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Biomedical subjects

Peter Munro

Publications and source records attributed to Peter Munro.

8 recordsLinked to original sources

Dynamic targeting image-guided radiotherapy.

Volumetric imaging and planning for 3-dimensional (3D) conformal radiotherapy and intensity-modulated radiotherapy (IMRT) have highlighted the need to the oncology community to better understand the geometric uncertainties inherent in the radiotherapy delivery process, including setup error (interfraction) as well as organ motion during treatment (intrafraction). This has ushered in the development of emerging technologies and clinical processes, collectively referred to as image-guided radiotherapy (IGRT). The goal of IGRT is to provide the tools needed to manage both inter- and intrafraction motion to improve the accuracy of treatment delivery. Like IMRT, IGRT is a process involving all steps in the radiotherapy treatment process, including patient immobilization, computed tomography (CT) simulation, treatment planning, plan verification, patient setup verification and correction, delivery, and quality assurance. The technology and capability of the Dynamic Targeting IGRT system developed by Varian Medical Systems is presented. The core of this system is a Clinac or Trilogy accelerator equipped with a gantry-mounted imaging system known as the On-Board Imager (OBI). This includes a kilovoltage (kV) x-ray source, an amorphous silicon kV digital image detector, and 2 robotic arms that independently position the kV source and imager orthogonal to the treatment beam. A similar robotic arm positions the PortalVision megavoltage (MV) portal digital image detector, allowing both to be used in concert. The system is designed to support a variety of imaging modalities. The following applications and how they fit in the overall clinical process are described: kV and MV planar radiographic imaging for patient repositioning, kV volumetric cone beam CT imaging for patient repositioning, and kV planar fluoroscopic imaging for gating verification. Achieving image-guided motion management throughout the radiation oncology process requires not just a single product, but a suite of integrated products to manipulate all patient data, including images, efficiently and effectively.

Humans↗

Region of interest reconstruction from truncated data in circular cone-beam CT.

The circular scanning trajectory is one of the most widely adopted data-acquisition configurations in computed tomography (CT). The Feldkamp, Davis, Kress (FDK) algorithm and its various modifications have been developed for reconstructing approximately three-dimensional images from circular cone-beam data. When data contain transverse truncations, however, these algorithms may reconstruct images with significant truncation artifacts. It is of practical significance to develop algorithms that can reconstruct region-of-interest (ROI) images from truncated circular cone-beam data that are free of truncation artifacts and that have an accuracy comparable to that obtained from nontruncated cone-beam data. In this work, we have investigated and developed a backprojection-filtration (BPF)-based algorithm for ROI-image reconstruction from circular cone-beam data containing transverse truncations. Furthermore, we have developed a weighted BPF algorithm to exploit "redundant" information in data for improving image quality. In an effort to validate and evaluate the proposed BPF algorithms for circular cone-beam CT, we have performed numerical studies by using both computer-simulation data and experimental data acquired with a radiotherapy cone-beam CT system. Quantitative results in these studies demonstrate that the proposed BPF algorithms for circular cone-beam CT can reconstruct ROI images free of truncation artifacts.

Algorithms↗

Low-dose megavoltage cone-beam computed tomography for lung tumors using a high-efficiency image receptor.

We report on the capabilities of a low-dose megavoltage cone-beam computed tomography (MV CBCT) system. The high-efficiency image receptor consists of a photodiode array coupled to a scintillator composed of individual CsI crystals. The CBCT system uses the 6 MV beam from a linear accelerator. A synchronization circuit allows us to limit the exposure to one beam pulse [0.028 monitor units (MU)] per projection image. 150-500 images (4.2-13.9 MU total) are collected during a one-minute scan and reconstructed using a filtered backprojection algorithm. Anthropomorphic and contrast phantoms are imaged and the contrast-to-noise ratio of the reconstruction is studied as a function of the number of projections and the error in the projection angles. The detector dose response is linear (R2 value 0.9989). A 2% electron density difference is discernible using 460 projection images and a total exposure of 13 MU (corresponding to a maximum absorbed dose of about 12 cGy in a patient). We present first patient images acquired with this system. Tumors in lung are clearly visible and skeletal anatomy is observed in sufficient detail to allow reproducible registration with the planning kV CT images. The MV CBCT system is shown to be capable of obtaining good quality three-dimensional reconstructions at relatively low dose and to be clinically usable for improving the accuracy of radiotherapy patient positioning.

