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Program Information

Static Gantry Digital Tomosynthesis From the Beam's-Eye-View


L Partain

L Partain1*, J Kwon1 , J Rottmann2 , G Zentai3 , R Berbeco2 , D Boyd1 , (1) TeleSecurity Sciences, Las Vegas, NV,(2) Brigham and Woman's Hospital, Boston, MA, (3) Varian Medical Systems, Palo Alto, CA

Presentations

SU-E-J-56 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose: We have designed a novel TumoTrak™ x-ray system that delivers 19 distinct kV views with the linac gantry stationary. It images MV treatment beam above and below the patient with a kV tomosysthesis slice image from the therapy beam’s-eye-view. Results will be high quality images without MLC shadowing for notable improvements relative to conventional fluoroscopic MV imaging and fluoroscopic kV imaging.

Methods: A complete design has a kV electron beam multisource X-ray tube that fits around the MV treatment beam path, with little interference with normal radiotherapy and unblocked by the multi-leaf-collimator. To simulate digital tomosynthesis, we used cone-beam CT projection data from a lung SBRT patient. These data were acquired at 125 kVp and 11 fps (0.4 mAs per projection). We chose 19 projections evenly spaced over 27° around one of the treatment angles (240°). Digital tomosynthesis reconstruction of a slice through the tumor was performed using iterative reconstruction. The visibility of the lesion was assessed for the reconstructed digital tomosynthesis (DTS), using fluoroscopy MV images acquired during radiation therapy, and a kV single projection image acquired at the same angle as the treatment field (240°).

Results: The fluoroscopic DTS images provide the best tumor contrast, surpassing the conventional radiographic and the in-treatment MV portal images. The electron beam multisource X-ray tube design has been completed and the tube is being fabricated. The estimated time to cycle through all 19 projections is 700 ms, enabling high frame-rate imaging. While the initial proposed use case is for image guided and gated treatment delivery, the enhanced imaging will also deliver superior radiographic images for patient setup.

Conclusion: The proposed device will deliver high quality planar images from the beam’s-eye-view without MLC obstruction. The prototype has been designed and is being assembled with first imaging scheduled for May 2015.

Funding Support, Disclosures, and Conflict of Interest: L. Partain, J. Kwon, D. Boyd: NIH/SBIR R43CA192489-01. J. Rottmann, G. Zentai, R. Berbeco: NIH/NCI 1R01CA188446-01. R. Berbeco: E. Research Grant, Varian Medical Systems


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