Abstract
Portal imaging using electronic portal imaging device (EPID) is a well-established image-guided radiation therapy (IGRT) technique for external beam radiation therapy. The aims of this study are threefold; (i) to assess the accuracy of isocentre localization in the fiducial-based stereoscopic image registration, (ii) to investigate the impact of errors in the beam collimation device on stereoscopic registration, and (iii) to evaluate the intra- and inter-observer variability in stereoscopic registration. Portal images of a ball bearing phantom were acquired and stereoscopic image registrations were performed based on a point centred in the ball bearing as the surrogate for registration. Experiments were replicated by applying intentional offsets in the beam collimation device to simulate collimation errors. The accuracy of fiducial markers localization was performed by repeating the experiment using three spherical lead shots implanted in a pelvic phantom. Portal images of pelvis phantom were given to four expert users to assess the inter-observer variability in performing registration. The isocentre localization accuracy tested using ball bearing phantom was within 0.3 mm. Gravity-induced systematic errors of beam collimation device by 2 mm resulted in positioning offsets of the order of 2 mm opposing the simulated errors. Relatively large inter-portal pair projection errors ranges from 1.3 mm to 1.8 mm were observed with simulated errors in the beam collimation device. The intra-user and inter-user variabilities were observed to be 0.8 and 0.4 mm respectively. Fiducial-based stereoscopic image registration using EPID is robust for IGRT procedure.
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References
Chung PWM, Haycocks T, Brown T, Cambridge Z, Kelly V, Alasti H, Jaffray DA, Catton CN (2004) On-line aSi portal imaging of implanted fiducial markers for the reduction of interfraction error during conformal radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys 60(1):329–334
Keall PJ, Todor AD, Vedam SS, Bartee CL, Siebers JV, Kini VR, Mohan R (2004) On the use of EPID-based implanted marker tracking for 4D radiotherapy. Med Phys 31(12):3492–3499
Schallenkamp JM, Herman MG, Kruse JJ, Pisansky TM (2005) Prostate position relative to pelvic bony anatomy based on intraprostatic gold markers and electronic portal imaging. Int J Radiat Oncol Biol Phys 63(3):800–811
Greer PB, Dahl K, Ebert MA, White M, Wratten C, Ostwald P, Pichler P, Denham JW (2008) Assessment of a daily online implanted fiducial marker-guided prostate radiotherapy process. J Med Imaging Radiat Oncol 52(5):517–524
Miranpuri AS, Tomé WA, Paliwal BR, Kesslering C, Mehta MP (2001) Assessment of patient independent intrinsic error for a noninvasive frame for fractionated stereotactic radiotherapy. Int J Cancer 96(5):320–325
Bert C, Metheany KG, Doppke K, Chen GTY (2005) A phantom evaluation of a stereo-vision surface imaging system for radiotherapy patient setup. Med Phys 32(9):2753–2762
Mao W, Lee L, Xing L (2008) Development of a QA phantom and automated analysis tool for geometric quality assurance of on-board MV and kV X-ray imaging systems. Med Phys 35(4):1497–1506
Wiehle R, Koth HJ, Nanko N, Grosu AL, Hodapp N (2009) On the accuracy of isocenter verification with kV imaging in stereotactic radiosurgery. Strahlenther Onkol 185(5):325–330
Phillips MH, Singer K, Miller E, Stelzer K (2000) Commissioning an image-guided localization system for radiotherapy. Int J Radiat Oncol Biol Phys 48(1):267–276
Du W, Yang J, Luo D, Martel M (2010) A simple method to quantify the coincidence between portal image graticules and radiation field centers or radiation isocenter. Med Phys 37(5):2256–2263
Elekta. Installation Manual for XVI R4.0
Murphy MJ (2002) Fiducial-based targeting accuracy for external-beam radiotherapy. Med Phys 29(3):334–344
Balter JM, Pelizzari CA, Chen GTY (1992) Correlation of projection radiographs in radiation therapy using open curve segments and points. Med Phys 19(2):329–334
Wang HC, Chui CS, Tsai HY, Chen CH, Tsai LF (2008) Dose deviations caused by positional inaccuracy of multileaf collimator in intensity modulated radiotherapy. Radiat Measur 43(2–6):925–928
Ung NM, Harper C, Wee L (2011) Dosimetric impact of systematic MLC positional errors on step and shoot IMRT for prostate cancer: a planning study. Australas Phys Eng Sci Med 34(2):291–298
Mu G, Ludlum E, Xia P (2008) Impact of MLC leaf position errors on simple and complex IMRT plans for head and neck cancer. Phys Med Biol 53(1):77–88
Sastre-Padro M, Welleweerd J, Malinen E, Eilertsen K, Olsen DR, van der Heide UA (2007) Consequences of leaf calibration errors on IMRT delivery. Phys Med Biol 4:1147–1156
Acknowledgments
This study was carried out at Genesis Cancer Care WA (formerly Perth Radiation Oncology), Wembley, Western Australia. The authors thank the assistance of Sara Lyons Hackett and Simon Woodings in the preparation of this manuscript. They also acknowledge the financial support of one of the authors (N.M. Ung) by the Malaysian Ministry of Higher Education and the University of Malaya.
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Ung, N.M., Wee, L. On the accuracy of localization achievable in fiducial-based stereoscopic image registration system using an electronic portal imaging device. Australas Phys Eng Sci Med 35, 205–213 (2012). https://doi.org/10.1007/s13246-012-0148-y
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DOI: https://doi.org/10.1007/s13246-012-0148-y