Evidence map›Paper›PMID 31448218›Full record

ArticleQuantitative imaging in medicine and surgery2019

Enhancing liver tumor localization accuracy by prior-knowledge-guided motion modeling and a biomechanical model.

You Zhang, Michael R Folkert, Xiaokun Huang, Lei Ren, Jeffrey Meyer, Joubin Nasehi Tehrani, Robert Reynolds, Jing Wang

Abstract read
In one paragraph

Article in Quantitative imaging in medicine and surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

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7citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

You ZhangDepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Michael R FolkertDepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Xiaokun HuangDepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Lei RenDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Jeffrey MeyerDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.
Joubin Nasehi TehraniDepartment of Radiation Oncology, University of Virginia Medical Center, Charlottesville, VA, USA.
Robert ReynoldsDepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jing WangDepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Funding

A Limited-angle Intra-fractional Verification (LIVE) System for SBRT TreatmentsR01CA184173 · NCI · DUKE UNIVERSITY · PI REN, LEI, YIN, FANG-FANG · 2015 to 2018
$1.5M
NCI NIH HHS R01 CA184173
6 · The paper itself

Abstract

backgroundPre-treatment liver tumor localization remains a challenging task for radiation therapy, mostly due to the limited tumor contrast against normal liver tissues, and the respiration-induced liver tumor motion. Recently, we developed a biomechanical modeling-based, deformation-driven cone-beam CT estimation technique (Bio-CBCT), which achieved substantially improved accuracy on low-contrast liver tumor localization. However, the accuracy of Bio-CBCT is still affected by the limited tissue contrast around the caudal liver boundary, which reduces the accuracy of the boundary condition that is fed into the biomechanical modeling process. In this study, we developed a motion modeling and biomechanical modeling-guided CBCT estimation technique (MM-Bio-CBCT), to further improve the liver tumor localization accuracy by incorporating a motion model into the CBCT estimation process.

methodsMM-Bio-CBCT estimates new CBCT images through deforming a prior high-quality CT or CBCT volume. The deformation vector field (DVF) is solved by iteratively matching the digitally-reconstructed-radiographs (DRRs) of the deformed prior image to the acquired 2D cone-beam projections. Using the same solved DVF, the liver tumor volume contoured on the prior image can be transferred onto the new CBCT image for automatic tumor localization. To maximize the accuracy of the solved DVF, MM-Bio-CBCT employs two strategies for additional DVF optimization: (I) prior-knowledge-guided liver boundary motion modeling with motion patterns extracted from a prior 4D imaging set like 4D-CTs/4D-CBCTs, to improve the liver boundary DVF accuracy; and (II) finite-element-analysis-based biomechanical modeling of the liver volume to improve the intra-liver DVF accuracy. We evaluated the accuracy of MM-Bio-CBCT on both the digital extended-cardiac-torso (XCAT) phantom images and real liver patient images. The liver tumor localization accuracy of MM-Bio-CBCT was evaluated and compared with that of the purely intensity-driven 2D-3D deformation technique, the 2D-3D deformation technique with motion modeling, and the Bio-CBCT technique. Metrics including the DICE coefficient and the center-of-mass-error (COME) were assessed for quantitative evaluation.

resultsUsing limited-view 20 projections for CBCT estimation, the average (± SD) DICE coefficients between the estimated and the 'gold-standard' liver tumors of the XCAT study were 0.57±0.31, 0.78±0.26, 0.83±0.21, and 0.89±0.11 for 2D-3D deformation, 2D-3D deformation with motion modeling, Bio-CBCT and MM-Bio-CBCT techniques, respectively. Using 20 projections for estimation, the patient study yielded average DICE results of 0.63±0.21, 0.73±0.13 and 0.78±0.12, and 0.83±0.09, correspondingly. The MM-Bio-CBCT localized the liver tumor to an average COME of ~2 mm for both the XCAT and the liver patient studies.

conclusionsCompared to Bio-CBCT, MM-Bio-CBCT further improves the accuracy of liver tumor localization. MM-Bio-CBCT can potentially be used towards pre-treatment liver tumor localization and intra-treatment liver tumor location verification to achieve substantial radiotherapy margin reduction.

Indexed as

4Dbiomechanical modelingCone-beam computed tomography (CBCT)livermotion modelingtumor localization

Identifiers

PMID31448218
PMCPMC6685812

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.