
- Orlando Aristizábal
- Kimmel Center for Biology and Medicine at the Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY, USA
- Department of Radiology, New York University School of Medicine, New York, NY, USA
- Lizzi Center for Biomedical Engineering, Riverside Research, New York, NY, USA
| | - Jonathan Mamou
- Lizzi Center for Biomedical Engineering, Riverside Research, New York, NY, USA
| | - Jeffrey A. Ketterling
- Lizzi Center for Biomedical Engineering, Riverside Research, New York, NY, USA
- Correspondence to: Jeffrey A. Ketterling, PhD, Lizzi Center for Biomedical Engineering, Riverside Research, 156 William Street, New York, NY, USA 10038, and Daniel H. Turnbull, PhD, Skirball Institute of Biomolecular Medicine, New York University School of Medicine, 540 First Avenue, New York, NY, USA 10016, Tel: (212) 263-7262, Fax: (212) 263-8214,
| | - Daniel H. Turnbull
- Kimmel Center for Biology and Medicine at the Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY, USA
- Department of Radiology, New York University School of Medicine, New York, NY, USA
- Correspondence to: Jeffrey A. Ketterling, PhD, Lizzi Center for Biomedical Engineering, Riverside Research, 156 William Street, New York, NY, USA 10038, and Daniel H. Turnbull, PhD, Skirball Institute of Biomolecular Medicine, New York University School of Medicine, 540 First Avenue, New York, NY, USA 10016, Tel: (212) 263-7262, Fax: (212) 263-8214,
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Van Der Gucht A, Serrano B, Hugonnet F, Paulmier B, Garnier N, Faraggi M. Impact of a new respiratory amplitude-based gating technique in evaluation of upper abdominal PET lesions. Eur J Radiol 2013; 83:509-15. [PMID: 24332351 DOI: 10.1016/j.ejrad.2013.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/11/2013] [Accepted: 11/12/2013] [Indexed: 01/17/2023]
Abstract
UNLABELLED PET acquisition requires several minutes which can lead to respiratory motion blurring, to increase partial volume effect and SUV under-estimation. To avoid these artifacts, conventional 10-min phase-based respiratory gating (PBRG) can be performed but is time-consuming and difficult with a non-compliant patient. We evaluated an automatic amplitude-based gating method (AABG) which keeps 35% of the counts at the end of expiration to minimize respiratory motion. We estimated the impact of AABG on upper abdominal lesion detectability, quantification and patient management. METHODS We consecutively included 31 patients (82 hepatic and 25 perihepatic known lesions). Each patient underwent 3 acquisitions on a Siemens Biograph mCT (4 rings and time-of-flight): a standard free-breathing whole-body (SWB, 5-7 steps/2.5 min per step, 3.3±0.4 MBq/kg of 18F-FDG), a 10-min PBRG with six bins and a 5-min AABG method. All gated acquisitions were performed with an ANZAI respiratory gating system. SUVmax and target to background ratio (TBR, defined as the maximum SUV of the lesion divided by the mean SUV of a region of interest drawn in healthy liver) were compared. RESULTS All 94 lesions in SWB images were detected in the gated images. 10-min PBRG and 5-min AABG acquisitions respectively revealed 9 and 13 new lesions and relocated 7 and 8 lesions. Four lesions revealed by 5-min AABG were missed by 10-min PBRG in 3 non-compliant patients. Both gated methods failed to relocate 2 lesions seen on SWB acquisition. Compared to SWB, TBR increased significantly with 10-min PBRG and with 5-min AABG (respectively 41±59%, p=4.10-3 and 66±75%, p=6.10-5) whereas SUVmax did not (respectively 14±43%, p=0.29 with 10-min PBRG, and 24±46%, p=0.11 with 5-min AABG). CONCLUSION The AABG is a fast and a user-friendly respiratory gating method to increase detectability and quantification of upper abdominal lesions compared to the conventional PBRG procedure and the SWB acquisition.
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Affiliation(s)
- Axel Van Der Gucht
- Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco.
| | - Benjamin Serrano
- Department of Medical Physics, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Florent Hugonnet
- Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Benoît Paulmier
- Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Nicolas Garnier
- Department of Medical Physics, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Marc Faraggi
- Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco
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