Journal
RADIOTHERAPY AND ONCOLOGY
Volume 98, Issue 3, Pages 309-316Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2011.01.019
Keywords
ABC (R); Repeat breath hold; Cone-beam CT; Breath-hold imaging
Funding
- Elekta, Crawley, UK
- Elekta Inc.
- Ministerium fur Bildung und Forschung, Baden-Wurttemberg
- ESF (European Social Fonds)
- NHS
- Institute of Cancer Research
- The Royal Marsden NHS Foundation Trust
- Cancer Research UK Section of Radiotherapy [CRUK] [C46/A2131]
- Cancer Research UK [10588] Funding Source: researchfish
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Background and Purpose: Computer controlled breath-hold effectively reduces organ motion for image-guided precision radiotherapy of lung tumors. However, the acquisition time of 3D cone-beam-CT (CBCT) exceeds maximum breath-hold times. We have developed an approach enabling online verification using CBCT image acquisition with ABC (R)-based breath-hold. Methods: Patient CBCT images were acquired with ABC (R)-based repeat breath-hold. The clinical situation was also simulated with a Motion Phantom. Reconstruction of patient and phantom images with selection of free-breathing and breath-hold projections only was performed. Results: CBCT-imaging in repeat breath-hold resulted in a precisely spherical appearance of a tumor-mimicking structure in the phantom. A faint ghost structure (free-breathing phases) can be clearly discriminated. Mean percentage of patient breath-hold time was 66%. Reconstruction based on free-breathing-only shows blurring of both tumor and diaphragm, reconstruction based on breath-hold projections only resulted in sharp contours of the same structures. From the phantom experiments, a maximal repositioning error of 1 mm in each direction can be estimated. Discussion and Conclusion: CBCT during repetitive breath hold provides reliable soft-tissue-based positioning. Fast 3D-imaging during one breath-hold is currently under development and has the potential to accelerate clinical linac-based volume imaging. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 98 (2011) 309-316
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