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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Stochastic triangulation for prostate positioning during radiotherapy using short CBCT arcs.

Wolfgang Hoegele1, Rainer Loeschel, Barbara Dobler

  • 1Regensburg University Medical Center, Department of Radiation Oncology, Regensburg, Germany. wolfgang@hoegele.de

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|February 12, 2013
PubMed
Summary

Stochastic triangulation offers fast and reliable tumor localization for radiotherapy using short imaging arcs. This method accurately tracks tumors during treatment, even with patient motion.

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Area of Science:

  • Medical Physics
  • Radiotherapy Technology
  • Image-Guided Therapy

Background:

  • Accurate tumor localization is crucial for modern radiotherapy, especially with advanced delivery techniques.
  • Existing methods require reliable and rapid tumor positioning for effective treatment.
  • New methods are needed to improve the speed and accuracy of tumor localization.

Purpose of the Study:

  • To demonstrate the efficacy of 'stochastic triangulation' for fast and reliable tumor localization.
  • To validate a novel stochastic Maximum A Posteriori (MAP) estimator for radiotherapy applications.
  • To assess the performance of stochastic triangulation using linac-mounted imaging devices.

Main Methods:

  • Developed a stochastic MAP estimator incorporating an uncertainty-driven model for acquisition geometry and anatomical variations.
  • Applied the MAP estimator using short imaging arcs (5°) and few projections (10) from cone-beam computed tomography (CBCT) and electronic portal imaging devices (EPID).
  • Validated the method on CBCT scans of a prostate cancer patient with implanted gold markers, performing 90 estimations.

Main Results:

  • Short-arc stochastic triangulation achieved a mean residual radial error of 1.4mm (SD 0.9mm) compared to manual inspection.
  • The method demonstrated robustness against abrupt intra-fractional motion (up to 10mm), with mean radial errors of 1.8mm (SD 1.1mm).
  • Slow periodic intra-fractional motions (up to 12mm) also yielded acceptable mean radial errors of 1.8mm (SD 1.1mm).

Conclusions:

  • The proposed stochastic triangulation method is fast and robust for target localization.
  • This technique is suitable for both inter- and intra-fractional tumor localization.
  • Stochastic triangulation can be effectively implemented using current cone-beam computed tomography (CBCT) units.