Design of a System for Target Localization and Tracking in Image-Guided Radiation Therapy

Abstract

This thesis contributes to the topic of image-based feature localization and tracking in fluoroscopic (2D x-ray) image sequences. Such tracking is needed to automatically measure organ motion in cancer patients treated with radiation therapy. While the use of 3D cone-beam computed tomography (CBCT) images is a standard clinical practice for verifying the agreement of the patient's position to a plan, it is done before the treatment procedure. Hence, measurement of the motion during the procedure could improve plan design and the accuracy of treatment delivery. Using an existing CBCT imaging system is one way of collecting fluoroscopic sequences for such analysis. Since x-ray images of soft tissues are typically characterized with low contrast and high noise, radio-opaque fiducial markers are often inserted in or around the target. This thesis describes techniques that comprise a complete system for automated detection and tracking of the markers in fluoroscopic image sequences.

One of the cornerstone design ideas in this thesis is the use of the 3D CBCT image of the patient, from which the markers can be extracted more easily, to initialize the tracking in the fluoroscopic image sequences. To do this, a specific marker-based image registration framework was proposed. It includes multiple novel techniques, such as marker segmentation and modelling, the marker enhancement filter, and marker-specific template image generation approaches.

Through extensive experiments on testing data sets, these novel techniques were combined with appropriate state-of-the-art methods to produce a sleek, computationally efficient, fully automated system that achieved reliable marker localization and tracking. The accuracy of the system is sufficient for clinical implementation. The thesis demonstrates an application of the system to the images of prostate cancer patients, and includes examples of statistical analysis of organ motion that can be used to improve treatment planning.