Real-time dual energy markerless monitoring of lung tumors using a clinical room-mounted stereoscopic and monoscopic x-ray imaging system

Abstract

This thesis develops real-time dual-energy markerless imaging technology to monitor lung tumor motion using a clinical room-mounted x-ray imaging system to enhance radiotherapy precision. The first chapter introduces the fundamentals of x-ray production, interactions, and imaging system, providing a comprehensive review of x-ray tubes, detectors, and the imaging process.

The second chapter presents a detailed research manuscript focusing on the development of a novel dual-energy tumor localization technique for real-time applications. This work addresses the critical challenge of x-ray beam obstruction by rotating gantries in room-mounted stereoscopic imaging systems. It employs a Gaussian probability density function approach to estimate the 3D position of lung tumors using limited 2D information from single x-ray views, enhancing localization accuracy. The chapter thoroughly discusses the methodologies, experimental findings, and clinical implications, demonstrating that dual-energy imaging improves tumor monitoring success rates, particularly for smaller tumors and in situations where bone obstructions are present. It also explores the integration of other motion prediction algorithms such as the Kalman filter and the application of epipolar constraints to improve 3D localization accuracy.

The final chapter summarizes the key results of the research, re-emphasizing the potential clinical benefits of the developing technique in reducing planning margins and minimizing the treatment of healthy tissues. It also outlines suggested avenues for future research, including immediate next steps based on the findings of the manuscript. Future work involves considering the clinical implementation of the techniques developed in this thesis. This thesis aims to contribute to the advancement of precision radiotherapy by providing a robust technique for real-time, markerless lung tumor monitoring.