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Erschienen in: Strahlentherapie und Onkologie 3/2017

05.12.2016 | Original Article

A 4D ultrasound real-time tracking system for external beam radiotherapy of upper abdominal lesions under breath-hold

verfasst von: Dwi Seno Kuncoro Sihono, MSc, Lena Vogel, MSc, Christel Weiß, Ph.D, Johannes Thölking, MSc, Frederik Wenz, MD, Frank Lohr, MD, Judit Boda-Heggemann, MD, Ph.D, Hansjörg Wertz, Ph.D

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 3/2017

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Abstract

Background and purpose

To evaluate a novel four-dimensional (4D) ultrasound (US) tracking system for external beam radiotherapy of upper abdominal lesions under computer-controlled deep-inspiration breath-hold (DIBH).

Materials and methods

The tracking accuracy of the research 4D US system was evaluated using two motion phantoms programmed with sinusoidal and breathing patterns to simulate free breathing and DIBH. Clinical performance was evaluated with five healthy volunteers. US datasets were acquired in computer-controlled DIBH with varying angular scanning angles. Tracked structures were renal pelvis (spherical structure) and portal/liver vein branches (non-spherical structure). An external marker was attached to the surface of both phantoms and volunteers as a secondary object to be tracked by an infrared camera for comparison.

Results

Phantom measurements showed increased accuracy of US tracking with decreasing scanning range/increasing scanning frequency. The probability of lost tracking was higher for small scanning ranges (43.09% for 10° and 13.54% for 20°).The tracking success rates in healthy volunteers during DIBH were 93.24 and 89.86% for renal pelvis and portal vein branches, respectively. There was a strong correlation between marker motion and US tracking for the majority of analyzed breath-holds: 84.06 and 88.41% of renal pelvis target results and 82.26 and 91.94% of liver vein target results in anteroposterior and superoinferior directions, respectively; Pearson’s correlation coefficient was between 0.71 and 0.99.

