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首页> 外文期刊>International Journal of Radiation Oncology, Biology, Physics >Comparison of kilovoltage cone-beam computed tomography with megavoltage projection pairs for paraspinal radiosurgery patient alignment and position verification.
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Comparison of kilovoltage cone-beam computed tomography with megavoltage projection pairs for paraspinal radiosurgery patient alignment and position verification.

机译：千伏锥束计算机断层扫描与兆伏投影对的比较，用于脊柱旁放射手术患者对准和位置验证。

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摘要

PURPOSE: Implanted gold markers and megavoltage (MV) portal imaging are commonly used for setup verification of paraspinal tumors treated with high-dose, single-fraction radiotherapy. We investigated whether the use of kilovoltage cone-beam computed tomography (CBCT) imaging eliminates the need for marker implantation. METHODS AND MATERIALS: Patients with paraspinal disease who were eligible for single-fraction stereotactic body radiotherapy were accrued to an institutional review board-approved protocol. Each of 16 patients underwent implantation of fiducial markers near the target. The markers were visible on the MV images. Three MV image pairs were acquired for each patient (initial, verification, and final) and were registered to the reference images. Every MV pair was complemented by a CBCT scan. CBCT image registration was performed automatically by maximizing the mutual information using a region of interest that excluded the markers. The corrections, as determined from the MV images, were compared with these from CBCT and were used for actual patient setup. RESULTS: The mean and standard deviation of the absolute values of the differences between the CBCT and MV corrections were 1.0 +/- 0.7, 1.0 +/- 0.6, and 1.0 +/- 0.8 mm for the left-right, anteroposterior, and superoinferior directions, respectively. The absolute differences between the corresponding pre- and post-treatment kilovoltage CBCT image registration were 0.6 +/- 0.5, 0.6 +/- 0.5, and 1.0 +/- 0.8 mm. CONCLUSION: The setup corrections found using CBCT without the use of implanted markers were consistent with the marker registration on MV projections. CBCT has additional advantages, including better positioning precision and robust automatic three-dimensional registration, as well as eliminating the need for invasive marker implantation. We have adopted CBCT for the setup of all single-fraction paraspinal patients. Our data have also demonstrated that target displacements during treatment are insignificant.
机译：目的：植入的金标记和兆电压（MV）门成像通常用于对大剂量单次放疗治疗的椎旁肿瘤进行设置验证。我们调查了使用千伏锥束计算机断层扫描（CBCT）成像是否消除了标记物植入的需要。方法和材料：符合准直立体定向放射疗法的椎旁疾病患者应纳入机构审查委员会批准的方案。 16位患者中的每位均在目标附近植入了基准标记。标记在MV图像上可见。为每位患者获取了三个MV图像对（初始，验证和最终），并将其注册到参考图像中。每个MV对均辅以CBCT扫描。 CBCT图像配准通过使用排除标记的目标区域来最大化互信息来自动执行。根据MV图像确定的校正结果与CBCT的校正结果进行比较，并用于实际患者设置。结果：CBCT和MV校正之间的差异的绝对值的平均值和标准偏差分别为1.0 +/- 0.7、1.0 +/- 0.6和1.0 +/- 0.8 mm，左右，前后和上下方向。相应的治疗前和治疗后千伏CBCT图像配准之间的绝对差为0.6 +/- 0.5、0.6 +/- 0.5和1.0 +/- 0.8 mm。结论：在不使用植入标记的情况下使用CBCT进行的设置校正与MV投影上的标记注册一致。 CBCT具有其他优势，包括更好的定位精度和强大的自动三维定位功能，以及消除了侵入性标记物植入的需要。我们采用CBCT来设置所有单级椎旁患者。我们的数据还表明，治疗过程中的目标位移微不足道。

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