Engineering topics

Fichtinger, G

Publications and source records attributed to Fichtinger, G.

4 records

DOE OSTI2015

SU-E-T-231: Cross-Validation of 3D Gamma Comparison Tools

Purpose: Moving the computational analysis for 3D gel dosimetry into the 3D Slicer (www.slicer.org) environment has made gel dosimetry more clinically accessible. To ensure accuracy, we cross-validate the 3D gamma comparison module in 3D Slicer with an independently developed algorithm using simulated and measured dose distributions. Methods: Two reference dose distributions were generated using the Varian Eclipse treatment planning system. The first distribution consisted of a four-field box irradiation delivered to a plastic water phantom and the second, a VMAT plan delivered to a gel dosimeter phantom. The first reference distribution was modified within Eclipse to create an evaluated dose distribution by spatially shifting one field by 3mm, increasing the monitor units of the second field, applying a dynamic wedge for the third field, and leaving the fourth field unchanged. The VMAT plan was delivered to a gel dosimeter and the evaluated dose in the gel was calculated from optical CT measurements. Results from the gamma comparison tool built into the SlicerRT toolbox were compared to results from our in-house gamma algorithm implemented in Matlab (via MatlabBridge in 3D Slicer). The effects of noise, resolution and the exchange of reference and evaluated designations on the gamma comparison were also examined. Results: Perfect agreement was found between the gamma results obtained using the SlicerRT tool and our Matlab implementation for both the four-field box and gel datasets. The behaviour of the SlicerRT comparison with respect to changes in noise, resolution and the role of the reference and evaluated dose distributions was consistent with previous findings. Conclusion: Two independently developed gamma comparison tools have been cross-validated and found to be identical. As we transition our gel dosimetry analysis from Matlab to 3D Slicer, this validation serves as an important test towards ensuring the consistency of dose comparisons using the 3D Slicer environment.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

SU-D-BRF-07: Ultrasound and Fluoroscopy Based Intraoperative Image-Guidance System for Dynamic Dosimetry in Prostate Brachytherapy

Purpose: Prostate brachytherapy is a common treatment method for low-risk prostate cancer patients. Intraoperative treatment planning is known to improve the treatment procedure and the outcome. The current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. We developed an image-guidance system to fulfill this need to achieve intraoperative dynamic dosimetry in prostate brachytherapy. Methods: Our system is based on standard imaging equipments available in the operating room, including the transrectal ultrasound (TRUS) and the mobile C-arm. A simple fiducial is added to compute the C-arm pose. Three fluoroscopic images and an ultrasound volume of the seeds and the prostate are acquired and processed by four image processing algorithms: seed segmentation, fiducial detection with pose estimation, seed reconstruction, and seeds-to-TRUS registration. The updated seed positions allow the physician to assess the quality of implantation and dynamically adjust the treatment plan during the course of surgery to achieve improved exit dosimetry. Results: The system was tested on 10 phantoms and 37 patients. Seed segmentation resulted in a 1% false negative and 2% false positive rates. Fiducial detection with pose estimation resulted in a detection rate of 98%. Seed reconstruction had a mean reconstruction error of 0.4 mm. Seeds-to-TRUS registration had a mean registration error of 1.3 mm. The total processing time from image acquisition to registration was approximately 1 minute. Conclusion: We present an image-guidance system for intraoperative dynamic dosimetry in prostate brachytherapy. Using standard imaging equipments and a simple fiducial, our system can be easily adopted in any clinics. Robust image processing algorithms enable accurate and fast computation of the delivered dose. Especially, the system enables detection of possible hot/cold spots during the surgery, allowing the physician to address these in the operating room rather than requiring additional therapy afterwards. This research was supported in part by the National Institutes of Health/National Cancer Institute (NIH/NCI) under grant 2R44CA099374 and grant 1R01CA151395, and in part by the Department of Defense (DoD) under grant W81XWH-05-1-0407.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2014

SU-E-J-42: Customized Deformable Image Registration Using Open-Source Software SlicerRT

Purpose: SlicerRT is a flexible platform that allows the user to incorporate the necessary images registration and processing tools to improve clinical workflow. This work validates the accuracy and the versatility of the deformable image registration algorithm of the free open-source software SlicerRT using a deformable physical pelvic phantom versus available commercial image fusion algorithms. Methods: Optical camera images of nonradiopaque markers implanted in an anatomical pelvic phantom were used to measure the ground-truth deformation and evaluate the theoretical deformations for several DIR algorithms. To perform the registration, full and empty bladder computed tomography (CT) images of the phantom were obtained and used as fixed and moving images, respectively. The DIR module, found in SlicerRT, used a B-spline deformable image registration with multiple optimization parameters that allowed customization of the registration including a regularization term that controlled the amount of local voxel displacement. The virtual deformation field at the center of the phantom was obtained and compared to the experimental ground-truth values. The parameters of SlicerRT were then varied to improve spatial accuracy. To quantify image similarity, the mean absolute difference (MAD) parameter using Hounsfield units was calculated. In addition, the Dice coefficient of the contoured rectum was evaluated to validate the strength of the algorithm to transfer anatomical contours. Results: Overall, SlicerRT achieved one of the lowest MAD values across the algorithm spectrum, but slightly smaller mean spatial errors in comparison to MIM software (MIM). On the other hand, SlicerRT created higher mean spatial errors than Velocity Medical Solutions (VEL), although obtaining an improvement on the DICE to 0.91. The large spatial errors were attributed to the poor contrast in the prostate bladder interface of the phantom. Conclusion: Based phantom validation, SlicerRT is capable of achieving comparable DIR accuracy to commercial programs such as MIM and VEL.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

SU-E-T-04: 3D Printed Patient-Specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions

Purpose: Evaluate the feasibility of constructing 3D-printed patient-specific surface mould applicators for HDR brachytherapy treatment of superficial lesions. Methods: We propose using computer-aided design software to create 3D printed surface mould applicators for brachytherapy. A mould generation module was developed in the open-source 3D Slicer ( http://www.slicer.org ) medical image analysis platform. The system extracts the skin surface from CT images, and generates smooth catheter paths over the region of interest based on user-defined start and end points at a specified stand-off distance from the skin surface. The catheter paths are radially extended to create catheter channels that are sufficiently wide to ensure smooth insertion of catheters for a safe source travel. An outer mould surface is generated to encompass the channels. The mould is also equipped with fiducial markers to ensure its reproducible placement. A surface mould applicator with eight parallel catheter channels of 4mm diameters was fabricated for the nose region of a head phantom; flexible plastic catheters of 2mm diameter were threaded through these channels maintaining 10mm catheter separations and a 5mm stand-off distance from the skin surface. The apparatus yielded 3mm thickness of mould material between channels and the skin. The mould design was exported as a stereolithography file to a Dimension SST1200es 3D printer and printed using ABS Plus plastic material. Results: The applicator closely matched its design and was found to be sufficiently rigid without deformation during repeated application on the head phantom. Catheters were easily threaded into channels carved along catheter paths. Further tests are required to evaluate feasibility of channel diameters smaller than 4mm. Conclusion: Construction of 3D-printed mould applicators show promise for use in patient specific brachytherapy of superficial lesions. Further evaluation of 3D printing techniques and materials is required for constructing sufficiently thin, rigid and durable surface moulds suitable for clinical deployment.

60 APPLIED LIFE SCIENCES↗