Publisher DOI: 10.1259/bjr.20160926
Title: Impact of robotic ultrasound image guidance on plan quality in SBRT of the prostate
Language: English
Authors: Gerlach, Stefan 
Kuhlemann, Ivo 
Ernst, Floris 
Fürweger, Christoph 
Schlaefer, Alexander 
Issue Date: 26-Sep-2017
Publisher: Wiley
Source: British Journal of Radiology 1078 (90): 20160926 (2017-01-01)
Journal or Series Name: BJR 
Abstract (english): Objective: Ultrasound provides good image quality, fast volumetric imaging and is established for abdominal image guidance. Robotic transducer placement may facilitate intrafractional motion compensation in radiation therapy. We consider integration with the CyberKnife and study whether the kinematic redundancy of a seven-degrees-of-freedom robot allows for acceptable plan quality for prostate treatments. Methods: Reference treatment plans were generated for 10 prostate cancer cases previously treated with the CyberKnife. Considering transducer and prostate motion by different safety margins, 10 different robot poses, and 3 different elbow configurations, we removed all beams colliding with robot or transducer. For each combination, plans were generated using the same strict dose constraints and the objective to maximize the target coverage. Additionally, plans for the union of all unblocked beams were generated. Results: In 9 cases the planning target coverage with the ultrasound robot was within 1.1 percentage points of the reference coverage. It was 1.7 percentage points for one large prostate. For one preferable robot position, kinematic redundancy decreased the average number of blocked beam directions from 23.1 to 14.5. Conclusion: The impact of beam blocking can largely be offset by treatment planning and using a kinematically redundant robot. Plan quality can be maintained by carefully choosing the ultrasound robot position and pose. For smaller planning target volumes the difference in coverage is negligible for safety margins of up to 35 mm. Advances in knowledge: Integrating a robot for online intrafractional image guidance based on ultrasound can be realized while maintaining acceptable plan quality for prostate cancer treatments with the CyberKnife.
URI: http://hdl.handle.net/11420/3407
ISSN: 1748-880X
Institute: Medizintechnische Systeme E-1 
Type: (wissenschaftlicher) Artikel
Funded by: Funded by Deutsche Forschungsgemeinschaft (grants ER 817/1–1 and SCHL 1844/3-1).
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