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Proceedings Paper

Comparisons of 6 fps volume-rendered x-ray digital tomosynthesis TumoTrak-guided to 2D-MRI-guided radiotherapy of lung cancer
Author(s): Larry Partain; Stanley Benedict; Namho Kim; Megan Daly; Austin Ely; Andrew Hernandez; Samuel Song; Micheal Weil; Vitaliy Ziskin; Kyle Foletta; John Boone; Douglas Boyd
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Paper Abstract

Retrospective kV x-ray 4DCT treatment planning for lung cancer MV linac treatment is becoming a standard-of-care for this widely used procedure for the largest cancer cause-of-death in the US. It currently provides the best estimate of a fixed-in-time but undulating and closed 3D "shell" to which a minimum curative-intent radiation dose should be delivered to provide the best estimated patient survival and the least morbidity, usually characterized by quantitative dose-volume-histograms (DVHs). Unfortunately this closed shell volume or internal target volume (ITV) currently has to be increased enough to enclose the full range of respiratory lesion motion (plus set-up etc. uncertainties) which cannot yet be accurately determined in real time during treatment delivery. With accurate motion-tracking, the planning target volume (PTV) or outer “shell” may be reduced by up to 40%. However there is no single 2D plane that precisely follows the reduced-PTV-volume’s 3D respiratory motion, currently best estimated by the retrospective hand contouring by a trained and experienced MD radiation oncology MD using the full 3D-time information of 4DCT. Once available, 3D motion tracking in real time has the potential to substantially decrease DVH doses to surrounding organs-at-risk (OARs), while maintaining or raising the curative-intent dose to the lesion itself. The assertion argued here is that, the 3D volume-rendered imaging of lung cancer lesion-trajectories in real-time from TumoTrak digital x-ray tomosythesis, has the potential to provide more accurate 3D motion tracking and improved dose delivery at lower cost than the real time, 2D single slice imaging of MRI-guided radiotherapy.

Paper Details

Date Published: 1 March 2019
PDF: 15 pages
Proc. SPIE 10948, Medical Imaging 2019: Physics of Medical Imaging, 109483L (1 March 2019); doi: 10.1117/12.2511993
Show Author Affiliations
Larry Partain, Imatrex, Inc. (United States)
Stanley Benedict, UC Davis Medical Ctr. (United States)
Namho Kim, Imatrex, Inc. (United States)
Megan Daly, UC Davis Medical Ctr. (United States)
Austin Ely, Imatrex, Inc. (United States)
Andrew Hernandez, UC Davis Medical Ctr. (United States)
Samuel Song, Imatrex, Inc. (United States)
Micheal Weil, Sirius Medicine, LLC (United States)
Vitaliy Ziskin, Imatrex, Inc. (United States)
Kyle Foletta, Imatrex, Inc. (United States)
John Boone, UC Davis Medical Ctr. (United States)
Douglas Boyd, Imatrex, Inc. (United States)

Published in SPIE Proceedings Vol. 10948:
Medical Imaging 2019: Physics of Medical Imaging
Taly Gilat Schmidt; Guang-Hong Chen; Hilde Bosmans, Editor(s)

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