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01-03-2017 | Original Article

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

Authors: 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

Published in: Strahlentherapie und Onkologie | Issue 3/2017

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.

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Title: A 4D ultrasound real-time tracking system for external beam radiotherapy of upper abdominal lesions under breath-hold
Authors: 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
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 3/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1076-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background and purpose

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and purpose

Materials and methods

Results

Conclusion

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