Integrating respiratory gating into a megavoltage cone-beam CT system Journal Article


Authors: Chang, J.; Sillanpaa, J.; Ling, C. C.; Seppi, E.; Yorke, E.; Mageras, G.; Amols, H.
Article Title: Integrating respiratory gating into a megavoltage cone-beam CT system
Abstract: We have previously described a low-dose megavoltage cone beam computed tomography (MV CBCT) system capable of producing projection image using one beam pulse. In this study, we report on its integration with respiratory gating for gated radiotherapy. The respiratory gating system tracks a reflective marker on the patient's abdomen midway between the xiphoid and umbilicus, and disables radiation delivery when the marker position is outside predefined thresholds. We investigate two strategies for acquiring gated scans. In the continuous rotation-gated acquisition, the linear accelerator (LINAC) is set to the fixed x-ray mode and the gantry makes a 5 min, 360° continuous rotation, during which the gating system turns the radiation beam on and off, resulting in projection images with an uneven distribution of projection angles (e.g., in 70 arcs each covering 2°). In the gated rotation-continuous acquisition, the LINAC is set to the dynamic arc mode, which suspends the gantry rotation when the gating system inhibits the beam, leading to a slightly longer (6-7 min) scan time, but yielding projection images with more evenly distributed projection angles (e.g., ∼0.8° between two consecutive projection angles). We have tested both data acquisition schemes on stationary (a contrast detail and a thoracic) phantoms and protocol lung patients. For stationary phantoms, a separate motion phantom not visible in the images is used to trigger the RPM system. Frame rate is adjusted so that approximately 450 images (13 MU) are acquired for each scan and three-dimensional tomographic images reconstructed using a Feldkamp filtered backprojection algorithm. The gated rotation-continuous acquisition yield reconstructions free of breathing artifacts. The tumor in parenchymal lung and normal tissues are easily discernible and the boundary between the diaphragm and the lung sharply defined. Contrast-to-noise ratio (CNR) is not degraded relative to nongated scans of stationary phantoms. The continuous rotation-gated acquisition scan also yields tomographic images with discernible anatomic features; however, streak artifacts are observed and CNR is reduced by approximately a factor of 4. In conclusion, we have successfully developed a gated MV CBCT system to verify the patient positioning for gated radiotherapy. © 2006 American Association of Physicists in Medicine.
Keywords: controlled study; cancer radiotherapy; computer assisted tomography; lung neoplasms; radiotherapy; lung cancer; tomography, x-ray computed; radiography, thoracic; abdomen; algorithm; image quality; three dimensional imaging; collimator; phantom; phantoms, imaging; patient positioning; respiration; diaphragm; electrons; sternum; umbilicus; artifact reduction; linear accelerator; particle accelerators; radiographic image interpretation, computer-assisted; x ray; epid; lung parenchyma; rotation; respiratory gating; noise; setup verification; mega-voltage cbct; contrast noise ratio
Journal Title: Medical Physics
Volume: 33
Issue: 7
ISSN: 0094-2405
Publisher: American Association of Physicists in Medicine  
Date Published: 2006-07-01
Start Page: 2354
End Page: 2361
Language: English
DOI: 10.1118/1.2207136
PUBMED: 16898437
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 26" - "Export Date: 4 June 2012" - "CODEN: MPHYA" - "Source: Scopus"
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MSK Authors
  1. Jenghwa Chang
    63 Chang
  2. Gikas S Mageras
    277 Mageras
  3. Ellen D Yorke
    451 Yorke
  4. Howard I Amols
    157 Amols
  5. C Clifton Ling
    331 Ling