Conclusion

The US system showed a good tracking performance in 4D motion phantoms. The tracking capability of surrogate structures for upper abdominal lesions in DIBH fulfills clinical requirements. Further investigation in a larger cohort of patients is underway.
Literatur
2.
Zurück zum Zitat Kirkpatrick JP, Kelsey CR, Palta M, Cabrera AR, Salama JK, Patel P, Perez BA, Lee J, Yin F‑F (2014) Stereotactic body radiotherapy: a critical review for nonradiation oncologists. Cancer 120(7):942–954. doi:10.1002/cncr.28515 CrossRefPubMed Kirkpatrick JP, Kelsey CR, Palta M, Cabrera AR, Salama JK, Patel P, Perez BA, Lee J, Yin F‑F (2014) Stereotactic body radiotherapy: a critical review for nonradiation oncologists. Cancer 120(7):942–954. doi:10.​1002/​cncr.​28515 CrossRefPubMed
3.
Zurück zum Zitat Boda-Heggemann J, Frauenfeld A, Weiss C, Simeonova A, Neumaier C, Siebenlist K, Attenberger U, Heußel CP, Schneider F, Wenz F, Lohr F (2014) Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases. Radiat Oncol 9(1):1–9. doi:10.1186/1748-717X-9-10 CrossRef Boda-Heggemann J, Frauenfeld A, Weiss C, Simeonova A, Neumaier C, Siebenlist K, Attenberger U, Heußel CP, Schneider F, Wenz F, Lohr F (2014) Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases. Radiat Oncol 9(1):1–9. doi:10.​1186/​1748-717X-9-10 CrossRef
4.
Zurück zum Zitat EB-v G, Svd M, Hendry J, Buijsen J, Visser P, Fontanarosa D, Lachainey M, Lammering G, Verhaegen F (2012) Active breathing control in combination with ultrasound imaging: a feasibility study of image guidance in stereotactic body radiation therapy of liver lesions. Int J Radiat Oncol Biol Phys 85(4):1096–1102. doi:10.1016/j.ijrobp.2012.08.016 EB-v G, Svd M, Hendry J, Buijsen J, Visser P, Fontanarosa D, Lachainey M, Lammering G, Verhaegen F (2012) Active breathing control in combination with ultrasound imaging: a feasibility study of image guidance in stereotactic body radiation therapy of liver lesions. Int J Radiat Oncol Biol Phys 85(4):1096–1102. doi:10.​1016/​j.​ijrobp.​2012.​08.​016
5.
Zurück zum Zitat Shirato H, Suzuki K, Sharp GC, Fujita K, Onimaru R, Fujino M, Kato N, Osaka Y, Kinoshita R, Taguchi H, Onodera S, Miyasaka K (2006) Speed and amplitude of lung tumor motion precisely detected in four-dimensional setup and in real-time tumor-tracking radiotherapy. Int J Radiat Oncol Biol Phys 64(4):1229–1236CrossRefPubMed Shirato H, Suzuki K, Sharp GC, Fujita K, Onimaru R, Fujino M, Kato N, Osaka Y, Kinoshita R, Taguchi H, Onodera S, Miyasaka K (2006) Speed and amplitude of lung tumor motion precisely detected in four-dimensional setup and in real-time tumor-tracking radiotherapy. Int J Radiat Oncol Biol Phys 64(4):1229–1236CrossRefPubMed
6.
Zurück zum Zitat Harris EJ, Miller NR, Bamber JC, Symonds-Tayler JRN, Evans PM (2010) Speckle tracking in a phantom and feature-based tracking in liver in the presence of respiratory motion using 4D ultrasound. Phys Med Biol 55:3363–3380. doi:10.1088/0031-9155/55/12/007 CrossRefPubMed Harris EJ, Miller NR, Bamber JC, Symonds-Tayler JRN, Evans PM (2010) Speckle tracking in a phantom and feature-based tracking in liver in the presence of respiratory motion using 4D ultrasound. Phys Med Biol 55:3363–3380. doi:10.​1088/​0031-9155/​55/​12/​007 CrossRefPubMed
7.
Zurück zum Zitat Boda-Heggemann J, Walter C, Mai S, Dobler B, Dinter D, Wenz F, Lohr F (2006) Frameless stereotactic radiosurgery of a solitary liver metastasis using active breathing control and stereotactic ultrasound. Strahlenther Onkol 182:216–221CrossRefPubMed Boda-Heggemann J, Walter C, Mai S, Dobler B, Dinter D, Wenz F, Lohr F (2006) Frameless stereotactic radiosurgery of a solitary liver metastasis using active breathing control and stereotactic ultrasound. Strahlenther Onkol 182:216–221CrossRefPubMed
8.
Zurück zum Zitat O’Shea T, Bamber J, Fontanarosa D, van der Meer S, Verhaegen F, Harris E (2016) Review of ultrasound image guidance in external beam radiotherapy part II: intra-fraction motion management and novel applications. Phys Med Biol 61(8):R90–R137. doi:10.1088/0031-9155/61/8/r90 CrossRefPubMed O’Shea T, Bamber J, Fontanarosa D, van der Meer S, Verhaegen F, Harris E (2016) Review of ultrasound image guidance in external beam radiotherapy part II: intra-fraction motion management and novel applications. Phys Med Biol 61(8):R90–R137. doi:10.​1088/​0031-9155/​61/​8/​r90 CrossRefPubMed
