F. Kreuder, B. Schreiber, C. Kausch, and O. Dössel. A structure-based method for on-line matching of portal images for an optimal patient set-up in radiotherapy. In Philips Journal of Research, vol. 51(2) , pp. 317-337, 1998
In radiotherapy, portal images are used to ensure a correct patient position during every radiation session. A reliable on-line verification is of clinical interest to interrupt the radiation in time in case the patient is not at the right position. A great problem for successful image registration is the poor image quality of portal images. They are corrupted by noise and of very low contrast. A method directly based on the grey levels is not sufficient. Therefore a structure-based method was developed which is almost insensitive to distrubances (air bubbles, noise, slowly varying grey levels). In most cases the selection of a region of interest (ROI) can be omitted. Besides the automatical segmentation of the radiation field, only the structures relevant for matching the anatomy are enhanced by using a bandpass filter. It is possible to detect the maximum correlation between different image modalities reliably (simulator image, digitally reconstructed radiograph, portal image). By using Fast Fourier Transformation (FFT), the calculation time is smaller than five seconds, which enables a clinical on-line verification. We have matched 1139 pairs of images of different modalities and various regions of the body (pelvis, nasopharyngeal space, head, lung). The success rate is greater than 95%.
The imaging performance of metal plate/phosphor screens which are used for the creation of portal images in radiotherapy is investigated by using Monte Carlo simulations. To this end the modulation transfer function, the noise power spectrum and the detective quantum efficiency [DQE(f)] are calculated for different metals and phosphors and different thicknesses of metal and phosphor for a range of spatial resolutions. The interaction of x-rays with the metal plate/phosphor screen is modeled with the EGS4 electron gamma shower code. Optical transport in the phosphor is modeled by simulating scattering and reabsorption events of individual optical photons. It is shown that metals with a high atomic number perform better than lighter metals in maximizing the DQE(f). It is furthermore shown that the DQE(f) for the metal plate/phosphor screen alone is nearly x-ray quantum absorption limited up to spatial frequencies of 0.4 cycles/mm. In addition, it is argued that the secondary quantum sink of optical photons imposed by the optical chain (mirror, lenses and video camera) leads to a significant degradation of the signal-to-noise ratio at spatial frequencies which are most important for successful registration of portal images. Therefore, the conclusion is that a replacement of the optical chain by a flat array of photodiodes placed directly under the phosphor will lead to a substantial improvement in image quality of portal images.
F. Kreuder. 2D-3D-Registrierung mit Parameterentkopplung für die Patientenlagerung in der Strahlentherapie. KIT Scientific Publishing. Dissertation. 2009
Die optimale Lagerung des Patienten ist von entscheidender Bedeutung für den Erfolg einer Bestrahlung. In dieser Arbeit wird ein 2D-3D-Registrierungsverfahren für Hochenergiekontrollaufnahmen entwickelt, das die relevante anatomische Information gezielt herausarbeitet. Virtuelle Projektionsbilder können unter Ausnutzung des 3D-Radonraumes schnell berechnet werden. Die mathematische Entkopplung der Freiheitsgrade ermöglicht eine vollständige und robuste Lagebestimmung innerhalb weniger Sekunden.