Michael R. Rossi

Experimental verification of numerical simulations of cryosurgery with application to computerized planning.

As a part of an ongoing effort to develop computerized planning tools for cryosurgery, an experimental study has been conducted to verify a recently developed numerical technique for bioheat transfer simulations. Experiments were performed on gelatin solution as a phantom material, using proprietary liquid-nitrogen cryoprobes. Urethral warming was simulated with the application of a cryoheater, which is a proprietary temperature-controlled electrical heater. The experimental design was aimed at creating a 2D heat transfer problem. Analysis of experimental results was based on reconstruction of the frozen region from video recordings, using a region-growing segmentation algorithm. Results of this study show an average disagreement of 2.9% in the size of the frozen region, between experimental data and numerical simulation of the same experiment, which validates both the recently developed algorithm for numerical simulations and the newly developed algorithm for segmentation from video recordings.

Fast kilovoltage/megavoltage (kVMV) breathhold cone-beam CT for image-guided radiotherapy of lung cancer

Long image acquisition times of 60-120 s for cone-beam CT (CBCT) limit the number of patients with lung cancer who can undergo volume image guidance under breathhold. We developed a low-dose dual-energy kilovoltage-megavoltage-cone-beam CT (kVMV-CBCT) based on a clinical treatment unit reducing imaging time to < or =15 s. Simultaneous kVMV-imaging was achieved by dedicated synchronization hardware controlling the output of the linear accelerator (linac) based on detector panel readout signals, preventing imaging artifacts from interference of the linacs MV-irradiation and panel readouts. Optimization was performed to minimize the imaging dose. Single MV-projections, reconstructed MV-CBCT images and images of simultaneous 90 degrees kV- and 90 degrees MV-CBCT (180 degrees kVMV-CBCT) were acquired with different parameters. Image quality and imaging dose were evaluated and compared to kV-imaging. Hardware-based kVMV synchronization resulted in artifact-free projections. A combined 180 degrees kVMV-CBCT scan with a total MV-dose of 5 monitor units was acquired in 15 s and with sufficient image quality. The resolution was 5-6 line pairs cm(-1) (Catphan phantom). The combined kVMV-scan dose was equivalent to a kV-radiation scan dose of approximately 33 mGy. kVMV-CBCT based on a standard linac is promising and can provide ultra-fast online volume image guidance with low imaging dose and sufficient image quality for fast and accurate patient positioning for patients with lung cancer under breathhold.

Cryosurgery planning using bubble packing in 3D

As part of an ongoing project to develop automated tools for cryosurgery planning, the current study focuses on the development of a 3D bubble packing method. A proof-of-concept for the new method is demonstrated on five prostate models, reconstructed from ultrasound images. The new method is a modification of an established method in 2D. Ellipsoidal bubbles are packed in the volume of the prostate in the current study; such bubbles can be viewed as a first-order approximation of a frozen region around a single cryoprobe. When all cryoprobes are inserted to the same depth, optimum planning was found to occur at about 60% of the length of the prostate (measured from its apex), which leads to cooling of approximately 75% of the prostate volume below a specific temperature threshold of − 22°C. Bubble packing has the potential to dramatically reduce the run time for automated planning.