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Mathew J Fitzpatrick

Publications and source records attributed to Mathew J Fitzpatrick.

3 recordsLinked to original sources

Displacement-based binning of time-dependent computed tomography image data sets.

Respiration can cause tumors in the thorax or abdomen to move by as much as 3 cm; this movement can adversely affect the planning and delivery of radiation treatment. Several techniques have been used to compensate for respiratory motion, but all have shortcomings. Manufacturers of computed tomography (CT) equipment have recently used a technique developed for cardiac CT imaging to track respiratory-induced anatomical motion and to sort images according to the phase of the respiratory cycle they represent. Here we propose a method of generating CT images that accounts for respiratory-induced anatomical motion on the basis of displacement, i.e., displacement-binned CT image sets. This technique has shown great promise, however, it is not fully supported by currently used CT image reconstruction software. As an interim solution, we have developed a method for extracting displacement-binned CT image data sets from data sets assembled on the basis of a prospectively determined breathing phase acquired on a multislice helical CT scanner. First, the projection data set acquired from the CT scanner was binned at small phase intervals before reconstruction. The manufacturer's software then generated image sets identified as belonging to particular phases of the respiratory cycle. All images were then individually correlated to the displacement of an external fiducial marker. Next, CT image data sets were resorted on the basis of the displacement and assigned an appropriate phase. Finally, displacement-binned image data sets were transferred to a treatment-planning system for analysis. Although the technique is currently limited by the phase intervals allowed by the CT software, some improvement in image reconstruction was seen, indicating that this technique is useful at least as an interim measure.

Algorithms↗

A novel platform simulating irregular motion to enhance assessment of respiration-correlated radiation therapy procedures.

Respiratory motion continues to present challenges in the delivery of radiation therapy to tumors in the thorax and abdomen by causing movement of structures within those areas. Several approaches to account for this movement in the planning and delivery of treatment have been developed over the past several years. To assist in the development and assessment of various techniques for respiration-correlated radiation therapy, a platform capable of programmable irregular longitudinal motion has been designed and fabricated to simulate intrafractional respiratory motion. A sliding platform and the base on which it was mounted were constructed from polycarbonate plastic, and a stepper motor provided platform motion. Respiratory motion data, either artificially generated on a spreadsheet or extracted from respiratory monitoring files, were converted to a format appropriate for driving the stepper motor. Various phantoms were placed on top of the platform and used in studies related to respiration-correlated radiation therapy. Several applications of the platform were demonstrated, such as improving the quality of acquisition of time-dependent computed tomography image datasets, comparing various methods of acquiring such datasets, and implementing feedback-guided breath hold treatment delivery procedures. This study showed that a platform capable of programmable irregular motion is a useful tool for the development and assessment of procedures related to the effects of respiratory motion in radiation therapy.

Artifacts↗

Respiration-correlated treatment delivery using feedback-guided breath hold: a technical study.

Respiratory motion causes movement of internal structures in the thorax and abdomen, making accurate delivery of radiation therapy to tumors in those areas a challenge. To reduce the uncertainties caused by this motion, we have developed feedback-guided breath hold (FGBH), a novel delivery technique in which radiation is delivered only during a voluntary breath hold that is sustained for as long as the patient feels comfortable. Here we present the technical aspects of FGBH, which involve (1) fabricating the hardware so the respiratory trace can be displayed to the patient, (2) assembling a delay box to be used as a breath-hold detector, and (3) performing quality control tests to ensure that FGBH can be delivered accurately and safely. A commercial respiratory tracking system that uses an external fiducial to monitor abdominal wall motion generates and displays the breathing trace and specific positions in the breathing cycle where a breath hold needs to occur. Hardware was developed to present this display to the patient in the treatment position. Patients view the presentation either on a liquid crystal display or through a pair of virtual reality goggles. Using the respiratory trace as a visual aid, the patient performs a breath hold so that the position representing the location of a fiducial is held within a specified gating window. A delay box was fabricated to differentiate between gating signals received during free breathing and those received during breath hold, allowing radiation delivery only when the fiducial was within the breath-hold gating window. A quality control analysis of the gating delay box and the integrated system was performed to ensure that all of the hardware and components were ready for clinical use.

Abdomen↗