Evaluation of respiration-correlated digital tomosynthesis in lung Journal Article


Authors: Santoro, J.; Kriminski, S.; Lovelock, D. M.; Rosenzweig, K.; Mostafavi, H.; Amols, H. I.; Mageras, G. S.
Article Title: Evaluation of respiration-correlated digital tomosynthesis in lung
Abstract: Digital tomosynthesis (DTS) with a linear accelerator-mounted imaging system provides a means of reconstructing tomographic images from radiographic projections over a limited gantry arc, thus requiring only a few seconds to acquire. Its application in the thorax, however, often results in blurred images from respiration-induced motion. This work evaluates the feasibility of respiration-correlated (RC) DTS for soft-tissue visualization and patient positioning. Image data acquired with a gantry-mounted kilovoltage imaging system while recording respiration were retrospectively analyzed from patients receiving radiotherapy for non-small-cell lung carcinoma. Projection images spanning an approximately 30° gantry arc were sorted into four respiration phase bins prior to DTS reconstruction, which uses a backprojection, followed by a procedure to suppress structures above and below the reconstruction plane of interest. The DTS images were reconstructed in planes at different depths through the patient and normal to a user-selected angle close to the center of the arc. The localization accuracy of RC-DTS was assessed via a comparison with CBCT. Evaluation of RC-DTS in eight tumors shows visible reduction in image blur caused by the respiratory motion. It also allows the visualization of tumor motion extent. The best image quality is achieved at the end-exhalation phase of the respiratory motion. Comparison of RC-DTS with respiration-correlated cone-beam CT in determining tumor position, motion extent and displacement between treatment sessions shows agreement in most cases within 2-3 mm, comparable in magnitude to the intraobserver repeatability of the measurement. These results suggest the method's applicability for soft-tissue image guidance in lung, but must be confirmed with further studies in larger numbers of patients. © 2010 American Association of Physicists in Medicine.
Keywords: methodology; sensitivity and specificity; reproducibility; reproducibility of results; computer assisted tomography; statistics; lung neoplasms; lung cancer; tomography, x-ray computed; lung tumor; evaluation; statistics as topic; radiography; artifact; radiotherapy, conformal; respiration; computer assisted radiotherapy; artifacts; radiotherapy, computer-assisted; image-guided radiation treatment; tomosynthesis; tumor motion; respiratory gated imaging; respiratory-gated imaging techniques
Journal Title: Medical Physics
Volume: 37
Issue: 3
ISSN: 0094-2405
Publisher: American Association of Physicists in Medicine  
Date Published: 2010-03-01
Start Page: 1237
End Page: 1245
Language: English
DOI: 10.1118/1.3312276
PUBMED: 20384261
PROVIDER: scopus
PMCID: PMC2905456
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: MPHYA" - "Source: Scopus"
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  1. Gikas S Mageras
    277 Mageras
  2. Howard I Amols
    157 Amols
  3. Dale M Lovelock
    183 Lovelock