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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Biomedical Imaging

Background:

  • Accurate patient positioning is critical for effective radiation therapy, as positioning errors significantly impact treatment outcomes.
  • Quantifying loco-regional tissue deformation during radiation therapy remains a challenge with current imaging techniques.

Purpose of the Study:

  • To develop and validate an algorithmic method using Cherenkov image analysis for quantifying loco-regional tissue deformation and patient positioning accuracy.
  • To assess the feasibility of Cherenkov-based tracking for improving inter- and intrafraction positioning in breast cancer radiation therapy.

Main Methods:

  • Cherenkov images were analyzed, segmenting bio-morphological features like vessels.
  • A combined rigid/nonrigid registration technique was used to quantify both global shifts and local tissue deformations.
  • The method was validated using an anthropomorphic chest phantom and applied to clinical data from 10 breast cancer patients.

Main Results:

  • Phantom experiments demonstrated high accuracy (0.83 mm) for couch translations.
  • Clinical data revealed interfraction setup variations of 3.7 ± 2.4 mm (global shift) and up to 3.3 ± 1.9 mm (95th percentile loco-regional deformation).

Conclusions:

  • Cherenkov imaging with rigid/nonrigid registration effectively quantifies global and local patient positioning variations.
  • This novel approach offers quantitative guidance for inter/intrafraction positioning, addressing previously unappreciated loco-regional deformations.