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Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses

Turki Almatani, Richard Hugtenburg Orcid Logo, Ryan D Lewis, Susan E Barley, Mark A Edwards

The British Journal of Radiology, Volume: 89, Issue: 1066, Start page: 20160443

Swansea University Author: Richard Hugtenburg Orcid Logo

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DOI (Published version): 10.1259/bjr.20160443

Abstract

ABSTRACTOBJECTIVE:Cone beam CT (CBCT) images contain more scatter than a conventional CT image and therefore provide inaccurate Hounsfield units (HUs). Consequently, CBCT images cannot be used directly for radiotherapy dose calculation. The aim of this study is to enable dose calculations to be perf...

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Published in: The British Journal of Radiology
ISSN: 0007-1285 1748-880X
Published: 2016
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URI: https://cronfa.swan.ac.uk/Record/cronfa30155
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2019-09-26T18:00:59.8672047</datestamp><bib-version>v2</bib-version><id>30155</id><entry>2016-09-22</entry><title>Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses</title><swanseaauthors><author><sid>efd2f52ea19cb047e01a01e6fa6fa54c</sid><ORCID>0000-0003-0352-9607</ORCID><firstname>Richard</firstname><surname>Hugtenburg</surname><name>Richard Hugtenburg</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2016-09-22</date><deptcode>MEDP</deptcode><abstract>ABSTRACTOBJECTIVE:Cone beam CT (CBCT) images contain more scatter than a conventional CT image and therefore provide inaccurate Hounsfield units (HUs). Consequently, CBCT images cannot be used directly for radiotherapy dose calculation. The aim of this study is to enable dose calculations to be performed with the use of CBCT images taken during radiotherapy and evaluate the necessity of replanning.METHODS:A patient with prostate cancer with bilateral metallic prosthetic hip replacements was imaged using both CT and CBCT. The multilevel threshold (MLT) algorithm was used to categorize pixel values in the CBCT images into segments of homogeneous HU. The variation in HU with position in the CBCT images was taken into consideration. This segmentation method relies on the operator dividing the CBCT data into a set of volumes where the variation in the relationship between pixel values and HUs is small. An automated MLT algorithm was developed to reduce the operator time associated with the process. An intensity-modulated radiation therapy plan was generated from CT images of the patient. The plan was then copied to the segmented CBCT (sCBCT) data sets with identical settings, and the doses were recalculated and compared.RESULTS:Gamma evaluation showed that the percentage of points in the rectum with &#x3B3;&#x2009;&lt;&#x2009;1 (3%/3&#x2009;mm) were 98.7% and 97.7% in the sCBCT using MLT and the automated MLT algorithms, respectively. Compared with the planning CT (pCT) plan, the MLT algorithm showed &#x2212;0.46% dose difference with 8&#x2009;h operator time while the automated MLT algorithm showed &#x2212;1.3%, which are both considered to be clinically acceptable, when using collapsed cone algorithm.CONCLUSION:The segmentation of CBCT images using the method in this study can be used for dose calculation. For a patient with prostate cancer with bilateral hip prostheses and the associated issues with CT imaging, the MLT algorithms achieved a sufficient dose calculation accuracy that is clinically acceptable. The automated MLT algorithm reduced the operator time associated with implementing the MLT algorithm to achieve clinically acceptable accuracy. This saved time makes the automated MLT algorithm superior and easier to implement in the clinical setting.ADVANCES IN KNOWLEDGE:The MLT algorithm has been extended to the complex example of a patient with bilateral hip prostheses, which with the introduction of automation is feasible for use in adaptive radiotherapy, as an alternative to obtaining a new pCT and reoutlining the structures.</abstract><type>Journal Article</type><journal>The British Journal of Radiology</journal><volume>89</volume><journalNumber>1066</journalNumber><paginationStart>20160443</paginationStart><publisher/><issnPrint>0007-1285</issnPrint><issnElectronic>1748-880X</issnElectronic><keywords/><publishedDay>17</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2016</publishedYear><publishedDate>2016-08-17</publishedDate><doi>10.1259/bjr.20160443</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical Physics</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDP</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-09-26T18:00:59.8672047</lastEdited><Created>2016-09-22T12:28:05.3653441</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Turki</firstname><surname>Almatani</surname><order>1</order></author><author><firstname>Richard</firstname><surname>Hugtenburg</surname><orcid>0000-0003-0352-9607</orcid><order>2</order></author><author><firstname>Ryan D</firstname><surname>Lewis</surname><order>3</order></author><author><firstname>Susan E</firstname><surname>Barley</surname><order>4</order></author><author><firstname>Mark A</firstname><surname>Edwards</surname><order>5</order></author></authors><documents><document><filename>0030155-26092019180002.pdf</filename><originalFilename>TA_BJR_Final.pdf</originalFilename><uploaded>2019-09-26T18:00:02.5100000</uploaded><type>Output</type><contentLength>2981301</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2019-09-26T00:00:00.0000000</embargoDate><copyrightCorrect>false</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2019-09-26T18:00:59.8672047 v2 30155 2016-09-22 Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses efd2f52ea19cb047e01a01e6fa6fa54c 0000-0003-0352-9607 Richard Hugtenburg Richard Hugtenburg true false 2016-09-22 MEDP ABSTRACTOBJECTIVE:Cone beam CT (CBCT) images contain more scatter than a conventional CT image and therefore provide inaccurate Hounsfield units (HUs). Consequently, CBCT images cannot be used directly for radiotherapy dose calculation. The aim of this study is to enable dose calculations to be performed with the use of CBCT images taken during radiotherapy and evaluate the necessity of replanning.METHODS:A patient with prostate cancer with bilateral