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SU‐E‐J‐38: Improved DRR Image Quality Using Polyetheretherketone (PEEK) Fiducial in Image Guided Radiotherapy (IGRT)
Author(s) -
Shen S,
Jacob R,
Popple R,
Duan J,
Wu X,
Cardan R,
Brezovich I
Publication year - 2015
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.4924125
Subject(s) - fiducial marker , peek , image guided radiation therapy , imaging phantom , streak , nuclear medicine , full width at half maximum , image quality , materials science , medical imaging , medicine , optics , physics , radiology , computer science , computer vision , image (mathematics) , polymer , composite material
Purpose Fiducial‐based imaging is often used in IGRT. Traditional gold fiducial marker often has substantial reconstruction artifacts. These artifacts Result in poor image quality of DRR for online kV‐to‐DRR matching. This study evaluated the image quality of PEEK in DRR in static and moving phantom. Methods CT scan of the Gold and PEEK fiducial (both 1×3 mm) was acquired in a 22 cm cylindrical phantom filled with water. Image artifacts was evaluated with maximum CT value deviated from water due to artifacts; volume of artifacts in 10×10 cm in the center slice; maximum length of streak artifacts from the fiducial. DRR resolution were measured using FWHM and FWTM. 4DCT of PEEK fiducial was acquired with the phantom moving sinusoidally in superior‐inferior direction. Motion artifacts were assessed for various 4D phase angles. Results The maximum CT value deviation was −174 for Gold and −24 for PEEK. The volume of artifacts in a 10x10 cm 3 mm slice was 0.369 for Gold and 0.074 cm3 for PEEK. The maximum length of streak artifact was 80mm for Gold and 7 mm for PEEK. PEEK in DRR, FWHM was close to actual (1.0 mm for Gold and 1.1 mm for PEEK). FWTM was 1.8 mm for Gold and 1.3 mm for PEEK in DRR. Barrel motion artifact of PEEK fiducial was noticeable for free‐breathing scan. The apparent PEEK length due to residual motion was in close agreement with the calculated length (13 mm for 30–70 phase, 10 mm in 40–60 phase). Conclusion Streak artifacts on planning CT associated with use of gold fiducial can be significantly reduced by PEEK fiducial, while having adequate kV image contrast. DRR image resolution at FWTM was improved from 1.8 mm to 1.3 mm. Because of this improvement, we have been routinely use PEEK for liver IGRT.