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Proceedings Paper

Fiducial migration following small peripheral lung tumor image-guided CyberKnife stereotactic radiosurgery
Author(s): Konrad L. Strulik; Min H. Cho; Brian T. Collins; Noureen Khan; Filip Banovac; Rebecca Slack; Kevin Cleary
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Paper Abstract

To track respiratory motion during CyberKnife stereotactic radiosurgery in the lung, several (three to five) cylindrical gold fiducials are implanted near the planned target volume (PTV). Since these fiducials remain in the human body after treatment, we hypothesize that tracking fiducial movement over time may correlate with the tumor response to treatment and pulmonary fibrosis, thereby serving as an indicator of treatment success. In this paper, we investigate fiducial migration in 24 patients through examination of computed tomography (CT) volume images at four time points: pre-treatment, three, six, and twelve month post-treatment. We developed a MATLAB based GUI environment to display the images, identify the fiducials, and compute our performance measure. After we semi-automatically segmented and detected fiducial locations in CT images of the same patient over time, we identified them according to their configuration and introduced a relative performance measure (ACD: average center distance) to detect their migration. We found that the migration tended to result in a movement towards the fiducial center of the radiated tissue area (indicating tumor regression) and may potentially be linked to the patient prognosis.

Paper Details

Date Published: 17 March 2008
PDF: 9 pages
Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling, 69181A (17 March 2008); doi: 10.1117/12.769042
Show Author Affiliations
Konrad L. Strulik, Georgetown Univ. (United States)
Univ. of Luebeck (Germany)
Min H. Cho, Georgetown Univ. (United States)
Kyung Hee Univ. (South Korea)
Brian T. Collins, Georgetown Univ. Hospital (United States)
Noureen Khan, Georgetown Univ. (United States)
Case Western Reserve Univ. (United States)
Filip Banovac, Georgetown Univ. (United States)
Rebecca Slack, Georgetown Univ. (United States)
Kevin Cleary, Georgetown Univ. (United States)

Published in SPIE Proceedings Vol. 6918:
Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling
Michael I. Miga; Kevin Robert Cleary, Editor(s)

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