Search PubMed⌕ Search

Biomedical subjects

Paul J Reckwerdt

Publications and source records attributed to Paul J Reckwerdt.

3 recordsLinked to original sources

Accurate convolution/superposition for multi-resolution dose calculation using cumulative tabulated kernels.

Convolution/superposition (C/S) is regarded as the standard dose calculation method in most modern radiotherapy treatment planning systems. Different implementations of C/S could result in significantly different dose distributions. This paper addresses two major implementation issues associated with collapsed cone C/S: one is how to utilize the tabulated kernels instead of analytical parametrizations and the other is how to deal with voxel size effects. Three methods that utilize the tabulated kernels are presented in this paper. These methods differ in the effective kernels used: the differential kernel (DK), the cumulative kernel (CK) or the cumulative-cumulative kernel (CCK). They result in slightly different computation times but significantly different voxel size effects. Both simulated and real multi-resolution dose calculations are presented. For simulation tests, we use arbitrary kernels and various voxel sizes with a homogeneous phantom, and assume forward energy transportation only. Simulations with voxel size up to 1 cm show that the CCK algorithm has errors within 0.1% of the maximum gold standard dose. Real dose calculations use a heterogeneous slab phantom, both the 'broad' (5 x 5 cm2) and the 'narrow' (1.2 x 1.2 cm2) tomotherapy beams. Various voxel sizes (0.5 mm, 1 mm, 2 mm, 4 mm and 8 mm) are used for dose calculations. The results show that all three algorithms have negligible difference (0.1%) for the dose calculation in the fine resolution (0.5 mm voxels). But differences become significant when the voxel size increases. As for the DK or CK algorithm in the broad (narrow) beam dose calculation, the dose differences between the 0.5 mm voxels and the voxels up to 8 mm (4 mm) are around 10% (7%) of the maximum dose. As for the broad (narrow) beam dose calculation using the CCK algorithm, the dose differences between the 0.5 mm voxels and the voxels up to 8 mm (4 mm) are around 1% of the maximum dose. Among all three methods, the CCK algorithm is demonstrated to be the most accurate one for multi-resolution dose calculations.

Algorithms↗

Reduction in radiation dose to lung and other normal tissues using helical tomotherapy to treat lung cancer, in comparison to conventional field arrangements.

The purpose of this study was to determine whether the use of tomotherapy in the treatment of non-small-cell lung cancer (NSCLC) has the potential to reduce radiation dose to normal tissues, in particular, the lungs, esophagus, and spinal cord, as compared with standard radiotherapy. Five patients with anatomically or physiologically inoperable stage III NSCLC were studied, representing a variety of tumor sizes and locations. For each patient, two treatment plans were generated. One was developed using conventional field arrangements (CFA), and the other for tomotherapy. Using dose-volume histogram reduction techniques, including mean normalized dose (NTDmean), V20, and effective uniform dose (EUD), the normal tissue doses for CFA and tomotherapy plans for a given fixed tumor dose were compared. In addition, the maximum tumor doses possible for a given level of mean normalized lung dose were computed and compared for the CFA and tomotherapy plans. The gross tumor volumes in the five patients studied ranged from 13.5 to 87.1 cm. The tumor dose distributions, determined by EUD and minimum dose, were similar for both CFA and tomotherapy plans, as intended. In all cases, the NTDmean of both lungs was significantly reduced using tomotherapy planning (range: 10-53% reduction, mean: 31%). The volume of lung receiving more than 20 Gy was also reduced in all cases using tomotherapy (range: 17-37% reduction, mean: 22%). For a constant lung NTDmean, it is shown that it should be possible to increase tumor dose to up to 160 Gy in certain patients with tomotherapy. The dose to the spinal cord and esophagus was also reduced in all cases with tomotherapy planning, compared with plans generated using conventional field arrangements. Both tomotherapy, and to a lesser extent conventional three-dimensional conformal radiotherapy, have the potential to significantly decrease radiation dose to lung and other normal structures in the treatment of NSCLC. This has important implications for dose escalation strategies in the future.

Carcinoma, Non-Small-Cell Lung↗

Methods for improving limited field-of-view radiotherapy reconstructions using imperfect a priori images.

There are many benefits to having an online CT imaging system for radiotherapy, as it helps identify changes in the patient's position and anatomy between the time of planning and treatment. However, many current online CT systems suffer from a limited field-of-view (LFOV) in that collected data do not encompass the patient's complete cross section. Reconstruction of these data sets can quantitatively distort the image values and introduce artifacts. This work explores the use of planning CT data as a priori information for improving these reconstructions. Methods are presented to incorporate this data by aligning the LFOV with the planning images and then merging the data sets in sinogram space. One alignment option is explicit fusion, producing fusion-aligned reprojection (FAR) images. For cases where explicit fusion is not viable, FAR can be implemented using the implicit fusion of normal setup error, referred to as normal-error-aligned reprojection (NEAR). These methods are evaluated for multiday patient images showing both internal and skin-surface anatomical variation. The iterative use of NEAR and FAR is also investigated, as are applications of NEAR and FAR to dose calculations and the compensation of LFOV online MVCT images with kVCT planning images. Results indicate that NEAR and FAR can utilize planning CT data as imperfect a priori information to reduce artifacts and quantitatively improve images. These benefits can also increase the accuracy of dose calculations and be used for augmenting CT images (e.g., MVCT) acquired at different energies than the planning CT.

Algorithms↗