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01.10.2013 | Original article

Three-dimensional surface scanning for accurate patient positioning and monitoring during breast cancer radiotherapy

verfasst von: C. Gaisberger, MSc, P. Steininger, B. Mitterlechner, S. Huber, H. Weichenberger, F. Sedlmayer, H. Deutschmann

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 10/2013

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Abstract

Purpose

Clinical evaluation of an optical three-dimensional surface scanning (3D-SS) system for patient positioning and monitoring during radiotherapy (RT) for breast cancer.

Materials and methods

A ceiling-mounted scanner was developed to acquire multiple 3D body surface images and tested in 14 conservatively operated breast cancer patients. A reference skin surface was derived from the planning computed tomography (CT) scan as basis for rigid registration with the surface scans. In addition to electronic portal images (EPIs), optical scans were acquired at three defined time points before and during daily RT. Patient setup was guided by laser alignments and corrected according to EPI findings. The accuracy of the 3D-SS system was validated by comparison of the optical scans to EPIs generated in parallel. Interfraction shifts were investigated by comparison of the first 3D-SS image with the reference body outline. Intrafractional motions were analysed by comparing the three daily surface scans with the first EPI.

Results

Comparison of EPIs and 3D-SS images revealed good accordance (− 0.05 ± 0.94 mm). Analysis of daily patient positions revealed average deviations of 0.4 ± 2.4 mm laterally, 0.3 ± 1.9 mm longitudinally and 0.2 ± 3.3 mm vertically. After 2 weeks, a systematic interfraction shift in patient positioning was noted, particularly in the vertical direction (4.9 ± 0.56 mm), which was attributed to patients progressively relaxing. 3D-SS images showed intrafractional shifts of 1.2 ± 0.7 mm over a time course of 2 min.

Conclusion

Optical surface scanning is a simple, fast and reproducible method for breast cancer patient alignment. Particularly for more sophisticated irradiation techniques, it helps to improve accuracy in patient positioning during radiotherapy without the exposure to additional ionizing radiation.

Bartoncini S, Fiandra C, Ruo Redda MG et al (2012) Target registration errors with surface imaging system in conformal radiotherapy for prostate cancer: study on 19 patients. Radiol Med 117(8):1419–1428PubMedCrossRef

Bert C, Metheany KG, Doppke K et al (2005) A phantom evaluation of a stereo-vision surface imaging system for radiotherapy setup. Med Phys 2:2753–2762CrossRef

Bert C, Metheany KG, Doppke KP et al (2006) Clinical experience with a 3D surface patient setup system for alignment of partial-breast irradiation patients. Int J Radiat Oncol Biol Phys 64:1265–1274PubMedCrossRef

Besl P, McKay N (1992) A method for registration of 3-D shapes. IEEE trans. Pat Anal Mach Intel 14(2):239–256CrossRef

Brahme A, Nyman P, Skatt B (2008) 4D laser camera for accurate patient positioning, collision avoidance, image fusion and adaptive approaches during diagnostic and therapeutic procedures. Med Phys 35:1670–1681PubMedCrossRef

Calow R, Gademann G, Krell G et al (2002) Photogrammetric measurement of patients in radiotherapy. ISPRS J Photogrammet Remote Sensing 56:347–359CrossRef

Czigner K, Agoston P, Forgács G et al (2012) Patient positioning variations to reduce dose to normal tissues during 3D conformal radiotherapy for high-risk prostate cancer. Strahlenther Onkol 188(9):816–822PubMedCrossRef

Boer HC de, Sörnsen de Koste JR van, Senan S et al (2001) Analysis and reduction of 3D systematic and random setup errors during the simulation and treatment of lung cancer patients with CT-based external beam radiotherapy dose planning. Int J Radiat Oncol Biol Phys 49(3):857–868PubMedCrossRef

Deutschmann H, Steininger P, Nairz O et al (2008) “Augmented reality” in conventional simulation by projection of 3-D structures into 2-D images: a comparison with virtual methods. Strahlenther Onkol 184(2):93–99PubMedCrossRef

10.

Dickie-Euler C, Parent A, Griffin A et al (2008) Measuring interfraction and intrafraction motion with Cone Beam ComputedTomography (CBCT) and an Optical Localization System (OLS) for lower extremity soft tissue sarcoma patients treated with Preoperative Intensity Modulated Radiation Therapy (IMRT). Int J Radiat Oncol Biol Phys 72:S105–S105CrossRef

11.

Gierga DP, Riboldi M, Turcotte JC et al (2008) Comparison of target registration errors for multiple image-guided techniques in accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys 70(4):1239–1246PubMedCrossRef

12.

