Real-time 3D-surface-guided head refixation useful for fractionated stereotactic radiotherapy.
Accurate and precise head refixation in fractionated stereotactic radiotherapy has been achieved through alignment of real-time 3D-surface images with a reference surface image. The reference surface image is either a 3D optical surface image taken at simulation with the desired treatment position, or a CT/MRI-surface rendering in the treatment plan with corrections for patient motion during CT/MRI scans and partial volume effects. The real-time 3D surface images are rapidly captured by using a 3D video camera mounted on the ceiling of the treatment vault. Any facial expression such as mouth opening that affects surface shape and location can be avoided using a new facial monitoring technique. The image artifacts on the real-time surface can generally be removed by setting a threshold of jumps at the neighboring points while preserving detailed features of the surface of interest. Such a real-time surface image, registered in the treatment machine coordinate system, provides a reliable representation of the patient head position during the treatment. A fast automatic alignment between the real-time surface and the reference surface using a modified iterative-closest-point method leads to an efficient and robust surface-guided target refixation. Experimental and clinical results demonstrate the excellent efficacy of <2 min set-up time, the desired accuracy and precision of <1 mm in isocenter shifts, and <1 degree in rotation.
Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University School of Medicine, USA. sli1@hfhs.org
Shidong
S
Li
Dezhi
D
Liu
Gongjie
G
Yin
Ping
P
Zhuang
Jason
J
Geng
D016477:Artifacts; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008953:Models, Anatomic; D009038:Motion; D019047:Phantoms, Imaging; D011877:Radionuclide Imaging; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography