在用于自适应放疗的Pinnacle(3)治疗计划系统中自动复制锥形束CT引导的治疗。

Automated replication of cone beam CT-guided treatments in the Pinnacle(3) treatment planning system for adaptive radiotherapy.

作者信息

Hargrave Catriona, Mason Nicole, Guidi Robyn, Miller Julie-Anne, Becker Jillian, Moores Matthew, Mengersen Kerrie, Poulsen Michael, Harden Fiona

机构信息

Radiation Oncology Mater Centre Cancer Services, Metro South Health Service District South Brisbane Queensland Australia; Faculty of Health School of Clinical Sciences Queensland University of Technology Brisbane Queensland Australia; Institute for Health and Biomedical Innovation Queensland University of Technology Kelvin Grove Queensland Australia.

Radiation Oncology Mater Centre Cancer Services, Metro South Health Service District South Brisbane Queensland Australia.

出版信息

J Med Radiat Sci. 2016 Mar;63(1):48-58. doi: 10.1002/jmrs.141. Epub 2015 Oct 3.

DOI:10.1002/jmrs.141

PMID:27087975

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4775828/

Abstract

INTRODUCTION

Time-consuming manual methods have been required to register cone-beam computed tomography (CBCT) images with plans in the Pinnacle(3) treatment planning system in order to replicate delivered treatments for adaptive radiotherapy. These methods rely on fiducial marker (FM) placement during CBCT acquisition or the image mid-point to localise the image isocentre. A quality assurance study was conducted to validate an automated CBCT-plan registration method utilising the Digital Imaging and Communications in Medicine (DICOM) Structure Set (RS) and Spatial Registration (RE) files created during online image-guided radiotherapy (IGRT).

METHODS

CBCTs of a phantom were acquired with FMs and predetermined setup errors using various online IGRT workflows. The CBCTs, DICOM RS and RE files were imported into Pinnacle(3) plans of the phantom and the resulting automated CBCT-plan registrations were compared to existing manual methods. A clinical protocol for the automated method was subsequently developed and tested retrospectively using CBCTs and plans for six bladder patients.

RESULTS

The automated CBCT-plan registration method was successfully applied to thirty-four phantom CBCT images acquired with an online 0 mm action level workflow. Ten CBCTs acquired with other IGRT workflows required manual workarounds. This was addressed during the development and testing of the clinical protocol using twenty-eight patient CBCTs. The automated CBCT-plan registrations were instantaneous, replicating delivered treatments in Pinnacle(3) with errors of ±0.5 mm. These errors were comparable to mid-point-dependant manual registrations but superior to FM-dependant manual registrations.

CONCLUSION

The automated CBCT-plan registration method quickly and reliably replicates delivered treatments in Pinnacle(3) for adaptive radiotherapy.

摘要

引言

在Pinnacle(3)治疗计划系统中，为了复制适形放疗的已交付治疗，需要耗时的手动方法来将锥形束计算机断层扫描（CBCT）图像与计划进行配准。这些方法依赖于在CBCT采集期间放置基准标记（FM）或使用图像中点来定位图像等中心。进行了一项质量保证研究，以验证一种利用在线图像引导放射治疗（IGRT）期间创建的医学数字成像和通信（DICOM）结构集（RS）和空间配准（RE）文件的CBCT-计划自动配准方法。

方法

使用各种在线IGRT工作流程，通过FM和预定的设置误差获取体模的CBCT。将CBCT、DICOM RS和RE文件导入体模的Pinnacle(3)计划中，并将由此产生的CBCT-计划自动配准与现有的手动方法进行比较。随后制定了一种自动方法的临床方案，并使用六名膀胱患者的CBCT和计划进行回顾性测试。

结果

CBCT-计划自动配准方法成功应用于通过在线0毫米行动水平工作流程获取的34幅体模CBCT图像。通过其他IGRT工作流程获取的10幅CBCT需要手动解决方法。在使用28例患者CBCT的临床方案开发和测试过程中解决了这一问题。CBCT-计划自动配准是即时的，在Pinnacle(3)中复制已交付的治疗，误差为±0.5毫米。这些误差与依赖中点的手动配准相当，但优于依赖FM的手动配准。