9.
Zurück zum Zitat Boda-Heggemann J, Dinter D, Weiss C, Frauenfeld A, Siebenlist K, Attenberger U, Ottstadt M, Schneider F, Hofheinz R‑D, Wenz F, Lohr F (2012) Hypofractionated image-guided breath-hold SABR (Stereotactic Ablative Body Radiotherapy) of liver metastases – clinical results. Radiat Oncol 7(1):92CrossRefPubMedPubMedCentral Boda-Heggemann J, Dinter D, Weiss C, Frauenfeld A, Siebenlist K, Attenberger U, Ottstadt M, Schneider F, Hofheinz R‑D, Wenz F, Lohr F (2012) Hypofractionated image-guided breath-hold SABR (Stereotactic Ablative Body Radiotherapy) of liver metastases – clinical results. Radiat Oncol 7(1):92CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Wong JW, Sharpe MB, Jaffray DA, Kini VR, Robertson JM, Stromberg JS, Martinez AA (1999) The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol Biol Phys 44(4):911–919CrossRefPubMed Wong JW, Sharpe MB, Jaffray DA, Kini VR, Robertson JM, Stromberg JS, Martinez AA (1999) The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol Biol Phys 44(4):911–919CrossRefPubMed
11.
Zurück zum Zitat Boda-Heggemann J, Knopf A‑C, Simeonova-Chergou A, Wertz H, Stieler F, Jahnke A, Jahnke L, Fleckenstein J, Vogel L, Arns A, Blessing M, Wenz F, Lohr F (2016) Deep inspiration breath hold – based radiation therapy: a clinical review. Int J Radiat Oncol Biol Phys 94(3):478–492CrossRefPubMed Boda-Heggemann J, Knopf A‑C, Simeonova-Chergou A, Wertz H, Stieler F, Jahnke A, Jahnke L, Fleckenstein J, Vogel L, Arns A, Blessing M, Wenz F, Lohr F (2016) Deep inspiration breath hold – based radiation therapy: a clinical review. Int J Radiat Oncol Biol Phys 94(3):478–492CrossRefPubMed
13.
Zurück zum Zitat Lachaine M, Falco T (2013) Intrafractional prostate motion management with the Clarity Autoscan system. Med Phys Int 1:72–80 Lachaine M, Falco T (2013) Intrafractional prostate motion management with the Clarity Autoscan system. Med Phys Int 1:72–80
14.
Zurück zum Zitat Boda-Heggemann J, Fleckenstein J, Lohr F, Wertz H, Nachit M, Blessing M, Stsepankou D, Löb I, Küpper B, Kavanagh A, Hansen VN, Brada M, Wenz F, McNair H (2011) Multiple breath-hold CBCT for online image guided radiotherapy of lung tumors: simulation with a dynamic phantom and first patient data. Radiother Oncol 98(3):309–316. doi:10.1016/j.radonc.2011.01.019 CrossRefPubMed Boda-Heggemann J, Fleckenstein J, Lohr F, Wertz H, Nachit M, Blessing M, Stsepankou D, Löb I, Küpper B, Kavanagh A, Hansen VN, Brada M, Wenz F, McNair H (2011) Multiple breath-hold CBCT for online image guided radiotherapy of lung tumors: simulation with a dynamic phantom and first patient data. Radiother Oncol 98(3):309–316. doi:10.​1016/​j.​radonc.​2011.​01.​019 CrossRefPubMed
15.
Zurück zum Zitat Shimizu S, Shirato H, Xo B, Kagei K, Nishioka T, Hashimoto S, Tsuchiya K, Aoyama H, Miyasaka K (1999) Three-dimensional movement of a liver tumor detected by high-speed magnetic resonance imaging. Radiother Oncol 50:367–370CrossRefPubMed Shimizu S, Shirato H, Xo B, Kagei K, Nishioka T, Hashimoto S, Tsuchiya K, Aoyama H, Miyasaka K (1999) Three-dimensional movement of a liver tumor detected by high-speed magnetic resonance imaging. Radiother Oncol 50:367–370CrossRefPubMed
16.
Zurück zum Zitat Park JC, Park SH, Kim JH, Yoon SM, Song SY, Liu Z, Song B, Kauweloa K, Webster MJ, Sandhu A, Mell LK, Jiang SB, Mundt AJ, Song WY (2012) Liver motion during cone beam computed tomography guided stereotactic body radiation therapy. Med Phys 39:6431. doi:10.1118/1.4754658 CrossRefPubMed Park JC, Park SH, Kim JH, Yoon SM, Song SY, Liu Z, Song B, Kauweloa K, Webster MJ, Sandhu A, Mell LK, Jiang SB, Mundt AJ, Song WY (2012) Liver motion during cone beam computed tomography guided stereotactic body radiation therapy. Med Phys 39:6431. doi:10.​1118/​1.​4754658 CrossRefPubMed
17.
Zurück zum Zitat Hallman JL, Mori S, Sharp GC, Lu H‑M, Hong TS, Chen GTY (2012) A four-dimensional computed tomography analysis of multiorgan abdominal motion. Int J Radiat Oncol Biol Phys 83(1):435–441CrossRefPubMed Hallman JL, Mori S, Sharp GC, Lu H‑M, Hong TS, Chen GTY (2012) A four-dimensional computed tomography analysis of multiorgan abdominal motion. Int J Radiat Oncol Biol Phys 83(1):435–441CrossRefPubMed
18.
Zurück zum Zitat Wong VYW, Tung SY, Ng AWY, Li FAS, Leung JOY (2010) Real-time monitoring and control on deep inspiration breath-hold for lung cancer radiotherapy – Combination of ABC and external marker tracking. Med Phys 37(9):4673–4683. doi:10.1118/1.3476463 CrossRefPubMed Wong VYW, Tung SY, Ng AWY, Li FAS, Leung JOY (2010) Real-time monitoring and control on deep inspiration breath-hold for lung cancer radiotherapy – Combination of ABC and external marker tracking. Med Phys 37(9):4673–4683. doi:10.​1118/​1.​3476463 CrossRefPubMed
19.
Zurück zum Zitat Tanguturi SK, Lyatskaya Y, Chen Y, Catalano PJ, Chen MH, Yeo WP, Marques A, Truong L, Yeh M, Orlina L, Wong JS, Punglia RS, Bellon JR (2015) Prospective assessment of deep inspiration breath-hold using 3‑dimensional surface tracking for irradiation of left-sided breast cancer. Pract Radiat Oncol 5(6):358–365. doi:10.1016/j.prro.2015.06.002 CrossRefPubMed Tanguturi SK, Lyatskaya Y, Chen Y, Catalano PJ, Chen MH, Yeo WP, Marques A, Truong L, Yeh M, Orlina L, Wong JS, Punglia RS, Bellon JR (2015) Prospective assessment of deep inspiration breath-hold using 3‑dimensional surface tracking for irradiation of left-sided breast cancer. Pract Radiat Oncol 5(6):358–365. doi:10.​1016/​j.​prro.​2015.​06.​002 CrossRefPubMed
20.
Zurück zum Zitat Stieler F, Wenz F, Scherrer D, Bernhardt M, Lohr F (2012) Clinical evaluation of a commercial surface-imaging system for patient positioning in radiotherapy. Strahlenther Onkol 188(12):1080–1084. doi:10.1007/s00066-012-0244-7 CrossRefPubMed Stieler F, Wenz F, Scherrer D, Bernhardt M, Lohr F (2012) Clinical evaluation of a commercial surface-imaging system for patient positioning in radiotherapy. Strahlenther Onkol 188(12):1080–1084. doi:10.​1007/​s00066-012-0244-7 CrossRefPubMed
21.
Zurück zum Zitat Willoughby TR, Kupelian PA, Pouliot J, Shinohara K, Aubin M, Roach M, Skrumeda LL, Balter JM, Litzenberg DW, Hadley SW, Wei JT, Sandler HM (2006) Target localization and real-time tracking using the Calypso 4D localization system in patients with localized prostate cancer. Int J Radiat Oncol Biol Phys 65:528–534CrossRefPubMed Willoughby TR, Kupelian PA, Pouliot J, Shinohara K, Aubin M, Roach M, Skrumeda LL, Balter JM, Litzenberg DW, Hadley SW, Wei JT, Sandler HM (2006) Target localization and real-time tracking using the Calypso 4D localization system in patients with localized prostate cancer. Int J Radiat Oncol Biol Phys 65:528–534CrossRefPubMed
22.
Zurück zum Zitat Shirato H, Shimizu S, Kunieda T, Kitamura K, Herk MV, Kagei K, Nishioka T, Hashimoto S, Fujita K, Aoyama H, Tsuchiya K, Kudo K, Miyasaka K (2000) Physical aspects of a real-time tumor-tracking system for gated radiotherapy. Int J Radiat Oncol Biol Phys 48(4):1187–1195CrossRefPubMed Shirato H, Shimizu S, Kunieda T, Kitamura K, Herk MV, Kagei K, Nishioka T, Hashimoto S, Fujita K, Aoyama H, Tsuchiya K, Kudo K, Miyasaka K (2000) Physical aspects of a real-time tumor-tracking system for gated radiotherapy. Int J Radiat Oncol Biol Phys 48(4):1187–1195CrossRefPubMed
23.
Zurück zum Zitat Bell MAL, Byram BC, Harris EJ, Evans PM, Bamber JC (2012) In vivo liver tracking with a high volume rate 4D ultrasound scanner and a 2D matrix array probe. Phys Med Biol 57:1359–1374CrossRefPubMed Bell MAL, Byram BC, Harris EJ, Evans PM, Bamber JC (2012) In vivo liver tracking with a high volume rate 4D ultrasound scanner and a 2D matrix array probe. Phys Med Biol 57:1359–1374CrossRefPubMed
24.
Zurück zum Zitat Fayad H, Pan T, Clément J‑F, Visvikis D (2011) Technical note: Correlation of respiratory motion between external patient surface and internal anatomical landmarks. Med Phys 38:3157–3164CrossRefPubMedPubMedCentral Fayad H, Pan T, Clément J‑F, Visvikis D (2011) Technical note: Correlation of respiratory motion between external patient surface and internal anatomical landmarks. Med Phys 38:3157–3164CrossRefPubMedPubMedCentral
Metadaten
Titel
A 4D ultrasound real-time tracking system for external beam radiotherapy of upper abdominal lesions under breath-hold
verfasst von
Dwi Seno Kuncoro Sihono, MSc
Lena Vogel, MSc
Christel Weiß, Ph.D
Johannes Thölking, MSc
Frederik Wenz, MD
Frank Lohr, MD
Judit Boda-Heggemann, MD, Ph.D
Hansjörg Wertz, Ph.D
Publikationsdatum
05.12.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 3/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-016-1076-7

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