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Biomedical subjects

E A Schloesser

Publications and source records attributed to E A Schloesser.

6 recordsLinked to original sources

Megavoltage CT image reconstruction during tomotherapy treatments.

An integrated tomotherapy system allows for improved radiotherapy verification by enabling the collection of megavoltage computed tomography (MVCT) images before or after treatment delivery. In this investigation, the possibility of collecting MV tomographic data and reconstructing images during a tomotherapy treatment is examined. By overcoming difficulties with the normalization of modulated treatment data and with the incompleteness of treatment data, it is possible to use data collected during tomotherapeutic treatments for MVCT reconstruction. The benefits of these techniques include potential increases in patient throughput, reductions in imaging dose, visualization of the patient in the treatment position and improvements in image contrast.

Animals↗

Calibration of a tomotherapeutic MVCT system.

Megavoltage CT provides the ability to image the patient before, during or after a radiotherapy treatment. This allows one to verify not only the placement of a patient's external boundary, but also the locations of internal anatomy. In addition, the reconstructed MVCT values are potentially useful for treatment planning inhomogeneity corrections and dose reconstruction. To this end, dosimetric calibration of the University of Wisconsin Tomotherapy Benchtop MVCT system was investigated. It was found that MVCT values correlate extremely well with electron density and that unlike kilovoltage CT, this correlation is well maintained for higher atomic number materials. Improvements of the order of 1% in the dosimetric calculations of high atomic number materials should be possible by deriving input images from MVCT as opposed to kVCT, and calibrating in terms of electron density, as opposed to physical density.

Calibration↗

Megavoltage CT imaging as a by-product of multileaf collimator leakage.

In addition to their potential for the delivery of highly conformal radiation therapy treatments, tomotherapeutic treatments also feature increased potential for verification. For example, megavoltage CT allows one to use the megavoltage linac to generate tomographic images of the patient in the treatment position. This is typically done before or after radiation therapy treatments. However, it is also possible to collect MVCT images entirely during the treatment itself. This process utilizes the leakage radiation through the closed leaves of the Nomos MIMiC MLC, along with slight inefficiencies in treatment delivery, to generate MVCT images during treatment that require neither additional time nor dose. The image quality is limited, yet sufficient to see a patient's external boundary, density differences over 8% for 25.0 mm objects and resolutions of 3.0 mm for high-contrast objects. Such images can potentially be viewed during treatment, used to flag additional CT immediately after the treatment and provide a representation of the patient's exact position during treatment for use with dose reconstruction.

Humans↗

Megavoltage CT on a tomotherapy system.

A megavoltage computed tomography (MVCT) system was developed on the University of Wisconsin tomotherapy benchtop. This system can operate either axially or helically, and collect transmission data without any bounds on delivered dose. Scan times as low as 12 s per slice are possible, and scans were run with linac output rates of 100 MU min(-1), although the system can be tuned to deliver arbitrarily low dose rates. Images were reconstructed with clinically reasonable doses ranging from 8 to 12 cGy. These images delineate contrasts below 2% and resolutions of 3.0 mm. Thus, the MVCT image quality of this system should be sufficient for verifying the patient's position and anatomy prior to radiotherapy. Additionally, synthetic data were used to test the potential for improved MVCT contrast using maximum-likelihood (ML) reconstruction. Specifically, the maximum-likelihood expectation-maximization (ML-EM) algorithm and a transmission ML algorithm were compared with filtered backprojection (FBP). It was found that for expected clinical MVCT doses enough imaging photons are used such that little benefit is conferred by the improved noise model of ML algorithms. For significantly lower doses, some quantitative improvement is achieved through ML reconstruction. Nonetheless, the image quality at those lower doses is not satisfactory for radiotherapy verification.

Algorithms↗

Registration using tomographic projection files.

An algorithm has been developed and experimentally verified for tomographic registration--a patient positioning method using internal anatomy and standard external fiducial marks. This algorithm improves patient set-up and verification to an accuracy sufficient for tomotherapy. By implementation of this technique, the time-consuming reconstruction process is avoided. Instead, offsets in the x, y and z directions are determined directly from sinogram data by an algorithm that utilizes cross-correlations and Fourier transforms. To verify the efficiency and stability of the algorithm, data were collected on the University of Wisconsin's dedicated tomotherapy research workbench. The experiment indicates offset statistical errors of less than +/-0.8 mm for offsets up to 30 mm. With standard clinical techniques, initial patient offsets are expected to be less than 5 mm, so the 30 mm limitation is of no consequence. The angular resolution for the direction of patient translation is within the +/-2 degrees needed for tomotherapy.

Algorithms↗

Delivery verification in sequential and helical tomotherapy.

Conformal and conformal avoidance radiation therapy are new therapeutic techniques that are generally characterized by high dose gradients. The success of this kind of treatment relies on quality assurance procedures in order to verify the delivery of the treatment. A delivery verification technique should consider quality assurance procedures for patient positioning and radiation delivery verification. A methodology for radiation delivery verification was developed and tested with our tomotherapy workbench. The procedure was investigated for two cases. The first treatment using a torus-shaped target was optimized for 72 beam directions and sequentially delivered as a single slice to a 33 cm diameter cylinder of homogeneous solid water. For the second treatment, a random pattern of energy fluence was helically delivered for two slices to a 9.0 cm diameter phantom containing inhomogeneities. The presented process provides the energy fluence (or a related quantity) delivered through the multileaf collimator (MLC) using the signal measured at the exit detector during the treatment delivery. As this information is created for every pulse of the accelerator, the energy fluence and state for each MLC leaf were verified on a pulse-by-pulse basis. The pulse-by-pulse results were averaged to obtain projection-by-projection information to allow for a comparison with the planned delivery. The errors between the planned and delivered energy fluences were concentrated between +/-2.0%, with none beyond +/-3.5%. In addition to accurately achieving radiation delivery verification, the process is fast, which could translate to radiation delivery verification in real time. This technique can also be extended to reconstruct the dose actually deposited in the patient or phantom (dose reconstruction).

Acrylates↗