title: Collision prediction software for radiotherapy treatments.
abstract: OBJECTIVE
  This work presents a method of collision predictions for external beam radiotherapy using surface imaging. The present methodology focuses on collision prediction during treatment simulation to evaluate the clearance of a patient's treatment position and allow for its modification if necessary.
  
  
  METHODS
  A Kinect camera (Microsoft, Redmond, WA) is used to scan the patient and immobilization devices in the treatment position at the simulator. The surface is reconstructed using the skanect software (Occipital, Inc., San Francisco, CA). The treatment isocenter is marked using simulated orthogonal lasers projected on the surface scan. The point cloud of this surface is then shifted to isocenter and converted from Cartesian to cylindrical coordinates. A slab models the treatment couch. A cylinder with a radius equal to the normal distance from isocenter to the collimator plate, and a height defined by the collimator diameter is used to estimate collisions. Points within the cylinder clear through a full gantry rotation with the treatment couch at 0°, while points outside of it collide. The angles of collision are reported. This methodology was experimentally verified using a mannequin positioned in an alpha cradle with both arms up. A planning CT scan of the mannequin was performed, two isocenters were marked in pinnacle, and this information was exported to AlignRT (VisionRT, London, UK)--a surface imaging system for patient positioning. This was used to ensure accurate positioning of the mannequin in the treatment room, when available. Collision calculations were performed for the two treatment isocenters and the results compared to the collisions detected the room. The accuracy of the Kinect-Skanect surface was evaluated by comparing it to the external surface of the planning CT scan.
  
  
  RESULTS
  Experimental verification results showed that the predicted angles of collision matched those recorded in the room within 0.5°, in most cases (largest deviation -1.2°). The accuracy study for the Kinect-Skanect surface showed an average discrepancy between the CT external contour and the surface scan of 2.2 mm.
  
  
  CONCLUSIONS
  This methodology provides fast and reliable collision predictions using surface imaging. The use of the Kinect-Skanect system allows for a comprehensive modeling of the patient topography including all the relevant anatomy and immobilization devices that may lead to collisions. The use of this tool at the treatment simulation stage may allow therapists to evaluate the clearance of a patient's treatment position and optimize it before the planning CT scan is performed. This can allow for safer treatments for the patients due to better collision predictions and improved clinical workflow by minimizing replanning and resimulations due to unforeseen clearance issues.
authors.affiliation: Virginia Commonwealth University Medical Center, Richmond, Virginia 23298.
authors.forename: Laura
authors.initials: L
authors.lastname: Padilla
authors.affiliation: Techna Institute and the Princess Margaret Cancer Center, University Health Network, Toronto, Ontario M5G 2M9, Canada.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Pearson
authors.affiliation: Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Pelizzari
mesh_terms: D000465:Algorithms; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D056888:Patient Positioning / Q000379:methods*; D061214:Patient Safety; D010363:Pattern Recognition, Automated / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D012986:Software Validation; D013382:Subtraction Technique; D051598:Whole Body Imaging / Q000379:methods*