Accuracy estimation for projection-to-volume targeting during rotational therapy: a feasibility study.

PURPOSE: Estimating motion and deformation parameters from a series of projection radiographs acquired during arc therapy using a reference CT volume has become a promising technique for targeting treatment. The purpose of this work is to investigate the influence of rotational arc length on maximum achievable accuracy of motion estimation.
METHODS: The projection-to-volume alignment procedure used a nonrigid model to describe motion in thorax area, a cost function consisting of a least-squared error metric and a simple regularizer that encourages local invertibility, and a four-level multiresolution scheme with a conjugate gradient method to optimize the cost function. The authors tested both small and large scale deformations typically found in the thorax of a radiotherapy patient at different breathing states and limited-angle scans of six angular widths (12 degrees, 18 degrees, 24 degrees, 36 degrees, 60 degrees, and 90 degrees) centered at three angles (0 degrees, 45 degrees, and 90 degrees).
RESULTS: The experiments illustrate the potential accuracy of limited-angle projection-to-volume alignment. Registration accuracy can be sensitive to angular center, tends to be lower along direction of the projection set, and tends to decrease away from the rotation center. The studies of small as well as large but realistically scaled deformations show similar dependencies. These trends appear to have fairly low sensitivity to quantum noise effects.
CONCLUSIONS: There is potentially sufficient information present in a small spread of projections to monitor the configuration of reasonably high contrast tumors without implanted markers.