Development of a prediction model for target positioning by using diaphragm waveforms extracted from CBCT projection images

Author:

Sakurai Yuta1,Ambo Shintaro1,Nakamura Mitsuhiro1,Iramina Hiraku2ORCID,Iizuka Yusuke23,Mitsuyoshi Takamasa4,Matsuo Yukinori2,Mizowaki Takashi2ORCID

Affiliation:

1. Department of Advanced Medical Physics, Graduate School of Medicine Kyoto University Kyoto Japan

2. Department of Radiation Oncology and Image‐Applied Therapy, Graduate School of Medicine Kyoto University Kyoto Japan

3. Department of Radiation Oncology Shizuoka City Shizuoka Hospital Shizuoka Japan

4. Department of Radiation Oncology Kobe City Medical Center General Hospital Hyogo Japan

Abstract

AbstractPurposeTo develop a prediction model (PM) for target positioning using diaphragm waveforms extracted from CBCT projection images.MethodsNineteen patients with lung cancer underwent orthogonal rotational kV x‐ray imaging lasting 70 s. IR markers placed on their abdominal surfaces and an implanted gold marker located nearest to the tumor were considered as external surrogates and the target, respectively. Four different types of regression‐based PM were trained using surrogate motions and target positions for the first 60 s, as follows: Scenario A: Based on the clinical scenario, 3D target positions extracted from projection images were used as they were (PMCL). Scenario B: The short‐arc 4D‐CBCT waveform exhibiting eight target positions was obtained by averaging the target positions in Scenario A. The waveform was repeated for 60 s (W4D‐CBCT) by adapting to the respiratory phase of the external surrogate. W4D‐CBCT was used as the target positions (PM4D‐CBCT). Scenario C: The Amsterdam Shroud (AS) signal, which depicted the diaphragm motion in the superior–inferior direction was extracted from the orthogonal projection images. The amplitude and phase of W4D‐CBCT were corrected based on the AS signal. The AS‐corrected W4D‐CBCT was used as the target positions (PMAS‐4D‐CBCT). Scenario D: The AS signal was extracted from single projection images. Other processes were the same as in Scenario C. The prediction errors were calculated for the remaining 10 s.ResultsThe 3D prediction error within 3 mm was 77.3% for PM4D‐CBCT, which was 12.8% lower than that for PMCL. Using the diaphragm waveforms, the percentage of errors within 3 mm improved by approximately 7% to 84.0%‐85.3% for PMAS‐4D‐CBCT in Scenarios C and D, respectively. Statistically significant differences were observed between the prediction errors of PM4D‐CBCT and PMAS‐4D‐CBCT.ConclusionPMAS‐4D‐CBCT outperformed PM4D‐CBCT, proving the efficacy of the AS signal‐based correction. PMAS‐4D‐CBCT would make it possible to predict target positions from 4D‐CBCT images without gold markers.

Funder

Japan Agency for Medical Research and Development

Publisher

Wiley

Subject

Radiology, Nuclear Medicine and imaging,Instrumentation,Radiation

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