Equipment Design↗

Four-dimensional cone-beam computed tomography using an on-board imager.

On-board cone-beam computed tomography (CBCT) has recently become available to provide volumetric information of a patient in the treatment position, and holds promises for improved target localization and irradiation dose verification. The design of currently available on-board CBCT, however, is far from optimal. Its quality is adversely influenced by many factors, such as scatter, beam hardening, and intra-scanning organ motion. In this work we quantitatively study the influence of organ motion on CBCT imaging and investigate a strategy to acquire high quality phase-resolved [four-dimensional (4D)] CBCT images based on phase binning of the CBCT projection data. An efficient and robust method for binning CBCT data according to the patient's respiratory phase derived in the projection space was developed. The phase-binned projections were reconstructed using the conventional Feldkamp algorithm to yield 4D CBCT images. Both phantom and patient studies were carried out to validate the technique and to optimize the 4D CBCT data acquisition protocol. Several factors that are important to the clinical implementation of the technique, such as the image quality, scanning time, number of projections, and radiation dose, were analyzed for various scanning schemes. The general references drawn from this study are: (i) reliable phase binning of CBCT projections is accomplishable with the aid of external or internal marker and simple analysis of its trace in the projection space, and (ii) artifact-free 4D CBCT images can be obtained without increasing the patient radiation dose as compared to the current 3D CBCT scan.

Algorithms↗

A quality assurance program for the on-board imagers.

To develop a quality assurance (QA) program for the On-Board Imager (OBI) system and to summarize the results of these QA tests over extended periods from multiple institutions. Both the radiographic and cone-beam computed tomography (CBCT) mode of operation have been evaluated. The QA programs from four institutions have been combined to generate a series of tests for evaluating the performance of the On-Board Imager. The combined QA program consists of three parts: (1) safety and functionality, (2) geometry, and (3) image quality. Safety and functionality tests evaluate the functionality of safety features and the clinical operation of the entire system during the tube warm-up. Geometry QA verifies the geometric accuracy and stability of the OBI/CBCT hardware/software. Image quality QA monitors spatial resolution and contrast sensitivity of the radiographic images. Image quality QA for CBCT includes tests for Hounsfield Unit (HU) linearity, HU uniformity, spatial linearity, and scan slice geometry, in addition. All safety and functionality tests passed on a daily basis. The average accuracy of the OBI isocenter was better than 1.5 mm with a range of variation of less than 1 mm over 8 months. The average accuracy of arm positions in the mechanical geometry QA was better than 1 mm, with a range of variation of less than 1 mm over 8 months. Measurements of other geometry QA tests showed stable results within tolerance throughout the test periods. Radiographic contrast sensitivity ranged between 2.2% and 3.2% and spatial resolution ranged between 1.25 and 1.6 lp/mm. Over four months the CBCT images showed stable spatial linearity, scan slice geometry, contrast resolution (1%; <7 mm disk) and spatial resolution (>6 lp/cm). The HU linearity was within +/-40 HU for all measurements. By combining test methods from multiple institutions, we have developed a comprehensive, yet practical, set of QA tests for the OBI system. Use of the tests over extended periods show that the OBI system has reliable mechanical accuracy and stable image quality. Nevertheless, the tests have been useful in detecting performance deficits in the OBI system that needed recalibration. It is important that all tests are performed on a regular basis.

Equipment Failure Analysis↗

Megavoltage cone-beam computed tomography using a high-efficiency image receptor.

