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Towards fluoroscopic respiratory gating for lung tumours without radiopaque markers

Ross I Berbeco1, Hassan Mostafavi2, Gregory C Sharp1 and Steve B Jiang1

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Due to the risk of pneumothorax, many clinicians are reluctant to implant radiopaque markers within patients' lungs for the purpose of radiographic or fluoroscopic tumour localization. We propose a method of gated therapy using fluoroscopic information without the implantation of radiopaque markers. The method presented here does not rely on any external motion signal either. Breathing phase information is found by analysing the fluoroscopic intensity fluctuations in the lung. As the lungs fill/empty, the radiological pathlength through them shortens/lengthens, giving brighter/darker fluoroscopic intensities. The phase information is combined with motion-enhanced template matching to turn the beam on when the tumour is in the desired location. A study based on patient data is presented to demonstrate the feasibility of this procedure. The resulting beam-on pattern is similar to that produced by an external gating system. The only discrepancies occur briefly and at the gate edges.


PACS

87.59.C- Fluoroscopy

47.63.Ec Pulmonary fluid mechanics

87.19.U- Hemodynamics

87.55.-x Treatment strategy

Subjects

Fluid dynamics

Biological physics

Medical physics

Dates

Issue 19 (7 October 2005)

Received 14 October 2004, in final form 6 May 2005

Published 14 September 2005



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