Integration of on-line imaging, plan adaptation and radiation delivery: proof of concept using digital tomosynthesis.
Phys Med Biol
; 54(12): 3803-19, 2009 Jun 21.
Article
em En
| MEDLINE
| ID: mdl-19478375
ABSTRACT
The main objective of this manuscript is to propose a new approach to on-line adaptive radiation therapy (ART) in which daily image acquisition, plan adaptation and radiation delivery are integrated together and performed concurrently. A method is described in which on-line ART is performed based on intra-fractional digital tomosynthesis (DTS) images. Intra-fractional DTS images were reconstructed as the gantry rotated between treatment positions. An edge detection algorithm was used to automatically segment the DTS images as the gantry arrived at each treatment position. At each treatment position, radiation was delivered based on the treatment plan re-optimized for the most recent DTS image contours. To investigate the feasibility of this method, a model representing a typical prostate, bladder and rectum was used. To simulate prostate deformations, three clinically relevant, non-rigid deformations (small, medium and large) were modeled by systematically deforming the original anatomy. Using our approach to on-line ART, the original treatment plan was successfully adapted to arrive at a clinically acceptable plan for all three non-rigid deformations. In conclusion, we have proposed a new approach to on-line ART in which plan adaptation is performed based on intra-fractional DTS images. The study findings indicate that this approach can be used to re-optimize the original treatment plan to account for non-rigid anatomical deformations. The advantages of this approach are 1) image acquisition and radiation delivery are integrated in a single gantry rotation around the patient, reducing the treatment time, and 2) intra-fractional DTS images can be used to detect and correct for patient motion prior to the delivery of each beam (intra-fractional patient motion).
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Base de dados:
MEDLINE
Assunto principal:
Radiometria
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Radioterapia Assistida por Computador
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Planejamento da Radioterapia Assistida por Computador
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Intensificação de Imagem Radiográfica
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Radioterapia Conformacional
Tipo de estudo:
Evaluation_studies
/
Prognostic_studies
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article