PURPOSE: To develop an image receptor capable of forming high-quality megavoltage CT images using modest radiation doses. METHODS AND MATERIALS: A flat-panel imaging system consisting of a conventional flat-panel sensor attached to a thick CsI scintillator has been fabricated. The scintillator consists of individual CsI crystals 8 mm thick by 0.38 mm x 0.38-mm pitch. Five sides of each crystal are coated with a reflecting powder/epoxy mixture, and the sixth side is in contact with the flat-panel sensor. A timing interface coordinates acquisition by the imaging system and pulsing of the linear accelerator. With this interface, as little as one accelerator pulse (0.023 cGy at the isocenter) can be used to form projection images. Different CT phantoms irradiated by a 6-MV X-ray beam have been imaged to evaluate the performance of the imaging system. The phantoms have been mounted on a rotating stage and rotated while 360 projection images are acquired in 48 s. These projections have been reconstructed using the Feldkamp cone-beam CT reconstruction algorithm. RESULTS AND DISCUSSION: Using an irradiation of 16 cGy (360 projections x 0.046 cGy/projection), the contrast resolution is approximately 1% for large objects. High-contrast structures as small as 1.2 mm are clearly visible. The reconstructed CT values are linear (R(2) = 0.98) for electron densities between 0.001 and 2.16 g/cm(3), and the reconstruction time for a 512 x 512 x 512 data set is 6 min. Images of an anthropomorphic phantom show that soft-tissue structures such as the heart, lung, kidneys, and liver are visible in the reconstructed images (16 cGy, 5-mm-thick slices). CONCLUSIONS: The acquisition of megavoltage CT images with soft-tissue contrast is possible with irradiations as small as 16 cGy.

Phantoms, Imaging↗

A preliminary investigation of local tomography for megavoltage CT imaging.

We investigate the problem of reconstructing a two-dimensional (2-D) cross-sectional image of a tumor volume from a set of truncated MV projections that are produced by radiation therapy treatment beams. Our proposed approach is conceptually distinct from previously investigated approaches in that it utilizes a noniterative local tomography reconstruction algorithm. A local tomography reconstruction algorithm is implemented and systematically investigated using several sets of simulated and experimental MV projection data. We demonstrate that the conventional (nonlocal) filtered backprojection reconstruction algorithm cannot, in general, accurately reconstruct the edges and boundaries of low-contrast features from truncated MV projection data. We demonstrate that the local tomography algorithm is not adversely affected by projection truncation and can reconstruct accurately the boundaries of low-contrast structures within the region of interest from truncated MV projections.

Algorithms↗

Reducing the weight of the EC-L cassette.

PURPOSE: To model the EC-L portal film cassette to understand how its weight could be reduced without compromising image quality. METHODS AND MATERIALS: The BEAM99 Monte Carlo code was used to simulate a 6-MV X-ray beam impinging on a water phantom 15 or 40 cm thick and subsequently reaching image receptors of different designs. The image receptor model included the front cassette wall, lead or copper plates 0-1.2 g/cm(2) in thickness, a Lanex Fast screen pair, and the rear cassette wall. The signal generated in the phosphor screen from primary and scattered photons and charged particles was calculated for all image receptors and for both a water phantom and a water phantom plus bone object. Subject contract was calculated using the formalism of Motz and Danos, and the detective quantum efficiency was calculated using the formalism of Swank. Experimental cassettes with copper plate thicknesses of 0.5, 0.25, and 0.0 mm were used to image patients at several anatomic sites. RESULTS: Multiple scatter, especially at large field sizes, generates a low-energy X-ray component that can overrespond in the image receptor. The lead plate is more effective in reducing this X-ray scatter component than the copper plate. Filtering of the X-ray beam by the patient hardens the X-ray spectrum of a 6-MV X-ray beam, reducing subject contrast for thick patients. The front wall of the cassette plays an important role in contributing to the signals generated in the image receptor when the thickness of the metal plate is reduced. Over a wide variety of field sizes and patient thicknesses, subject contrast and detective quantum efficiency are relatively independent of metal plate thickness. CONCLUSIONS: The results suggest that a redesign of the EC-L cassette where the front wall of the cassette becomes part of the image receptor, and where the metal plate is changed to lead and the thickness reduced to 0.2 g/cm(2), would generate images of quality comparable to those of the existing EC-L cassette when used with a 6-MV X-ray beam. This change would reduce the weight of the EC-L cassette by 1040 g.

Radiography↗