The utility of megavoltage computed tomography images from a helical tomotherapy system for setup verification purposes

Lisa J. Forrest, Thomas Rockwell Mackie, Ken Ruchala, Michelle Turek, Jeff Kapatoes, Hazim Jaradat, Susanta Hui, John Balog, David M. Vail, Minesh P. Mehta

Research output: Contribution to journalArticlepeer-review

127 Scopus citations

Abstract

To evaluate the utility of relatively low-dose megavoltage computed tomography (MVCT) images from a clinical helical tomotherapy system for setup verification purposes. Cross-sectional kilovolt computed tomography (kVCT) images were obtained for treatment planning purposes on a diagnostic third-generation CT scanner, followed by MVCT images from a helical tomotherapy system in 8 pet dogs with spontaneously occurring tumors. The kVCT and MVCT images were aligned for setup verification purposes, allowing repositioning before treatment delivery. Tumors are readily visualized on the MVCT images. At a dose of 2-3 cGy, the MVCT images are of sufficient quality for verification of treatment setup, but soft-tissue contrast is inferior to that with conventional kVCT. The MV and kVCT images were successfully aligned. When necessary, patients undergoing helical tomotherapy were repositioned before treatment. Megavoltage CT image quality is sufficient for tumor identification and three-dimensional setup verification in dogs with spontaneous tumors. The MVCT images can be aligned with the planning kVCT to ensure proper patient registration before treatment. Image alignment was successful in these canine patients, despite no skin markings defining patient positioning between the two scans. MVCT images facilitate setup verification, and their tomographic nature offers improvements over conventional portal imaging.

Original languageEnglish (US)
Pages (from-to)1639-1644
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume60
Issue number5
DOIs
StatePublished - Dec 1 2004

Keywords

  • Helical tomotherapy
  • Intensity-modulated radiation therapy
  • Megavoltage computed tomography
  • Verification

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