Multi-institutional feasibility study of a fast patient localization method in total marrow irradiation with helical tomotherapy: A global health initiative by the international consortium of total marrow irradiation

Yutaka Takahashi, Stefano Vagge, Stefano Agostinelli, Eunyoung Han, Lukasz Matulewicz, Kai Schubert, Ravishankar Chityala, Vaneerat Ratanatharathorn, Koen Tournel, Jose A. Penagaricano, Sterzing Florian, Marc Andre Mahe, Michael R. Verneris, Daniel J. Weisdorf, Renzo Corvo, Kathryn E. Dusenbery, Guy Storme, Susanta K. Hui

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: To develop, characterize, and implement a fast patient localization method for total marrow irradiation. Methods and Materials: Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo). We also generated kilovoltage topograms (kVtopo) from the projection data of 3-dimensional CT images to reproduce the same geometry as helical tomotherapy. The MVtopo imaging dose and the optimal image acquisition parameters were investigated. A multi-institutional phantom study was performed to verify the image registration uncertainty. Forty-five MVtopo images were acquired and analyzed with in-house image registration software. Results: The smallest jaw size (front and backup jaws of 0) provided the best image contrast and longitudinal resolution. Couch velocity did not affect the image quality or geometric accuracy. The MVtopo dose was less than the MVCT dose. The image registration uncertainty from the multi-institutional study was within 2.8 mm. In patient localization, the differences in calculated couch shift between the registration with MVtopo-kVtopo and MVCT-kVCT images in lateral, cranial - caudal, and vertical directions were 2.2 ± 1.7 mm, 2.6 ± 1.4 mm, and 2.7 ± 1.1 mm, respectively. The imaging time in MVtopo acquisition at the couch speed of 3 cm/s was <1 minute, compared with ≥15 minutes in MVCT for all patients. Conclusion: Whole-body MVtopo imaging could be an effective alternative to time-consuming MVCT for total marrow irradiation patient localization.

Original languageEnglish (US)
Pages (from-to)30-38
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume91
Issue number1
DOIs
StatePublished - Jan 1 2015

Bibliographical note

Publisher Copyright:
© 2015 Elsevier Inc.

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