Cherenkov Imaged Bio-morphological Features Verify Patient Positioning with Deformable Tissue Translocation in Breast Radiotherapy

Yao Chen; Savannah M. Decker; Petr Bruza; David J. Gladstone; Lesley A. Jarvis; Brian W. Pogue; Kimberley S. Samkoe; Rongxiao Zhang

doi:10.1016/j.adro.2024.101684

arXiv · 2409.05680

Cherenkov Imaged Bio-morphological Features Verify Patient Positioning with Deformable Tissue Translocation in Breast Radiotherapy

Yao Chen·Savannah M. Decker·Petr Bruza·David J. Gladstone·Lesley A. Jarvis·Brian W. Pogue·Kimberley S. Samkoe·Rongxiao Zhang

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Abstract

Accurate patient positioning is critical for precise radiotherapy dose delivery, as positioning errors can significantly affect treatment outcomes. This study introduces a novel method for tracking loco-regional tissue deformation through Cherenkov image analysis during fractionated breast cancer radiotherapy. The primary goal was to develop and test an algorithm for Cherenkov-based regional position accuracy quantification, specifically for loco-regional deformations, which lack ideal quantification methods in radiotherapy. Blood vessel detection and segmentation were developed in Cherenkov images using a tissue phantom with incremental movements, and later applied to images from fractionated whole breast radiotherapy in human patients (n=10). A combined rigid and non-rigid registration technique was used to detect inter- and intra-fractional positioning variations. This approach quantified positioning variations in two parts: a global shift from rigid registration and a two-dimensional variation map of loco-regional deformation from non-rigid registration. The methodology was validated using an anthropomorphic chest phantom experiment, where known treatment couch translations and respiratory motion were simulated to assess inter- and intra-fractional uncertainties, yielding an average accuracy of 0.83 mm for couch translations up to 20 mm. Analysis of clinical Cherenkov data from ten breast cancer patients showed an inter-fraction setup variation of 3.7 plus minus 2.4 mm relative to the first fraction and loco-regional deformations (95th percentile) of up to 3.3 plus minus 1.9 mm. This study presents a Cherenkov-based approach to quantify global and local positioning variations, demonstrating feasibility in addressing loco-regional deformations that conventional imaging techniques fail to capture.

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Yao Chen, Savannah M. Decker, Petr Bruza, David J. Gladstone, Lesley A. Jarvis, Brian W. Pogue, Kimberley S. Samkoe, Rongxiao Zhang. 2025-08-19. Cherenkov Imaged Bio-morphological Features Verify Patient Positioning with Deformable Tissue Translocation in Breast Radiotherapy. https://doi.org/10.1016/j.adro.2024.101684

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