Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images

Abstract Background In radiotherapy, 2D orthogonally projected kV images are used for patient alignment when 3D-on-board imaging (OBI) is unavailable. However, tumor visibility is constrained due to the projection of patient’s anatomy onto a 2D plane, potentially leading to substantial setup errors....

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Main Authors: Yuzhen Ding, Jason M. Holmes, Hongying Feng, Baoxin Li, Lisa A. McGee, Jean-Claude M. Rwigema, Sujay A. Vora, William W. Wong, Daniel J. Ma, Robert L. Foote, Samir H. Patel, Wei Liu
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-024-00672-y
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author Yuzhen Ding
Jason M. Holmes
Hongying Feng
Baoxin Li
Lisa A. McGee
Jean-Claude M. Rwigema
Sujay A. Vora
William W. Wong
Daniel J. Ma
Robert L. Foote
Samir H. Patel
Wei Liu
author_facet Yuzhen Ding
Jason M. Holmes
Hongying Feng
Baoxin Li
Lisa A. McGee
Jean-Claude M. Rwigema
Sujay A. Vora
William W. Wong
Daniel J. Ma
Robert L. Foote
Samir H. Patel
Wei Liu
author_sort Yuzhen Ding
collection DOAJ
description Abstract Background In radiotherapy, 2D orthogonally projected kV images are used for patient alignment when 3D-on-board imaging (OBI) is unavailable. However, tumor visibility is constrained due to the projection of patient’s anatomy onto a 2D plane, potentially leading to substantial setup errors. In treatment room with 3D-OBI such as cone beam CT (CBCT), the field of view (FOV) of CBCT is limited with unnecessarily high imaging dose. A solution to this dilemma is to reconstruct 3D CT from kV images obtained at the treatment position. Methods We propose a dual-models framework built with hierarchical ViT blocks. Unlike a proof-of-concept approach, our framework considers kV images acquired by 2D imaging devices in the treatment room as the solo input and can synthesize accurate, full-size 3D CT within milliseconds. Results We demonstrate the feasibility of the proposed approach on 10 patients with head and neck (H&N) cancer using image quality (MAE: < 45HU), dosimetric accuracy (Gamma passing rate ((2%/2 mm/10%): > 97%) and patient position uncertainty (shift error: < 0.4 mm). Conclusions The proposed framework can generate accurate 3D CT faithfully mirroring patient position effectively, thus substantially improving patient setup accuracy, keeping imaging dose minimal, and maintaining treatment veracity.
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spelling doaj-art-b76a854caba441a88fc17eb6c01633232025-08-20T02:33:08ZengNature PortfolioCommunications Medicine2730-664X2024-11-014111010.1038/s43856-024-00672-yAccurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV imagesYuzhen Ding0Jason M. Holmes1Hongying Feng2Baoxin Li3Lisa A. McGee4Jean-Claude M. Rwigema5Sujay A. Vora6William W. Wong7Daniel J. Ma8Robert L. Foote9Samir H. Patel10Wei Liu11Department of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicSchool of Computing and Augmented Intelligence, Arizona State UniversityDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicDepartment of Radiation Oncology, Mayo ClinicAbstract Background In radiotherapy, 2D orthogonally projected kV images are used for patient alignment when 3D-on-board imaging (OBI) is unavailable. However, tumor visibility is constrained due to the projection of patient’s anatomy onto a 2D plane, potentially leading to substantial setup errors. In treatment room with 3D-OBI such as cone beam CT (CBCT), the field of view (FOV) of CBCT is limited with unnecessarily high imaging dose. A solution to this dilemma is to reconstruct 3D CT from kV images obtained at the treatment position. Methods We propose a dual-models framework built with hierarchical ViT blocks. Unlike a proof-of-concept approach, our framework considers kV images acquired by 2D imaging devices in the treatment room as the solo input and can synthesize accurate, full-size 3D CT within milliseconds. Results We demonstrate the feasibility of the proposed approach on 10 patients with head and neck (H&N) cancer using image quality (MAE: < 45HU), dosimetric accuracy (Gamma passing rate ((2%/2 mm/10%): > 97%) and patient position uncertainty (shift error: < 0.4 mm). Conclusions The proposed framework can generate accurate 3D CT faithfully mirroring patient position effectively, thus substantially improving patient setup accuracy, keeping imaging dose minimal, and maintaining treatment veracity.https://doi.org/10.1038/s43856-024-00672-y
spellingShingle Yuzhen Ding
Jason M. Holmes
Hongying Feng
Baoxin Li
Lisa A. McGee
Jean-Claude M. Rwigema
Sujay A. Vora
William W. Wong
Daniel J. Ma
Robert L. Foote
Samir H. Patel
Wei Liu
Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images
Communications Medicine
title Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images
title_full Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images
title_fullStr Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images
title_full_unstemmed Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images
title_short Accurate patient alignment without unnecessary imaging using patient-specific 3D CT images synthesized from 2D kV images
title_sort accurate patient alignment without unnecessary imaging using patient specific 3d ct images synthesized from 2d kv images
url https://doi.org/10.1038/s43856-024-00672-y
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