Med Phys
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Comparative Study
A comparison of daily megavoltage CT and ultrasound image guided radiation therapy for prostate cancer.
In order to quantify the differences between ultrasound-imaging and megavoltage-CT (MVCT) daily prostate localization in prostate-cancer radiotherapy and their dosimetric impacts, daily shifts were analyzed for a total of 140 prostate cancer patients; 106 positioned using ultrasound-based imaging [B-mode Acquisition and Targeting (BAT)], and 34 using the MVCT from a TomoTherapy Hi-Art unit. The shifts indicated by the two systems were compared statistically along the right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions. The systematic and random variations among the daily alignments were calculated. ⋯ The degradation from the plan caused by the MVCT alignment is trivial, while that by BAT is substantial. The MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is more reliable and precise for prostate localization. Ultrasound-based localization may overestimate the daily prostate motion, particularly in the A/P direction, negatively impacting prostate dose coverage and rectal sparing.
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Clinical Trial
Mutual-information-based image to patient re-registration using intraoperative ultrasound in image-guided neurosurgery.
An image-based re-registration scheme has been developed and evaluated that uses fiducial registration as a starting point to maximize the normalized mutual information (nMI) between intraoperative ultrasound (iUS) and preoperative magnetic resonance images (pMR). We show that this scheme significantly (p<0.001) reduces tumor boundary misalignment between iUS pre-durotomy and pMR from an average of 2.5 mm to 1.0 mm in six resection surgeries. ⋯ In addition, we report the translational and rotational capture ranges necessary for successful convergence of the nMI registration technique (5.9 mm and 5.2 deg, respectively). The proposed scheme is automatic, sufficiently robust, and computationally efficient (<2 min), and holds promise for routine clinical use in the operating room during image-guided neurosurgical procedures.
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MRI is rapidly growing as a tool for image-guided procedures in the breast such as needle localizations, biopsy, and cryotherapy. The ability of MRI to resolve small (<1 cm) lesions allows earlier detection and diagnosis than with ultrasound. Most MR-guidance methods perform a two-dimensional compression of the breast that distorts tissue anatomy and limits medial access. ⋯ Target lesions were 3-4 mm in diameter for 47% (13/28), 5-6 mm in diameter for 32% (9/28), and over 6 mm in diameter for 21% (6/28) of the trials, respectively. The 3D bladder concept was shown to immobilize a deformable animal tissue phantom during needle insertion. It is concluded that the MR-guidance system accurately localizes small targets on the order of 3-4 mm in a breast phantom with 360 degrees rotational access.
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Separation of water from fat tissues in magnetic resonance imaging is important for many applications because signals from fat tissues often interfere with diagnoses that are usually based on water signal characteristics. Water and fat can be separated with images acquired at different echo time shifts. The three-point method solves for the unknown off-resonance frequency together with the water and fat densities. ⋯ The NSA is particularly poor for the symmetric (-theta, 0, theta) CS encoding when the water and fat signals are comparable. This anomaly with equal amounts of water and fat is analyzed in a more intuitive geometric illustration. Theoretical prediction of NSA matches well with simulation results at high signal-to-noise ratio (SNR), while deviation arises at low SNR, which suggests that Monte Carlo simulation may be more appropriate to accurately predict noise performance of the algorithm when SNR is low.