Skip to main content
Log in

Display of positron emission tomography with Cadplan

  • Technical Report
  • Published:
Australasian Physics & Engineering Sciences in Medicine Aims and scope Submit manuscript

Abstract

Recent clinical experience at Peter MacCallum Cancer Institute1 (PMCI) with the use of unregistered Positron Emission Tomography (PET) images for radiotherapy target marking in the lung suggests that co-registered PET images would be invaluable20. PMCI has three radiotherapy treatment planning systems2,3,4 but none of them currently is able to display or co-register PET images with Computed Tomography (CT) images. This paper details the approach taken to display co-registered PET images with the CADPLAN3 treatment planning system. CT Image files are normally transferred to Cadplan by DICOM5 transfer, but the Cadplan DICOM server will not receive (has no presentation context for) PET images. The fundamental design of the CADPLAN system envisages display of only a single image dataset, which must be a CT scan for planning reasons. The problem of data transfer is crudely solved by File Transfer Protocol6 (FTP) over the network. Fortunately the multislice format of the PET image files7 makes individual transfer manageable. A menu based C8 program running at the same time as Cadplan is invoked to sample the DICOM PET Image and create multiple Cadplan CART9 image format files that are co-registered with each existing transverse CT slice. With the Cadplan in contour mode, the program allows the co-registered PET images to be swapped in and out of the image section of the CART files promptly, while keeping the contour information. This allows radiotherapy target volumes to be marked using transverse PET emission images, and effectively circumvents the design constraints prohibiting the display of more than one image set. Contours can be over-laid for review on reconstructed sagittal or coronal views of CT or PET images constructed using the standard Cadplan tools. Co-registration is facilitated by identical positioning with the aid of lasers and18FDG loaded fiducial markers on the PET scanner and CT couch. A polyurethane cast fixed with EFFILOCK is used to ensure identical patient orientation on the CT and PET couches. Since both imaging modalities are without significant geometric distortion10, 11 the co-registration is then simply a translation. PET transmission images can be used for co-registration verification. The practical implementation of display of PET images with CADPLAN has enabled us to begin a trial of 10 patients, the results of which will be reported separately.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Peter MacCallum Cancer Institute Internet Site http://www.petermac.org/

  2. Miften, M.M., Wiesmeyer, M., Monthofer, S., and Krippner, K.,Implementation of FFT convolution and multigrid superposition models in the FOCUS RTP system, Phys. Med. Biol., 45:817–833, 2000

    Article  CAS  PubMed  Google Scholar 

  3. Ding, G.X., Yu, M.K., and Cygler, J.E.,Dose verification of electron beams in the Cadplan 3D treatment planning system, Radiother. Oncol., 25:A196, 1998

    Google Scholar 

  4. Cygler, J.E., Ding, G.X., Ash, K.C., and Zhang, G.G.,Evaluation of a new electron beam algorithm in Theraplan Plus 3D planning system. Med. Phys., 25:1074, 1998.

    Google Scholar 

  5. Digital Imaging and Communications in Medicine (DICOM) Version 3.0 National Electrical Manufacturers Association (NEMA) 1300 N. 17th Street Rosslyn Virginia 22209 USA

  6. Quercia, V.,Internet in a Nutshell, 1st ed., O’Reilly & Associates, Sebastopol CA USA, 263–297, 1997.

    Google Scholar 

  7. Digital Imaging and Communications in Medicine (DICOM) Version 3.0 Part 3: Information Object Definitions Annex C.8.4.8 NM Multi-frame Module National Electrical Manufacturers Association (NEMA) 1300 N. 17th Street Rosslyn Virginia 22209 USA, 217, 2000

  8. Kernighan, B.W. and Ritchie, D. M.,The C Programming Language, 2nd ed., Prentice Hall, Englewood Cliffs New Jersey U.S.A., 1988

    Google Scholar 

  9. Maguire, G.Q., and Noz, M.E.,Image formats: five years after the AAPM standard for digital image interchange, Med. Phys.,16:818–23, 1989.

    Article  PubMed  Google Scholar 

  10. Webb, S.,The Physics of Medical Imaging, IOP Publishing, section 6.6.7 Positron Emission Tomography, 1988.

  11. Smith, D.K., Berquist, T.H., An, K. N., Robb, R.A. and Chao, E.Y.,Validation of three-dimensional reconstructions of knee anatomy: CT vs MR imaging, J. Comput. Assist. Tomogr., 13:294–301, 1989.

