| Chen Jing,Deng Xianzhi,Fu Fenfang,Zheng Fen,Zhang Jianping,He Shanting,Xu Benhua,Liu Yaqiang,Li Xiaobo.A phantom study on the feasibility of recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology in Cyberknife Synchrony-based respiratory tracking[J].Chinese Journal of Radiological Medicine and Protection,2022,42(11):865-870 |
| A phantom study on the feasibility of recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology in Cyberknife Synchrony-based respiratory tracking |
| Received:September 05, 2022 |
| DOI：10.3760/cma.j.cn112271-20220905-00360 |
| KeyWords:Recoverable fiducial marker Cyberknife Intelligent navigation Synchrony respiratory tracking |
| FundProject:福建省医学创新课题(2020CXA026) |
| Author Name | Affiliation | E-mail | | Chen Jing | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | Deng Xianzhi | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | Fu Fenfang | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | Zheng Fen | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | Zhang Jianping | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | He Shanting | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | Xu Benhua | School of Medical Imaging, Fujian Medical University, Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou 350001, China | | | Liu Yaqiang | Department of Engineering Physics, Tsinghua University, Beijing 100084, China | | | Li Xiaobo | Department of Engineering Physics, Tsinghua University, Beijing 100084, China | lixiaobo2004@126.com |
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| Abstract:: |
| Objective To explore the feasibility of recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology in the Cyberknife Synchrony-based respiratory tracking.Methods CT scans of an inflatable pig lung after anti-rot processing were obtained. Then, eight simulated tumor lesion sites were designed in the left and right lung lobes using intelligent navigation software, with four classified as the sputum bronchial environment group and four classified as the wet bronchial environment group. Based on the implantation principle of Cyberknife fiducial markers, 32 recoverable fiducial markers were implanted around various simulated tumor lesions via bronchus under intelligent guidance. Then, the end-expiratory state of the pig lung was simulated, the pig lung was scanned again to obtain CT images of the implanted recoverable fiducial markers, and the number of successfully implanted fiducial markers was recorded. Eight deliverable Synchrony treatment protocols were designed using the Cyberknife planning system (Multiplan v4.6), and then the pig lung with simulated respiratory movements was exposed to radiation. After radiation, the implanted recoverable fiducial markers were retrieved using the bronchoscopy technique, and the number of successfully retrieved fiducial markers was recorded. Moreover, the translational errors, rotational errors, and rigid body errors were extracted from the Cyberknife log file and analyzed.Results No recoverable fiducial markers slipped or fell during the experiment. Thirty-two recoverable fiducial markers were successfully implanted and recovered under the guidance of intelligent navigation bronchoscopy, with implantation and recovery success rates of both 100%. Moreover, the tracking rate and rigid body errors of the fiducial markers were 100% and less than 5 mm, respectively. The data from the Cyberknife log file indicated that there was no significant difference between the sputum bronchial environment group and the wet bronchial environment group in the translational errors in the left-right direction, the rotational errors in the roll direction, and the rotational errors in the pitch direction (P>0.05). Compared to the wet bronchial environment group, the sputum bronchial environment group had slightly higher translational errors in front-back (Z=-3.57, P<0.01) and cranio-caudal (Z=-2.53, P<0.05) directions, lower rotational errors along the yaw axis (Z = -3.88, P < 0.01), and lower rigid body error (Z=-3.32, P<0.01), and the differences were all statistically significant.Conclusions The recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology is feasible. Recoverable fiducial markers are stable in the bronchus of the phantom, and the Cyberknife tracking precision can meet clinical requirements. Therefore, the recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology has promising prospects in clinical and teaching applications. |
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