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dc.contributor.authorMorton, Natasha
dc.contributor.authorSykes, Jonathan
dc.contributor.authorBarber, Jeffrey
dc.contributor.authorHofmann, Christian
dc.contributor.authorKeall, Paul
dc.contributor.authorO'Brien, Ricky
dc.date.accessioned2021-01-13T05:49:29Z
dc.date.available2021-01-13T05:49:29Z
dc.date.issued2020en_AU
dc.identifier.urihttps://hdl.handle.net/2123/24299
dc.description.abstractBreathing variations during 4D CT imaging often manifest as geometric irregularities known as respiratory-induced image artifacts and ultimately effect radiotherapy treatment efficacy. To reduce such image artifacts we developed Respiratory Adaptive Computed Tomography (REACT) to trigger CT acquisition during periods of regular breathing. For the first time, we integrate REACT with clinical hardware and hypothesize that REACT will reduce respiratory-induced image artifacts ≥ 4 mm compared to conventional 4D CT. 4D image sets were acquired using REACT and conventional 4D CT on a Siemens Somatom scanner. Scans were taken for 13 respiratory traces (12 patients) that were reproduced on a lung-motion phantom. Motion was observed by the Varian RPM system and sent to the REACT software where breathing irregularity was evaluated in real-time and used to trigger the imaging beam. REACT and conventional 4D CT images were compared to a ground truth static-phantom image and compared for absolute geometric differences within the region-of-interest. Breathing irregularity during imaging was retrospectively assessed using the root-mean-square error of the RPM measured respiratory signal during beam on (RMSE_Beam_on) for each phase of the respiratory cycle. REACT significantly reduced the average frequency of respiratory-induced image artifacts ≥ 4 mm by 70% for the tumor (p = 0.003) and 76% for the lung (p = 0.0002) compared to conventional 4D CT. Volume reductions of 10% to 6% of the tumor and 2% to 1% of the lung compared to conventional 4D CT were seen. Breathing irregularity during imaging (RMSE_Beam_on) was significantly reduced by 27% (p = 0.013) using the REACT method. For the first time, REACT was successfully integrated with clinical hardware. Our findings support the hypothesis that REACT significantly reduced respiratory-induced image artifacts compared to conventional 4D CT. These experimental results provide compelling evidence for further REACT investigation, potentially providing clearer images for clinical use.en_AU
dc.language.isoenen_AU
dc.publisherIOP Sciencesen_AU
dc.relation.ispartofPhysics in Medicine & Biologyen_AU
dc.rightsCopyright All Rights Reserveden_AU
dc.subjectcomputer tomographyen_AU
dc.subjectmotion managementen_AU
dc.titleReducing 4D CT imaging artifacts at the source: first experimental results from the respiratory adaptive computed tomography (REACT) systemen_AU
dc.typeArticleen_AU
dc.subject.asrc0299 Other Physical Sciencesen_AU
dc.identifier.doi10.1088/1361-6560/ab7abe
dc.relation.nhmrc1112096
dc.relation.other1161748
usyd.facultySeS faculties schools::Faculty of Medicine and Healthen_AU
usyd.departmentCentral Clinical Schoolen_AU
usyd.citation.volume65en_AU
usyd.citation.issue7en_AU
usyd.citation.spage075012en_AU
workflow.metadata.onlyNoen_AU


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