An open-source development based on photogrammetry for a real-time IORT treatment planning system

Area of Science:

• Medical physics
• Radiotherapy technology
• Surgical oncology

Background:

• Intraoperative radiotherapy (IORT) requires precise tumor targeting.
• Traditional imaging methods may not be readily available or optimal in the operating room.
• Accurate dose calculation is crucial for effective IORT and minimizing side effects.

Purpose of the Study:

• To present a treatment planning system for intraoperative low-energy photon radiotherapy.
• To utilize photogrammetry from real-time surgical site images for dose calculation.
• To eliminate the need for computed tomography in IORT planning.

Main Methods:

• A photogrammetry system using smartphone/tablet images was developed.
• The system reconstructs a 3D model of the surgical site for dose calculation.
• Commissioning involved 3D printing of tumor bed reconstructions and verification with radiochromic films.

Main Results:

• The 3D model reconstruction time averaged 229.6 seconds.
• The entire planning and dose calculation procedure averaged 520.6 seconds.
• Radiochromic film measurements showed minimal differences (1.4%-6.2%) compared to calculated doses.

Conclusions:

• A photogrammetry-based IORT planning system was successfully demonstrated.
• The system enables real-time imaging and planning in the operating room.
• Verification confirmed the system's accuracy for low-energy photon IORT.