Open AccessAutomated replication of cone beam CT ‐guided treatments in the Pinnacle 3 treatment planning system for adaptive radiotherapy
Author(s) -
Hargrave Catriona,
Mason Nicole,
Guidi Robyn,
Miller JulieAnne,
Becker Jillian,
Moores Matthew,
Mengersen Kerrie,
Poulsen Michael,
Harden Fiona
Publication year - 2016
Publication title -
journal of medical radiation sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.484
H-Index - 18
eISSN - 2051-3909
pISSN - 2051-3895
DOI - 10.1002/jmrs.141
Subject(s) - pinnacle , dicom , image guided radiation therapy , fiducial marker , cone beam computed tomography , imaging phantom , image registration , workflow , medical physics , computer science , radiation treatment planning , medicine , medical imaging , nuclear medicine , artificial intelligence , radiation therapy , computed tomography , radiology , database , image (mathematics)
Time‐consuming manual methods have been required to register cone‐beam computed tomography ( CBCT ) images with plans in the Pinnacle 3 treatment planning system in order to replicate delivered treatments for adaptive radiotherapy. These methods rely on fiducial marker ( FM ) placement during CBCT acquisition or the image mid‐point to localise the image isocentre. A quality assurance study was conducted to validate an automated CBCT ‐plan registration method utilising the Digital Imaging and Communications in Medicine ( DICOM ) Structure Set ( RS ) and Spatial Registration ( RE ) files created during online image‐guided radiotherapy ( IGRT ). Methods CBCT s of a phantom were acquired with FM s and predetermined setup errors using various online IGRT workflows. The CBCT s, DICOM RS and RE files were imported into Pinnacle 3 plans of the phantom and the resulting automated CBCT ‐plan registrations were compared to existing manual methods. A clinical protocol for the automated method was subsequently developed and tested retrospectively using CBCT s and plans for six bladder patients. Results The automated CBCT ‐plan registration method was successfully applied to thirty‐four phantom CBCT images acquired with an online 0 mm action level workflow. Ten CBCT s acquired with other IGRT workflows required manual workarounds. This was addressed during the development and testing of the clinical protocol using twenty‐eight patient CBCT s. The automated CBCT ‐plan registrations were instantaneous, replicating delivered treatments in Pinnacle 3 with errors of ±0.5 mm. These errors were comparable to mid‐point‐dependant manual registrations but superior to FM ‐dependant manual registrations. Conclusion The automated CBCT ‐plan registration method quickly and reliably replicates delivered treatments in Pinnacle 3 for adaptive radiotherapy.