Giovanna S, Carocci M, Rodella R (1999) Three-dimensional vision based on a combination of gray-code and phase-shift light projection: analysis and compensation of the systematic errors. Appl Optics 38(31):6565–6573CrossRef

13.

Gong GZ, Yin Y, Xing LG et al (2012) RapidArc combined with the active breathing coordinator provides an effective and accurate approach for the radiotherapy of hepatocellular carcinoma. Strahlenther Onkol 188(3):262–268PubMedCrossRef

14.

Gulybán A, Kovács P, Sebestyén Z et al (2008) Multisegmented tangential breast fields: a rational way to treat breast cancer. Strahlenther Onkol 184(5):262–269PubMedCrossRef

15.

Hasan Y, Kim L, Martinez A et al (2008) Image guidance in external beam accelerated partial breast irradiation: comparison of surrogates for the lumpectomy cavity. Int J Radiat Oncol Biol Phys 70(2):619–625PubMedCrossRef

16.

Jin J, Ajlouni M, Ryu S et al (2007) A technique of quantitatively monitoring both respiratory and nonrespiratory motion in patients using external body markers. Med Phys 34:2875–2881PubMedCrossRef

17.

Kang HJ, Grelewicz Z, Wiersma RD (2012) Development of an automated region of interest selection method for 3D surface monitoring of head motion. Med Phys 39(6):3270–3282PubMedCrossRef

18.

Krengli M, Gaiano S, Mones E et al (2009) Reproducibility of patient setup by surface image registration system in conformal radiotherapy of prostate cancer. Radiat Oncol 4:9PubMedCrossRef

19.

Liebich J, Licher J, Scherf C et al (2011) Simple proposal for dosimetry with an Elekta iViewGT™ electronic portal imaging device (EPID) using commercial software modules. Strahlenther Onkol 187(5):316–321PubMedCrossRef

20.

Moore C, Lilley F, Sauret V et al (2003) Opto-electronic sensing of body surface topology changes during radiotherapy for rectal cancer. Int J Radiat Oncol Biol Phys 56(1):248–258PubMedCrossRef

21.

Mulchrone K (2003) Application of Delaunay triangulation to the nearest neighbour method of strain analysis. J Struct Geol 25:689–702CrossRef

22.

Nairz O, Merz F, Deutschmann H et al (2008) A strategy for the use of image-guided radiotherapy (IGRT) on linear accelerators and its impact on treatment margins for prostate cancer patients. Strahlenther Onkol 184:663–667PubMedCrossRef

23.

Pallotta S, Marrazzo L, Ceroti M et al (2012) A phantom evaluation of Sentinel(™), a commercial laser/camera surface imaging system for patient setup verification in radiotherapy. Med Phys 39(2):706–712PubMedCrossRef

24.

Pili G, Grimaldi L, Fidanza C et al (2011) Geometric and dosimetric approach to determine probability of late cardiac mortality in left tangential breast irradiation: comparison between wedged beams and field-in-field technique. Int J Radiat Oncol Biol Phys 81(3):894–900PubMedCrossRef

25.

Remouchamps VM, Letts N, Yan D et al (2003) Three-dimensional evaluation of intra- and interfraction immobilization of lung and chest wall using active breathing control: a reproducibility study with breast cancer patients. Int J Radiat Oncol Biol Phys 57(4):968–978PubMedCrossRef

26.

Stieler F, Wenz F, Scherrer D et al (2012) Clinical evaluation of a commercial surface-imaging system for patient positioning in radiotherapy. Strahlenther Onkol 188(12):1080–1084PubMedCrossRef

27.

Subramaniam S, Thirumalaiswamy S, Srinivas C et al (2012) Chest wall radiotherapy with volumetric modulated arcs and the potential role of flattening filter free photon beams. Strahlenther Onkol 188(6):484–490PubMedCrossRef

28.

Tsai R (1987) A versatile camera calibration techniaue for high-accuracy 3D machine vision metrology using off-the-shelf TV cameras and lenses. IEEE J Robotics Automation 3(4):323–344CrossRef

29.

Vaerenbergh K et al (2005) Automatic generation of a plan optimization volume for tangential field breast cancer radiation therapy. Strahlenther Onkol 181(2):82–88PubMedCrossRef

Titel: Three-dimensional surface scanning for accurate patient positioning and monitoring during breast cancer radiotherapy
verfasst von: C. Gaisberger, MSc
P. Steininger
B. Mitterlechner
S. Huber
H. Weichenberger
F. Sedlmayer
H. Deutschmann
Publikationsdatum: 01.10.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 10/2013
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-013-0358-6

Springer Medizin

Three-dimensional surface scanning for accurate patient positioning and monitoring during breast cancer radiotherapy