Combining marker-less patient setup and respiratory motion monitoring using low cost 3D camera technology

Abstract

Patient set-up misalignment/motion can be a significant source of error within external beam radiotherapy, leading to unwanted dose to healthy tissues and sub-optimal dose to the target tissue. Such inadvertent displacement or motion of the target volume may be caused by treatment set-up error, respiratory motion or an involuntary movement potentially decreasing therapeutic benefit. The conventional approach to managing abdominal-thoracic patient set-up is via skin markers (tattoos) and laser-based alignment. Alignment of the internal target volume with its position in the treatment plan can be achieved using Deep Inspiration Breath Hold (DIBH) in conjunction with marker-based respiratory motion monitoring. We propose a marker-less single system solution for patient set-up and respiratory motion management based on low cost 3D depth camera technology (such as the Microsoft Kinect). In this new work we assess this approach in a study group of six volunteer subjects. Separate simulated treatment mimic treatment fractions or set-ups are compared for each subject, undertaken using conventional laser-based alignment and with intrinsic depth images produced by Kinect. Microsoft Kinect is also compared with the well-known RPM system for respiratory motion management in terms of monitoring free-breathing and DIBH. Preliminary results suggest that Kinect is able to produce mm-level surface alignment and a comparable DIBH respiratory motion management when compared to the popular RPM system. Such an approach may also yield significant benefits in terms of patient throughput as marker alignment and respiratory motion can be automated in a single system.