metallic prosthetic hip replacements was imaged using both CT and CBCT. The multilevel threshold (MLT) algorithm was used to categorize pixel values in the CBCT images into segments of homogeneous HU. The variation in HU with position in the CBCT images was taken into consideration. This segmentation method relies on the operator dividing the CBCT data into a set of volumes where the variation in the relationship between pixel values and HUs is small. An automated MLT algorithm was developed to reduce the operator time associated with the process. An intensity-modulated radiation therapy plan was generated from CT images of the patient. The plan was then copied to the segmented CBCT (sCBCT) data sets with identical settings, and the doses were recalculated and compared.RESULTS:Gamma evaluation showed that the percentage of points in the rectum with γ < 1 (3%/3 mm) were 98.7% and 97.7% in the sCBCT using MLT and the automated MLT algorithms, respectively. Compared with the planning CT (pCT) plan, the MLT algorithm showed −0.46% dose difference with 8 h operator time while the automated MLT algorithm showed −1.3%, which are both considered to be clinically acceptable, when using collapsed cone algorithm.CONCLUSION:The segmentation of CBCT images using the method in this study can be used for dose calculation. For a patient with prostate cancer with bilateral hip prostheses and the associated issues with CT imaging, the MLT algorithms achieved a sufficient dose calculation accuracy that is clinically acceptable. The automated MLT algorithm reduced the operator time associated with implementing the MLT algorithm to achieve clinically acceptable accuracy. This saved time makes the automated MLT algorithm superior and easier to implement in the clinical setting.ADVANCES IN KNOWLEDGE:The MLT algorithm has been extended to the complex example of a patient with bilateral hip prostheses, which with the introduction of automation is feasible for use in adaptive radiotherapy, as an alternative to obtaining a new pCT and reoutlining the structures. Journal Article The British Journal of Radiology 89 1066 20160443 0007-1285 1748-880X 17 8 2016 2016-08-17 10.1259/bjr.20160443 COLLEGE NANME Medical Physics COLLEGE CODE MEDP Swansea University 2019-09-26T18:00:59.8672047 2016-09-22T12:28:05.3653441 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Turki Almatani 1 Richard Hugtenburg 0000-0003-0352-9607 2 Ryan D Lewis 3 Susan E Barley 4 Mark A Edwards 5 0030155-26092019180002.pdf TA_BJR_Final.pdf 2019-09-26T18:00:02.5100000 Output 2981301 application/pdf Accepted Manuscript true 2019-09-26T00:00:00.0000000 false eng
title Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
spellingShingle Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
Richard Hugtenburg
title_short Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
title_full Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
title_fullStr Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
title_full_unstemmed Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
title_sort Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses
author_id_str_mv efd2f52ea19cb047e01a01e6fa6fa54c
author_id_fullname_str_mv efd2f52ea19cb047e01a01e6fa6fa54c_***_Richard Hugtenburg
author Richard Hugtenburg
author2 Turki Almatani
Richard Hugtenburg
Ryan D Lewis
Susan E Barley
Mark A Edwards
format Journal article
container_title The British Journal of Radiology
container_volume 89
container_issue 1066
container_start_page 20160443
publishDate 2016
institution Swansea University
issn 0007-1285
1748-880X
doi_str_mv 10.1259/bjr.20160443
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description ABSTRACTOBJECTIVE:Cone beam CT (CBCT) images contain more scatter than a conventional CT image and therefore provide inaccurate Hounsfield units (HUs). Consequently, CBCT images cannot be used directly for radiotherapy dose calculation. The aim of this study is to enable dose calculations to be performed with the use of CBCT images taken during radiotherapy and evaluate the necessity of replanning.METHODS:A patient with prostate cancer with bilateral metallic prosthetic hip replacements was imaged using both CT and CBCT. The multilevel threshold (MLT) algorithm was used to categorize pixel values in the CBCT images into segments of homogeneous HU. The variation in HU with position in the CBCT images was taken into consideration. This segmentation method relies on the operator dividing the CBCT data into a set of volumes where the variation in the relationship between pixel values and HUs is small. An automated MLT algorithm was developed to reduce the operator time associated with the process. An intensity-modulated radiation therapy plan was generated from CT images of the patient. The plan was then copied to the segmented CBCT (sCBCT) data sets with identical settings, and the doses were recalculated and compared.RESULTS:Gamma evaluation showed that the percentage of points in the rectum with γ < 1 (3%/3 mm) were 98.7% and 97.7% in the sCBCT using MLT and the automated MLT algorithms, respectively. Compared with the planning CT (pCT) plan, the MLT algorithm showed −0.46% dose difference with 8 h operator time while the automated MLT algorithm showed −1.3%, which are both considered to be clinically acceptable, when using collapsed cone algorithm.CONCLUSION:The segmentation of CBCT images using the method in this study can be used for dose calculation. For a patient with prostate cancer with bilateral hip prostheses and the associated issues with CT imaging, the MLT algorithms achieved a sufficient dose calculation accuracy that is clinically acceptable. The automated MLT algorithm reduced the operator time associated with implementing the MLT algorithm to achieve clinically acceptable accuracy. This saved time makes the automated MLT algorithm superior and easier to implement in the clinical setting.ADVANCES IN KNOWLEDGE:The MLT algorithm has been extended to the complex example of a patient with bilateral hip prostheses, which with the introduction of automation is feasible for use in adaptive radiotherapy, as an alternative to obtaining a new pCT and reoutlining the structures.
published_date 2016-08-17T03:36:49Z
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score 11.013148

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