1,081 research outputs found
Predicting respiratory motion for real-time tumour tracking in radiotherapy
Purpose. Radiation therapy is a local treatment aimed at cells in and around
a tumor. The goal of this study is to develop an algorithmic solution for
predicting the position of a target in 3D in real time, aiming for the short
fixed calibration time for each patient at the beginning of the procedure.
Accurate predictions of lung tumor motion are expected to improve the precision
of radiation treatment by controlling the position of a couch or a beam in
order to compensate for respiratory motion during radiation treatment.
Methods. For developing the algorithmic solution, data mining techniques are
used. A model form from the family of exponential smoothing is assumed, and the
model parameters are fitted by minimizing the absolute disposition error, and
the fluctuations of the prediction signal (jitter). The predictive performance
is evaluated retrospectively on clinical datasets capturing different behavior
(being quiet, talking, laughing), and validated in real-time on a prototype
system with respiratory motion imitation.
Results. An algorithmic solution for respiratory motion prediction (called
ExSmi) is designed. ExSmi achieves good accuracy of prediction (error
mm/s) with acceptable jitter values (5-7 mm/s), as tested on out-of-sample
data. The datasets, the code for algorithms and the experiments are openly
available for research purposes on a dedicated website.
Conclusions. The developed algorithmic solution performs well to be
prototyped and deployed in applications of radiotherapy
Extracting respiratory signals from thoracic cone beam CT projections
Patient respiratory signal associated with the cone beam CT (CBCT)
projections is important for lung cancer radiotherapy. In contrast to
monitoring an external surrogate of respiration, such signal can be extracted
directly from the CBCT projections. In this paper, we propose a novel local
principle component analysis (LPCA) method to extract the respiratory signal by
distinguishing the respiration motion-induced content change from the gantry
rotation-induced content change in the CBCT projections. The LPCA method is
evaluated by comparing with three state-of-the-art projection-based methods,
namely, the Amsterdam Shroud (AS) method, the intensity analysis (IA) method,
and the Fourier-transform based phase analysis (FT-p) method. The clinical CBCT
projection data of eight patients, acquired under various clinical scenarios,
were used to investigate the performance of each method. We found that the
proposed LPCA method has demonstrated the best overall performance for cases
tested and thus is a promising technique for extracting respiratory signal. We
also identified the applicability of each existing method.Comment: 21 pages, 11 figures, submitted to Phys. Med. Bio
Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology
Until recently, Computer-Aided Medical Interventions (CAMI) and Medical
Robotics have focused on rigid and non deformable anatomical structures.
Nowadays, special attention is paid to soft tissues, raising complex issues due
to their mobility and deformation. Mini-invasive digestive surgery was probably
one of the first fields where soft tissues were handled through the development
of simulators, tracking of anatomical structures and specific assistance
robots. However, other clinical domains, for instance urology, are concerned.
Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU,
radiofrequency, or cryoablation), increasingly early detection of cancer, and
use of interventional and diagnostic imaging modalities, recently opened new
challenges to the urologist and scientists involved in CAMI. This resulted in
the last five years in a very significant increase of research and developments
of computer-aided urology systems. In this paper, we propose a description of
the main problems related to computer-aided diagnostic and therapy of soft
tissues and give a survey of the different types of assistance offered to the
urologist: robotization, image fusion, surgical navigation. Both research
projects and operational industrial systems are discussed
Translational Research of Audiovisual Biofeedback: An investigation of respiratory-guidance in lung and liver cancer patient radiation therapy
Through the act of breathing, thoracic and abdominal anatomy is in constant motion and is typically irregular. This irregular motion can exacerbate errors in radiation therapy, breathing guidance interventions operate to minimise these errors. However, much of the breathing guidance investigations have not directly quantified the impact of regular breathing on radiation therapy accuracy. The first aim of this thesis was to critically appraise the literature in terms of the use of breathing guidance interventions via systematic review. This review found that 21 of the 27 identified studies yielded significant improvements from the use of breathing guidance. None of the studies were randomised and no studies quantified the impact on 4DCT image quality. The second aim of this thesis was to quantify the impact of audiovisual biofeedback breathing guidance on 4DCT. This study utilised data from an MRI study to program the motion of a digital phantom prior to then simulating 4DCT imaging. Audiovisual biofeedback demonstrated to significantly improved 4DCT image quality over free breathing. The third aim of this thesis was to assess the impact of audiovisual biofeedback on liver cancer patient breathing over a course of stereotactic body radiation therapy (SBRT). The findings of this study demonstrated the effectiveness of audiovisual biofeedback in producing consistent interfraction respiratory motion over a course of SBRT. The fourth aim of this thesis was to design and implement a phase II clinical trial investigating the use and impact of audiovisual biofeedback in lung cancer radiation therapy. The findings of a retrospective analysis were utilised to design and determine the statistics of the most comprehensive breathing guidance study to date: a randomised, stratified, multi-site, phase II clinical trial.. The fifth aim of this thesis was to explore the next stages of audiovisual biofeedback in terms of translating evidence into broader clinical use through commercialisation. This aim was achieved by investigating the the product-market fit of the audiovisual biofeedback technology. The culmination of these findings demonstrates the clinical benefit of the audiovisual biofeedback respiratory guidance system and the possibility to make breathing guidance systems more widely available to patients
Magnetic resonance imaging of lung cancer in the presence of respiratory motion: Dynamic keyhole and audio visual biofeedback
Breath-to-breath variations in breathing can cause image artefacts. Day-to-day variations can cause a disagreement of position and volume between planning and treatment throughout radiotherapy procedures, requiring a larger treatment margin and longer treatment time. An advanced radiotherapy system requires: (1) a fast imaging technique for the compensation of breathing variations and/or (2) a respiratory motion management technique for the control of breathing variations. A novel MRI reconstruction method called “Dynamic keyhole” was proposed as a fast imaging technique. This thesis investigated (1) the concept of this method in terms of the improvement in temporal resolution with healthy volunteer MRI datasets and (2) the applicability of real-time lung tumour localization in terms of the accuracy of tumour motion and shape with lung cancer patient MRI datasets. The dynamic keyhole method achieved an increase in imaging frequency by up to a factor of five when compared with full k-space methods whilst achieving sub-millimetre tumour motion accuracy and preserving tumour shape within 98%. AV biofeedback respiratory guidance was used for healthy volunteers and lung cancer patients. This thesis investigated the impact of AV biofeedback on (1) intra- and inter-fraction lung tumour motion using cine-MRI, (2) inter-fraction lung tumour position and intra-fraction tumour volume using breath-hold MRI and (3) the improvement in image quality and the reduction in scan time using respiratory-gated MRI. AV biofeedback respiratory guidance improved intra- and inter-fraction tumour motion and position reproducibility, and intra-fraction tumour volume consistency. In addition, it was found to improve image quality and reduce scan time. The performance of the dynamic keyhole method and AV biofeedback respiratory guidance shown in this thesis illustrates potential advantages of real-time tumour imaging and tumour motion management in the course of lung cancer radiotherapy
A Preliminary Study For A Biomechanical Model Of The Respiratory System
Engineering and Computational Sciences for Medical Imaging in Oncology - ECSMIO is the special session 1 of International Conference on Computer Vision Theory and Applications - VISAPP 2010International audienceTumour motion is an essential source of error for treatment planning in radiation therapy. This motion is mostly due to patient respiration. To account for tumour motion, we propose a solution that is based on the biomechanical modelling of the respiratory system. To compute deformations and displacements, we use continuous mechanics laws solved with the finite element method. In this paper, we propose a preliminary study of a complete model of the respiratory system including lungs, chest wall and a simple model of the diaphragm. This feasibility study is achieved by using the data of a "virtual patient". Results are in accordance with the anatomic reality, showing the feasibility of a complete model of the respiratory system
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