Abstract

Purpose: To compare markerless template-based tracking of lung tumors using dual energy (DE) cone-beam computed tomography (CBCT) projections versus single energy (SE) CBCT projections. Methods: A RANDO chest phantom with a simulated tumor in the upper right lung was used to investigate the effectiveness of tumor tracking using DE and SE CBCT projections. Planar kV projections from CBCT acquisitions were captured at 60 kVp (4 mAs) and 120 kVp (1 mAs) using the Varian TrueBeam and non-commercial iTools Capture software. Projections were taken at approximately every 0.53° while the gantry rotated. Due to limitations of the phantom, angles for which the shoulders blocked the tumor were excluded from tracking analysis. DE images were constructed using a weighted logarithmic subtraction that removed bony anatomy while preserving soft tissue structures. The tumors were tracked separately on DE and SE (120 kVp) images using a template-based tracking algorithm. The tracking results were compared to ground truth coordinates designated by a physician. Matches with a distance of greater than 3 mm from ground truth were designated as failing to track. Results: 363 frames were analyzed. The algorithm successfully tracked the tumor on 89.8% (326/363) of DE frames compared to 54.3% (197/363) of SE frames (p<0.0001). Average distance between tracking and ground truth coordinates was 1.27 +/− 0.67 mm for DE versus 1.83+/−0.74 mm for SE (p<0.0001). Conclusion: This study demonstrates the effectiveness of markerless template-based tracking using DE CBCT. DE imaging resulted in better detectability with more accurate localization on average versus SE. Supported by a grant from Varian Medical Systems

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