Abstract
Introduction: To investigate the inter-observer and inter-modality variabilities of two imaging guided equipments—cone-beam computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body radiotherapy. Methods: A renal metastasis case implanted with three gold anchor fiducial markers was firstly scanned by US to acquire a 3-dimension US image and followed by 4-dimension CBCT in every fraction. Seven observers retrospectively registered the pre-treatment images with the corresponding reference images based on the gold markers. Registration uncertainty of the observers between two imaging modalities was evaluated. Results: The uncertainties over whole treatment course in CBCT were 0.88 mm, 1.94 mm and 0.86 mm in lateral, longitudinal and vertical directions respectively; while 0.8 mm, 0.97 mm and 1.36 mm were found in US. Conclusion: The greatest uncertainty was found in longitudinal direction in CBCT due to the fact that the respiration motion is the most rigorous in cranial-caudal direction. In US, since the probe was hold almost in upright position, the strong echo in vertical direction was attributed to the greatest uncertainty for such direction.
Highlights
To investigate the inter-observer and inter-modality variabilities of two imaging guided equipments—cone-beam computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body radiotherapy
Its accuracy and consistency were compared with other imaging modalities, for instance, cone-beam computed tomography (CBCT) and electromagnetic transponders, where it has proved to be clinically acceptable [12] [13]
This study aims to investigate the variations of inter-observer and inter-modality of using US and CBCT in kidney Stereotactic body radiotherapy (SBRT)
Summary
To investigate the inter-observer and inter-modality variabilities of two imaging guided equipments—cone-beam computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body radiotherapy. The implementation of image-guidance further facilitates the use of SBRT to provide accurate positioning and targeting of the tumors, which in turn promotes the margin reduction for dose escalation and normal tissue sparing. The advance of image-guided radiotherapy (IGRT) can provide pre-treatment positioning, target monitoring and post-treatment verification using different modalities such as infrared, X-rays, ultrasound and magnetic resonance imaging (MRI) [3]. Good visualization of the lumpectomy cavity and the tumor bed in US images was reported and potential margin reduction could be achieved by daily US guidance for localization and positioning [6] [7].
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