Yutaka Takahashi1, Stefano Vagge2, Stefano Agostinelli2, Eunyoung Han3, Lukasz Matulewicz4, Kai Schubert5, Ravishankar Chityala6, Vaneerat Ratanatharathorn3, Koen Tournel7, Jose A Penagaricano3, Sterzing Florian5, Marc-Andre Mahe8, Michael R Verneris9, Daniel J Weisdorf10, Renzo Corvo2, Kathryn E Dusenbery11, Guy Storme7, Susanta K Hui12. 1. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. 2. Department of Radiation Oncology, Instituto Nazionale per la Ricerca sul Cancro-National Institute for Cancer Research and University of Genoa, Genoa, Italy. 3. Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. 4. Department of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland. 5. Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. 6. Department of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota; Minnesota Super Computer Institute, University of Minnesota, Minneapolis, Minnesota. 7. Department of Radiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium. 8. Department of Radiation Oncology, Integrated Center of Oncology-René Gauducheau, Saint-Herblain Cédex, France. 9. Divisions of Hematology, Oncology, and Bone Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. 10. Department of Medicine, University of Minnesota, Minneapolis, Minnesota. 11. Department of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota. 12. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; Department of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota. Electronic address: huixx019@umn.edu.
Abstract
PURPOSE: To develop, characterize, and implement a fast patient localization method for total marrow irradiation. METHODS AND MATERIALS: Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo). We also generated kilovoltage topograms (kVtopo) from the projection data of 3-dimensional CT images to reproduce the same geometry as helical tomotherapy. The MVtopo imaging dose and the optimal image acquisition parameters were investigated. A multi-institutional phantom study was performed to verify the image registration uncertainty. Forty-five MVtopo images were acquired and analyzed with in-house image registration software. RESULTS: The smallest jaw size (front and backup jaws of 0) provided the best image contrast and longitudinal resolution. Couch velocity did not affect the image quality or geometric accuracy. The MVtopo dose was less than the MVCT dose. The image registration uncertainty from the multi-institutional study was within 2.8 mm. In patient localization, the differences in calculated couch shift between the registration with MVtopo-kVtopo and MVCT-kVCT images in lateral, cranial-caudal, and vertical directions were 2.2 ± 1.7 mm, 2.6 ± 1.4 mm, and 2.7 ± 1.1 mm, respectively. The imaging time in MVtopo acquisition at the couch speed of 3 cm/s was <1 minute, compared with ≥15 minutes in MVCT for all patients. CONCLUSION: Whole-body MVtopo imaging could be an effective alternative to time-consuming MVCT for total marrow irradiation patient localization.
PURPOSE: To develop, characterize, and implement a fast patient localization method for total marrow irradiation. METHODS AND MATERIALS: Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo). We also generated kilovoltage topograms (kVtopo) from the projection data of 3-dimensional CT images to reproduce the same geometry as helical tomotherapy. The MVtopo imaging dose and the optimal image acquisition parameters were investigated. A multi-institutional phantom study was performed to verify the image registration uncertainty. Forty-five MVtopo images were acquired and analyzed with in-house image registration software. RESULTS: The smallest jaw size (front and backup jaws of 0) provided the best image contrast and longitudinal resolution. Couch velocity did not affect the image quality or geometric accuracy. The MVtopo dose was less than the MVCT dose. The image registration uncertainty from the multi-institutional study was within 2.8 mm. In patient localization, the differences in calculated couch shift between the registration with MVtopo-kVtopo and MVCT-kVCT images in lateral, cranial-caudal, and vertical directions were 2.2 ± 1.7 mm, 2.6 ± 1.4 mm, and 2.7 ± 1.1 mm, respectively. The imaging time in MVtopo acquisition at the couch speed of 3 cm/s was <1 minute, compared with ≥15 minutes in MVCT for all patients. CONCLUSION: Whole-body MVtopo imaging could be an effective alternative to time-consuming MVCT for total marrow irradiation patient localization.
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