First clinical evaluation of breathing controlled four-dimensional computed tomography imaging

Background and Purpose: Four-dimensional computed tomography (4DCT) has become an essential part of radiotherapy planning but is often affected by artifacts. A new breathing controlled 4DCT (i4DCT) algorithm has been introduced. This study aims to present the first clinical data and to evaluate the...

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Autores principales:	Juliane Szkitsak, René Werner, Susanne Fernolendt, Annette Schwarz, Oliver J. Ott, Rainer Fietkau, Christian Hofmann, Christoph Bert
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	4DCT Motion artifacts Respiratory motion Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/f3d6ca473bcb47a79eb1a57c41031183
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spelling	oai:doaj.org-article:f3d6ca473bcb47a79eb1a57c410311832021-11-06T04:32:59ZFirst clinical evaluation of breathing controlled four-dimensional computed tomography imaging2405-631610.1016/j.phro.2021.09.005https://doaj.org/article/f3d6ca473bcb47a79eb1a57c410311832021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405631621000555https://doaj.org/toc/2405-6316Background and Purpose: Four-dimensional computed tomography (4DCT) has become an essential part of radiotherapy planning but is often affected by artifacts. A new breathing controlled 4DCT (i4DCT) algorithm has been introduced. This study aims to present the first clinical data and to evaluate the achieved image quality, projection data coverage and beam-on time. Material & Methods: The analysis included i4DCT data for 129 scans of patients with thoracic tumors. Projection data coverage and beam-on time were evaluated. Additionally, image quality was exemplarily discussed and rated by ten clinical experts with a 5-score-scale for 30 patients with large variations in their breathing pattern (‘challenging subgroup’). Rated images were reconstructed amplitude- and phase-based. Results: Expert scoring revealed that 78% (amplitude-based) and 63% (phase-based) of the challenging subgroup were artifact-free (rating ≥4). For the entire cohort, average beam-on time per couch position was 4.9 ± 1.6 s. For the challenging subgroup, time increased slightly but not significantly compared to the remaining patients (5.1 s vs. 4.9 s; p = 0.64). Median projection data coverage was 93% and 94% for inhalation and exhalation, respectively, for the entire cohort. The comparison for the subgroup and the remaining patients revealed a small but significant decrease of the median coverage values for the challenging cases (inhalation: 90% vs. 94%, p = 0.02; exhalation: 93% vs. 94%, p = 0.02). Conclusions: This first clinical evaluation of i4DCT shows very promising results in terms of image quality and projection data coverage. The results agree with and support the results of previous i4DCT phantom studies.Juliane SzkitsakRené WernerSusanne FernolendtAnnette SchwarzOliver J. OttRainer FietkauChristian HofmannChristoph BertElsevierarticle4DCTMotion artifactsRespiratory motionMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENPhysics and Imaging in Radiation Oncology, Vol 20, Iss , Pp 56-61 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	4DCT Motion artifacts Respiratory motion Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	4DCT Motion artifacts Respiratory motion Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Juliane Szkitsak René Werner Susanne Fernolendt Annette Schwarz Oliver J. Ott Rainer Fietkau Christian Hofmann Christoph Bert First clinical evaluation of breathing controlled four-dimensional computed tomography imaging
description	Background and Purpose: Four-dimensional computed tomography (4DCT) has become an essential part of radiotherapy planning but is often affected by artifacts. A new breathing controlled 4DCT (i4DCT) algorithm has been introduced. This study aims to present the first clinical data and to evaluate the achieved image quality, projection data coverage and beam-on time. Material & Methods: The analysis included i4DCT data for 129 scans of patients with thoracic tumors. Projection data coverage and beam-on time were evaluated. Additionally, image quality was exemplarily discussed and rated by ten clinical experts with a 5-score-scale for 30 patients with large variations in their breathing pattern (‘challenging subgroup’). Rated images were reconstructed amplitude- and phase-based. Results: Expert scoring revealed that 78% (amplitude-based) and 63% (phase-based) of the challenging subgroup were artifact-free (rating ≥4). For the entire cohort, average beam-on time per couch position was 4.9 ± 1.6 s. For the challenging subgroup, time increased slightly but not significantly compared to the remaining patients (5.1 s vs. 4.9 s; p = 0.64). Median projection data coverage was 93% and 94% for inhalation and exhalation, respectively, for the entire cohort. The comparison for the subgroup and the remaining patients revealed a small but significant decrease of the median coverage values for the challenging cases (inhalation: 90% vs. 94%, p = 0.02; exhalation: 93% vs. 94%, p = 0.02). Conclusions: This first clinical evaluation of i4DCT shows very promising results in terms of image quality and projection data coverage. The results agree with and support the results of previous i4DCT phantom studies.
format	article
author	Juliane Szkitsak René Werner Susanne Fernolendt Annette Schwarz Oliver J. Ott Rainer Fietkau Christian Hofmann Christoph Bert
author_facet	Juliane Szkitsak René Werner Susanne Fernolendt Annette Schwarz Oliver J. Ott Rainer Fietkau Christian Hofmann Christoph Bert
author_sort	Juliane Szkitsak
title	First clinical evaluation of breathing controlled four-dimensional computed tomography imaging
title_short	First clinical evaluation of breathing controlled four-dimensional computed tomography imaging
title_full	First clinical evaluation of breathing controlled four-dimensional computed tomography imaging
title_fullStr	First clinical evaluation of breathing controlled four-dimensional computed tomography imaging
title_full_unstemmed	First clinical evaluation of breathing controlled four-dimensional computed tomography imaging
title_sort	first clinical evaluation of breathing controlled four-dimensional computed tomography imaging
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/f3d6ca473bcb47a79eb1a57c41031183
work_keys_str_mv	AT julianeszkitsak firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT renewerner firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT susannefernolendt firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT annetteschwarz firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT oliverjott firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT rainerfietkau firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT christianhofmann firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging AT christophbert firstclinicalevaluationofbreathingcontrolledfourdimensionalcomputedtomographyimaging
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First clinical evaluation of breathing controlled four-dimensional computed tomography imaging

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