WE-AB-303-01: FEATURED PRESENTATION: A Dual-Detector Phase-Matched Digital Tomosynthesis (DTS) Imaging Scheme Using Aggregated KV and MV Projections for Intra-Treatment Lung Tumor Tracking.

PURPOSE: To develop a dual-detector phase-matched DTS technique for continuous and fast intra-treatment lung tumor localization.

METHODS: Tumor localization accuracy of limited-angle DTS imaging is affected by low inter-slice resolution. The dual-detector DTS technique aims to overcome this limitation through combining orthogonally acquired beam's eye view MV projections and kV projections for intra-treatment DTS reconstruction and localization. To aggregate the kV and MV projections for reconstruction, the MV projections were linearly converted to synthesize corresponding kV projections. To further address the lung motion induced localization errors, this technique uses respiratory phase-matching to match the motion information between on-board DTS and reference DTS to offset the adverse effects of motion blurriness in tumor localization.A study was performed using the CIRS008A lung phantom to simulate different on-board target variation scenarios for localization. The intra-treatment kV and MV acquisition was achieved through the Varian TrueBeam Developer Mode. Four methods were compared for their localization accuracy: 1. the proposed dual-detector phase-matched DTS technique; 2. the single-detector phase-matched DTS technique; 3. the dual-detector 3D-DTS technique without phase-matching; and 4. the single-detector 3D-DTS technique without phase-matching.

RESULTS: For scan angles of 2.5°, 5°, 10°, 20° and 30°, the dual-detector phase-matched DTS technique localized the tumor with average(±standard deviations) errors of 0.4±0.3 mm, 0.5±0.3 mm, 0.6±0.2 mm, 0.9±0.4 mm and 1.0±0.3 mm, respectively. The corresponding values of single-detector phase-matched DTS technique were 4.0±2.5 mm, 2.7±1.1 mm, 1.7±1.2 mm, 2.2±0.9 mm and 1.5±0.8 mm, respectively. The values of dual-detector 3D-DTS technique were 6.2±1.7 mm, 6.3±1.2 mm, 5.3±1.3 mm, 2.0±2.2 mm and 1.5±0.5 mm, respectively. And the values of single-detector 3D-DTS technique were 9.7±8.9 mm, 9.8±8.8 mm, 10.0±9.7 mm, 3.9±2.7 mm and 2.2±1.3 mm, respectively.

CONCLUSION: The dual-detector phase-matched DTS technique substantially improves the tumor localization accuracy, which can be applied to real-time intra-treatment lung tumor localization. The research was funded by the National Institutes of Health Grant No. R01-CA184173 and a grant from Varian Medical Systems.