Towards fluoroscopic respiratory gating for lung tumours without radiopaque markers

Ross I. Berbeco, Hassan Mostafavi, Gregory C. Sharp, Steve B. Jiang

Research output: Contribution to journalArticle

111 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)4481-4490
Number of pages10
JournalPhysics in Medicine and Biology
Volume50
Issue number19
DOIs
Publication statusPublished - Oct 7 2005

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ASJC Scopus subject areas

  • Biomedical Engineering
  • Physics and Astronomy (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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