Evaluation of respiratory motion-corrected cone-beam CT at end expiration in abdominal radiotherapy sites: A prospective study Journal Article


Authors: Kincaid, R. E. Jr; Hertanto, A. E.; Hu, Y. C.; Wu, A. J.; Goodman, K. A.; Pham, H. D.; Yorke, E. D.; Zhang, Q.; Chen, Q.; Mageras, G. S.
Article Title: Evaluation of respiratory motion-corrected cone-beam CT at end expiration in abdominal radiotherapy sites: A prospective study
Abstract: Background: Cone beam computed tomography (CBCT) for radiotherapy image guidance suffers from respiratory motion artifacts. This limits soft tissue visualization and localization accuracy, particularly in abdominal sites. We report on a prospective study of respiratory motion-corrected (RMC)-CBCT to evaluate its efficacy in localizing abdominal organs and improving soft tissue visibility at end expiration. Material and methods: In an IRB approved study, 11 patients with gastroesophageal junction (GEJ) cancer and five with pancreatic cancer underwent a respiration-correlated CT (4DCT), a respiration-gated CBCT (G-CBCT) near end expiration and a one-minute free-breathing CBCT scan on a single treatment day. Respiration was recorded with an external monitor. An RMC-CBCT and an uncorrected CBCT (NC-CBCT) were computed from the free-breathing scan, based on a respiratory model of deformations derived from the 4DCT. Localization discrepancy was computed as the 3D displacement of the GEJ region (GEJ patients), or gross tumor volume (GTV) and kidneys (pancreas patients) in the NC-CBCT and RMC-CBCT relative to their positions in the G-CBCT. Similarity of soft-tissue features was measured using a normalized cross correlation (NCC) function. Results: Localization discrepancy from the end-expiration G-CBCT was reduced for RMC-CBCT compared to NC-CBCT in eight of eleven GEJ cases (mean ± standard deviation, respectively, 0.21 ± 0.11 and 0.43 ± 0.28 cm), in all five pancreatic GTVs (0.26 ± 0.21 and 0.42 ± 0.29 cm) and all ten kidneys (0.19 ± 0.13 and 0.51 ± 0.25 cm). Soft-tissue feature similarity around GEJ was higher with RMC-CBCT in nine of eleven cases (NCC =0.48 ± 0.20 and 0.43 ± 0.21), and eight of ten kidneys (0.44 ± 0.16 and 0.40 ± 0.17). Conclusions: In a prospective study of motion-corrected CBCT in GEJ and pancreas, RMC-CBCT yielded improved organ visibility and localization accuracy for gated treatment at end expiration in the majority of cases. © 2018, © 2018 Acta Oncologica Foundation.
Journal Title: Acta Oncologica
Volume: 57
Issue: 8
ISSN: 0284-186X
Publisher: Informa Healthcare  
Date Published: 2018-01-01
Start Page: 1017
End Page: 1024
Language: English
DOI: 10.1080/0284186x.2018.1427885
PROVIDER: scopus
PMCID: PMC6053337
PUBMED: 29350579
DOI/URL:
Notes: Article -- Export Date: 4 September 2018 -- Source: Scopus
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MSK Authors
  1. Karyn A Goodman
    254 Goodman
  2. Qinghui Zhang
    26 Zhang
  3. Abraham Jing-Ching Wu
    279 Wu
  4. Gikas S Mageras
    274 Mageras
  5. Ellen D Yorke
    385 Yorke
  6. Hai Pham
    39 Pham
  7. Yu-Chi Hu
    84 Hu
  8. Qing Chen
    19 Chen