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Bouw en werking van de Cone Beam CT en gebruik XVI
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Bouw en werking van de Cone Beam CT en gebruik XVI
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vTECH 06-009Onderwijsvorm Studiebelasting
zelfstudie 3 SBU
Inleiding:
In de afgelopen twee decennia heeft er een enorme technische ontwikkeling plaatsgevonden
op het gebied van in-room imaging technieken. Er heeft een transitie plaatsgevonden van
het extensief gebruik van analoge beeldcassettes naar zeer intensieve beeld gestuurde
technieken, waarin inmiddels zelfs van MR beelden gebruikt kan worden.
Iedere nieuwe techniek dient voor implementatie te worden getest op onder andere
betrouwbaarheid en nauwkeurigheid. Hieronder vind je 2 abstracts (samenvattingen van een
onderzoek) waarin dergelijke onderzoek zijn beschreven. Uit deze onderzoeken is op te
maken wat de ervaringen zijn van de onderzoekers/gebruikers.
Lees voor deze zelfstudie de 2 abstracts beantwoord bijbehorende vragen. De vragen zullen
in de OGM worden behandeld (vTECH 06-010).
Doelstelling:
De student kan:
· de 3 verschillende acquisitie methodes die gebruikt worden voor positieverificatie
beschrijven
· uitleggen hoe de acquisitie met behulp van (2D) kV wordt uitgevoerd en beelden tot
stand komen
· uitleggen hoe de acquisitie van (2D MV) EPID wordt uitgevoerd en beelden tot stand
komen
· uitleggen hoe de acquisitie van CBCT wordt uitgevoerd en beelden tot stand komen
· uitleggen wat er beoordeeld kan worden op EPID, kV en CBCT beelden; welke
structuren zijn wel of niet zichtbaar?
· de voor- en nadelen van de verschillende acquisitie methodes benoemen.
Abstract 1:
Accuracy of boost volume tracking in whole breast irradiation using conebeam CT imaging of
surgical clips
G.G. Veenendaal, N.J.W. Willems, H.J.G.D. Van den Bongard, J.C.J. De Boer
UMC Utrecht, Radiation Oncology Department, Utrecht, The Netherlands
Purpose/Objective: Most local recurrences occur in or near the tumor bed after breast-
conserving therapy (lumpectomy followed by whole breast irradiation (WBRT)). Tracking the
boost volume instead of the thoracic wall using implanted surgical clips might reduce RT
planning margins. In this study, the accuracy of surgical clip matching on conebeam CT
(CBCT) and the relative motion of the clip area relative to the thoracic wall was investigated.
Materials and Methods: The accuracy of the clip matching was studied by determination of
the interobserver variation using the standard deviation of the X, Y and Z-direction in all
matches. In a group of 20 breast cancer patients, 5 to 8 CBCT's were acquired (128 scans in
total). During surgery 2 to 5 clips were implanted with a median of 4 clips per patient. Each
CBCT was registered (“matchen”) by 3 or 4 Radiation TherapisT (MBB-er) to the planning
CT in XVI software (Elekta AB) resulting in 484 independent registrations (on average 3.8
per scan). For registration, a clipbox (region of interest) encompassing the clips area was
defined. Next, the automatic seed match option was used for an initial registration, and then
manually adapted if this was judged necessary. Each CBCT was also registered using a
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