Med Phys
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Intraoperative imaging offers a means to account for morphological changes occurring during the procedure and resolve geometric uncertainties via integration with a surgical navigation system. Such integration requires registration of the image and world reference frames, conventionally a time consuming, error-prone manual process. This work presents a method of automatic image-to-world registration of intraoperative cone-beam computed tomography (CBCT) and an optical tracking system. ⋯ The projection-based automatic registration technique demonstrates accuracy and reproducibility equivalent or superior to the conventional manual technique for both neurosurgical and head and neck marker configurations. Use of this method with C-arm CBCT eliminates the burden of manual registration on surgical workflow by providing automatic registration of surgical tracking in 3D images within approximately 20 s of acquisition, with registration automatically updated with each CBCT scan. The automatic registration method is undergoing integration in ongoing clinical trials of intraoperative CBCT-guided head and neck surgery.
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Several updated Monte Carlo (MC) codes are available to perform calculations of voxel S values for radionuclide targeted therapy. The aim of this work is to analyze the differences in the calculations obtained by different MC codes and their impact on absorbed dose evaluations performed by voxel dosimetry. Voxel S values for monoenergetic sources (electrons and photons) and different radionuclides (90Y, 131I, and 188Re) were calculated. ⋯ Further, variations were observed up to about 30%, for small source-target voxel distances, when low-energy electrons cover an important part of the emission spectrum of the radionuclide (in our case, for 131I). For 90Y and 188Re, the differences among the various codes have a negligible impact (within few percents) on convolution calculations of the absorbed dose; thus either one of the MC programs is suitable to produce voxel S values for radionuclide targeted therapy dosimetry. However, if a low-energy beta-emitting radionuclide is considered, these differences can affect also dose depositions at small source-target voxel distances, leading to more conspicuous variations (about 9% for 1311) when calculating the absorbed dose in the volume of interest.