    Article  CAS  PubMed  Google Scholar 

  12. Peter MacCallum Cancer Institute Annual Report 2001, Peter MacCallum Cancer Institute, Melbourne, p14, 2001.

  13. Karp, J.S., Muehllehner, G., Mankoff, D.A., Ordonez, C.E., Ollinger, J.M., Daube-Witherspoon, M.E., Haigh, A.T., and Beerbohm, D.J.,Continuous-slice PENN-PET: a positron tomograph with volume imaging capability, J. Nucl. Med. 31:628–31, 1990

    Google Scholar 

  14. Tochon-Danguy, H.J., Sachinidis, J.I., Egan, G.F., Chan, J.G., Berlangieri, S.U., McKay, W.J., and Scott, A.M.,Positron emission tomography: radioisotope and radiopharmaceutical production, Australas. Phys. Eng. Sci. Med., 22:136–44, 1999.

    CAS  PubMed  Google Scholar 

  15. Wang, G., Frei, T., and Vannier, M.W,Fast iterative algorithm for metal artifact reduction in X-ray CT, Academic Radiology. 7:607–614, 2000.

    Article  CAS  PubMed  Google Scholar 

  16. International Commission on Radiation Units and MeasurementsPrescribing, Recording and Reporting Photon Beam Therapy (Supplement to ICRU Report 50)(1999)

  17. Leunens, G., Menten, J., Weltens, C., Verstraete, J., and van der Schueren, E.,Quality assessment of medical decision making in radiation oncology: variability in target volume delineation for brain tumours. Radiother. Oncol., 29:169–75, 1993

    Article  CAS  PubMed  Google Scholar 

  18. Quint, L.E., Francis, I.R., Wahl, R.L., Gross, B.H. and Glazer, G.M.,Preoperative staging of non-small cell carcinoma of the lung:imaging methods. Am. J. Roentgenol. 164:1349–1359, 1995

    CAS  Google Scholar 

  19. Senan, S., van Sörnsen de Koste, J., Samson, M., Tankink, H., Jansen, P., Nowak, P.J., Krol, A.D., Schmitz, P., and Lagerwaard, F. J.,Evaluation of a target contouring protocol for 3D conformal radiotherapy in non-small cell lung cancer, Radiother. Oncol., 53:247–255, 1999.

    Article  CAS  PubMed  Google Scholar 

  20. MacManus, M.P., Hicks, R.J., Ball, D.L., Kalff, V., Matthews, J.P., Salminen, E., Khaw, P., Wirth, A., Rischin, D. and McKenzie, A.F., 18fluorodeoxyglucose positron emission tomography staging in radical radiotherapy candidates with non small cell lung carcinoma: powerful correlation with survival and high impact on treatment, Cancer. 92(4):886–95, 2001

    Article  CAS  Google Scholar 

  21. Ackerly, T., Geso, M., and Cramb, J.,Planning of fixed field Stereotactic Radiotherapy using a Stereotactic Localising Program and a regular Treatment Planning System, Med. Phys., 25:A93, 1998.

    Google Scholar 

  22. Heller, D., and Ferguson, S.P.,Motif Programming Manual (The Definitive Guides to the X Window System, Volume 6), 2nd ed. O’Reilly & Associates, 1994

  23. Islam, M.K., Saeedi, F., and Al-Rajhi, N.,A simplified shielding approach for limiting fetal dose during radiation therapy of pregnant patients, Int. J. Radiat. Oncol. Biol. Phys., 49:1469–73, 2001.

    CAS  PubMed  Google Scholar 

  24. Jankharia, B.,Current status and history of teleradiology in India, International Journal of Medical Informatics 61:163–66, 2001.

    Article  CAS  PubMed  Google Scholar 

  25. Guyton, A.C.,Textbook of Medical Physiology, 8th ed., W.B.Saunders, Philadelphia, 402–403, 1991

    Google Scholar 

  26. Gonzalez, R. C. and Woods, R. E.,Digital image processing, Addison Wesley, Reading Massachusets, 166–185, 1993.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. Ackerly.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ackerly, T., Andrews, J., Ball, D. et al. Display of positron emission tomography with Cadplan. Australas. Phys. Eng. Sci. Med. 25, 67–77 (2002). https://doi.org/10.1007/BF03178468

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03178468

Key words

Navigation