Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers
PurposeTo develop an internal target volume (ITV) margin determination framework (or decision-supporting framework) for treating multiple lung metastases using CyberKnife Synchrony with intraoperatively implanted fiducial markers (IIFMs). The feasibility of using non-ideally implanted fiducial marke...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.753246/full |
| _version_ | 1818722056650358784 |
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| author | Jihun Kim Min Cheol Han Jee Suk Chang Chae-Seon Hong Kyung Hwan Kim Hwa Kyung Byun Ryeong Hwang Park Woong Sub Koom Seong Yong Park Jin Sung Kim |
| author_facet | Jihun Kim Min Cheol Han Jee Suk Chang Chae-Seon Hong Kyung Hwan Kim Hwa Kyung Byun Ryeong Hwang Park Woong Sub Koom Seong Yong Park Jin Sung Kim |
| author_sort | Jihun Kim |
| collection | DOAJ |
| description | PurposeTo develop an internal target volume (ITV) margin determination framework (or decision-supporting framework) for treating multiple lung metastases using CyberKnife Synchrony with intraoperatively implanted fiducial markers (IIFMs). The feasibility of using non-ideally implanted fiducial markers (a limited number and/or far from a target) for tracking-based lung stereotactic ablative radiotherapy (SABR) was investigated.MethodsIn the developed margin determination framework, an optimal set of IIFMs was determined to minimize a tracking uncertainty-specific ITV (ITVtracking) margin (margin required to cover target-to-marker motion discrepancy), i.e., minimize the motion discrepancies between gross tumor volume (GTV) and the selected set of fiducial markers (FMs). The developed margin determination framework was evaluated in 17 patients with lung metastases. To automatically calculate the respiratory motions of the FMs, a template matching-based FM tracking algorithm was developed, and GTV motion was manually measured. Furthermore, during-treatment motions of the selected FMs were analyzed using log files and compared with those calculated using 4D CTs.ResultsFor 41 of 42 lesions in 17 patients (97.6%), an optimal set of the IIFMs was successfully determined, requiring an ITVtracking margin less than 5 mm. The template matching-based FM tracking algorithm calculated the FM motions with a sub-millimeter accuracy compared with the manual measurements. The patient respiratory motions during treatment were, on average, significantly smaller than those measured at simulation for the patient cohort considered.ConclusionUse of the developed margin determination framework employing CyberKnife Synchrony with a limited number of IIFMs is feasible for lung SABR. |
| first_indexed | 2024-12-17T20:48:34Z |
| format | Article |
| id | doaj.art-9ab42162b62a493d88ddb6d885249b09 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-17T20:48:34Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9ab42162b62a493d88ddb6d885249b092022-12-21T21:33:06ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-10-011110.3389/fonc.2021.753246753246Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial MarkersJihun Kim0Min Cheol Han1Jee Suk Chang2Chae-Seon Hong3Kyung Hwan Kim4Hwa Kyung Byun5Ryeong Hwang Park6Woong Sub Koom7Seong Yong Park8Jin Sung Kim9Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei Cancer Center, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, South KoreaPurposeTo develop an internal target volume (ITV) margin determination framework (or decision-supporting framework) for treating multiple lung metastases using CyberKnife Synchrony with intraoperatively implanted fiducial markers (IIFMs). The feasibility of using non-ideally implanted fiducial markers (a limited number and/or far from a target) for tracking-based lung stereotactic ablative radiotherapy (SABR) was investigated.MethodsIn the developed margin determination framework, an optimal set of IIFMs was determined to minimize a tracking uncertainty-specific ITV (ITVtracking) margin (margin required to cover target-to-marker motion discrepancy), i.e., minimize the motion discrepancies between gross tumor volume (GTV) and the selected set of fiducial markers (FMs). The developed margin determination framework was evaluated in 17 patients with lung metastases. To automatically calculate the respiratory motions of the FMs, a template matching-based FM tracking algorithm was developed, and GTV motion was manually measured. Furthermore, during-treatment motions of the selected FMs were analyzed using log files and compared with those calculated using 4D CTs.ResultsFor 41 of 42 lesions in 17 patients (97.6%), an optimal set of the IIFMs was successfully determined, requiring an ITVtracking margin less than 5 mm. The template matching-based FM tracking algorithm calculated the FM motions with a sub-millimeter accuracy compared with the manual measurements. The patient respiratory motions during treatment were, on average, significantly smaller than those measured at simulation for the patient cohort considered.ConclusionUse of the developed margin determination framework employing CyberKnife Synchrony with a limited number of IIFMs is feasible for lung SABR.https://www.frontiersin.org/articles/10.3389/fonc.2021.753246/fulllung metastasisintraoperative fiducial marker implantationCyberKnife Synchronyfiducial trackinginternal target volumestereotactic ablative radiotherapy |
| spellingShingle | Jihun Kim Min Cheol Han Jee Suk Chang Chae-Seon Hong Kyung Hwan Kim Hwa Kyung Byun Ryeong Hwang Park Woong Sub Koom Seong Yong Park Jin Sung Kim Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers Frontiers in Oncology lung metastasis intraoperative fiducial marker implantation CyberKnife Synchrony fiducial tracking internal target volume stereotactic ablative radiotherapy |
| title | Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers |
| title_full | Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers |
| title_fullStr | Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers |
| title_full_unstemmed | Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers |
| title_short | Development of a Margin Determination Framework for Tumor-Tracking Radiation Therapy With Intraoperatively Implanted Fiducial Markers |
| title_sort | development of a margin determination framework for tumor tracking radiation therapy with intraoperatively implanted fiducial markers |
| topic | lung metastasis intraoperative fiducial marker implantation CyberKnife Synchrony fiducial tracking internal target volume stereotactic ablative radiotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.753246/full |
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