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Robust Characterization and Patient Experience of a Time-Resolved Ultrasound System for Prostate Tracking

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R Sandhu

R Sandhu1*, D Yan1 , D Ionascu1 , (1) William Beaumont Hospital, Royal Oak, MI


WE-G-BRF-8 Wednesday 4:30PM - 6:00PM Room: Ballroom F

Purpose:Characterization of a time resolved ultrasound device (4D-US), used for localization and motion monitoring of prostate radiotherapy.

Methods:The 4D-US system accuracy to reproduce prostate motion was investigated and artifacts were determined under detailed experimental and ultimately clinical conditions. Two fields of view (FOV) of 30 and 60 degrees and two corresponding acquisition speeds were evaluated under experimental conditions with gradual increased complexity. The reconstruction ability and trajectory tracking depends on the relative speed between the ultrasound probe and the moving object. Two different types of phantoms were developed; one capable of following a predetermined trajectory with variable speeds, and a second one designed to test the US ability to a track dynamically-deformed prostate. Four hypo-prostate patients (10fx) were monitored during the treatment to detect intrafraction motion.

Results:Prostate speeds up to 6mm/s and 3mm/s can be successfully tracked by the system when using the small and large FOV, respectively. The system response time, calculated based on the speed-induced volumetric distortion, is dependent on the FOV, with 1.1s for the small FOV and 1.4s for the large FOV. The response time was also found dependent on the size of target, increasing from 1.4s to 1.7s for target diameters of 4cm to 2.8cm. The deformable dynamic phantom has shown that the system is able to successfully follow a highly-deformed, slow-moving prostate with an error < 0.5mm. The overall range of patient intra-fraction motion was (-2.4 to 2.2)mm, (-2.6 to 2.4)mm, (-3.0 to 4.3)mm in the RL, SI and AP directions, respectively.

Conclusion:The 4DUS system using a large FOV is appropriate to monitor the prostate motion as well as the adjacent organs at risk. However, infrequent abrupt motion can be problematic and the small FOV system is preferred for such patients, particularly for future applications as online prostate monitoring employed for MLC tracking.

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