A Technical Note: Inter-Observer and Inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer
Introduction:To
investigate the inter-observer and inter-modality variabilities of two imaging
guided equipments—cone-beam
computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body
radiotherapy.Methods:A renal metastasis case implanted with three gold anchor fiducial
markers was firstly scanned by US to acquire a 3-dimension US image and
followed by 4-dimension CBCT in every fraction. Seven observers retrospectively
registered the pre-treatment images with the
corresponding reference images based on
the gold markers. Registration uncertainty of the observers between two imaging modalities was evaluated. Results:The
uncertainties over whole treatment course in CBCT were 0.88 mm, 1.94 mm and
0.86 mm in lateral, longitudinal and vertical directions respectively; while
0.8 mm, 0.97 mm and 1.36 mm were found in US. Conclusion:The
greatest uncertainty was found in longitudinal direction in CBCT due to the
fact that the respiration motion is the most rigorous in cranial-caudal
direction. In US, since the probe was hold almost in upright position, the
strong echo in vertical direction was attributed to the greatest uncertainty
for such direction.
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