Accuracy and feasibility of cone-beam computed tomography for stereotactic radiosurgery setup Journal Article


Authors: Chang, J.; Yenice, K. M.; Narayana, A.; Gutin, P. H.
Article Title: Accuracy and feasibility of cone-beam computed tomography for stereotactic radiosurgery setup
Abstract: Image fusion, target localization, and setup accuracy of cone-beam computed tomography (CBCT) for stereotactic radiosurgery (SRS) were investigated in this study. A Rando head phantom rigidly attached to a stereotactic Brown-Roberts-Wells (BRW) frame was utilized to study the geometric accuracy of CBCT. Measurements of distances and angular separations between selected pairs of multiple radio-opaque targets embedded in the head phantom from a conventional simulation CT provided comparative data for geometric accuracy analysis. Localization accuracy of the CBCT scan was investigated from an analysis of BRW localization of four cylindrical objects (9 mm in diameter and 25 mm in length) independently computed from CBCT and conventional CT scans. Image fusion accuracy was quantitatively evaluated from BRW localization of multiple simulated targets from the CBCT and conventional CT scan. Finally, a CBCT setup procedure for stereotactic radiosurgery treatments was proposed and its accuracy was assessed using orthogonal target verification imaging. Our study showed that CBCT did not present any significant geometric distortions. Stereotactic coordinates of the four cylindrical objects as determined from the CBCT differed from those determined from the conventional CT on average by 0.30 mm with a standard deviation (SD) of 0.09 mm. The mean image registration accuracy of CBCT with conventional CT was 0.28 mm (SD=0.10 mm). Setup uncertainty of our proposed CBCT setup procedure was on the same order as the conventional framed-based stereotactic systems reported in the literature (mean=1.34 mm, SD=0.33 mm). In conclusion, CBCT can be used to guide SRS treatment setup with accuracy comparable to the currently used frame-based stereotactic radiosurgery systems provided that intra-treatment patient motion is prevented. © 2007 American Association of Physicists in Medicine.
Keywords: sensitivity and specificity; accuracy; reproducibility of results; computer assisted tomography; algorithms; tomography, spiral computed; feasibility study; feasibility studies; radiosurgery; phantom; phantoms, imaging; radiographic image interpretation, computer-assisted; stereotaxic surgery; surgery, computer-assisted; radiographic image enhancement; patient setup; stereotactic radiosurgery (srs); cone-beam computed tomography (cbct)
Journal Title: Medical Physics
Volume: 34
Issue: 6
ISSN: 0094-2405
Publisher: American Association of Physicists in Medicine  
Date Published: 2007-06-01
Start Page: 2077
End Page: 2084
Language: English
DOI: 10.1118/1.2731031
PUBMED: 17654911
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 20" - "Export Date: 17 November 2011" - "CODEN: MPHYA" - "Source: Scopus"
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  1. Philip H Gutin
    163 Gutin
  2. Jenghwa Chang
    63 Chang