Abstract

Medical display systems are valuable tools in enabling the clinicians in the field of radiation therapy to view a patient's multi-modal information and treatment plan details. The effectiveness of display systems is further improved by including computer-based visualization systems that deliver the content comprehensively. In this paper, we present a medical display and visualization framework for radiation therapy that couples a computer-based simulation of real-time lung tumor motion and its dose accumulation during treatment with an Augmented Reality Center (ARC) based display system. The simulation framework provides insights on the variations in the effectiveness of the lung therapy for changes in the patient's breathing conditions. The display system aims to enhance the clinician's understanding by enhancing the 3D depth perception of the dose accumulation in lung tumors. Thus the framework acts as a tool for presenting both pre-operative studies and intra-operative treatment efficacy analysis when coupled with a real-time respiration monitor. A first evaluation of this framework was carried out using six clinical experts. Results show that, using the ARC compared to a 2D monitor, the experts were able to more efficiently perceive the radiation dose delivered to various aspects of the moving tumor and the surrounding normal tissues, as well as more quickly detecting radiation hot spots that are critical to minimizing damage to healthy tissue.

© 2008 IEEE

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  1. J. P. Rolland, F. Biocca, F. Hamza-lup, Y. Ha, R. Martins, "Development of head-mounted projection displays for distributed collaborative augmented reality applications," Presence: SI Immersive Projection Technol. 14, 528-549 (2005).
  2. M. van Herk, "Errors and margins in radiotherapy," Seminaire on Radiation Oncol. 14, 52-64 (2004).
  3. D. A. Low, M. Nystrom, E. Kalinin, P. Parikh, "A method for the re-construction of four dimensional synchronized CT scans acquired during free breathing," Med. Phys. 30, 1254-1263 (2003).
  4. D. A. Low, P. J. Parikh, W. Lu, J. F. Dempsey, S. H. Wahab, J. P. Hubenschmidt, M. M. Nystrom, M. Handoko, J. D. Bradley, "Novel breathing motion model for radiotherapy," Int. J. Rad. Oncol Biol. Phys. 63, 921-929 (2005).
  5. W. Lu, K. J. Ruchala, M.-L. Chen, Q. Chen, G. Olivera, "Real-time respiration monitoring using the radiotherapy treatment beam and four dimensional computed tomography (4DCT)—A conceptual study," Phys. in Medicine and Biol. 51, 4469-4495 (2006).
  6. I. J. Chetty, M. Rosu, N. Tyagi, L. H. Marsh, D. L. McShan, J. M. Balter, B. A. Fraass, R. K. Ten Haken, "A fluence convolution method to account for respiratory motion in three-dimensional dose calculations of the liver: A Monte Carlo study," Med. Phys. 30, 1776-1780 (2003).
  7. P. J. Keall, G. S. Mageras, J. M. Balter, R. S. Emery, K. M. Forster, S. B. Jiang, J. M. Kapatoes, D. A. Low, M. J. Murphy, B. R. Murray, C. R. Ramsey, M. B. Van Herk, S. S. Vedam, J. W. Wong, E. Yorke, "The management of respiratory motion in radiation oncology report of AAPM Task Group 76," Med. Phys. 33, 3874-3900 (2006).
  8. T. Pan, T. Y. Lee, E. Rietzel, G. T. Chen, "4D-CT imaging of a volume influenced by respiratory motion on multi-slice CT," Med. Phys. 31, 333-340 (2004).
  9. M. Schaefer, M. W. Munter, C. Thilmann, F. Sterzing, P. Haering, S. E. Combs, J. Debus, "Influence of intra-fractional breathing movement in step-and-shoot IMRT," Phys. in Medicine and Biol. 49, N175-N179 (2004).
  10. S. A. Naqvi, W. D. D'Souza, "A stochastic convolution/superposition method with isocenter sampling to evaluate intrafraction motion effects in IMRT," Med. Phys. 32, 1156-1163 (2005).
  11. W. D. D'Souza, S. A. Naqvi, C. X. Yu, "Real-time intra-fraction-motion tracking using the treatment couch: A feasibility study," Phys. in Medicine and Biol. 50, 4021-4033 (2005).
  12. B. Kanagaki, P. W. Read, J. A. Molloy, J. M. Larner, K. Sheng, "A motion phantom study on helical tomotherapy: The dosimetric impacts of delivery technique and motion," Phys. in Medicine and Biol. 52, 243-255 (2007).
  13. R. Kashani, K. Lam, D. Litzenberg, J. M. Balter, "Technical note: A deformable phantom for dynamic modeling in radiation therapy," Med. Phys. 34, 199-201 (2007).
  14. J. Geng, "Volumetric 3D display radiation therapy planning," IEEE J. Display Technol. 4, (2008).
  15. O. Cakmakci, J. P. Rolland, "Head-worn display," IEEE J. Display Technol. 2, 199-216 (2006).
  16. J. P. Rolland, O. Cakmakci, J. Covelli, C. Fidopiastis, F. Fournier, R. Martins, F. Hamza-lup, D. Nicholson, "Beyond the desktop: Emerging technologies for supporting 3D colloborative teams," Int. J. Interact. Des. Manuf. 4, 239-241 (2007).
  17. F. Hamza-lup, A. Santhanam, C. Imielinska, S. L. Meeks, J. P. Rolland, "Distributed augmented reality with 3D lung models—A planning tool concept," IEEE Trans. Inf. Technol. Biomed. 11, 40-46 (2007).
  18. O. Cakmakci, J. P. Rolland, "Design and fabrication of a dual-element off-axis near-eye optical magnifier," Opt. Lett. 32, 1363-1365 (2007).
  19. A. Santhanam, S. P. Mudur, J. P. Rolland, "An inverse 3D lung deformation analysis for medical visualization," IEEE Computer Graphics Soc. Computer Animation and Social Agents (CASA) (2006) pp. 229-242.
  20. A. Santhanam, C. Imielinska, P. Davenport, P. Kupelian, J. P. Rolland, "Modeling and simulation of real-time 3D lung dynamics," IEEE Trans. Inf. Technol. Biomed. 12, 257-270 (2008).
  21. A. Santhanam, Modeling Simulation and Visualization of 3D Lung Dynamics PhD Dissertation College of engineering and computer science Univ. Central FloridaOrlando (2006).
  22. D. H. Griffel, Applied Functional Analysis (Dover , 2002).
  23. J. P. Rolland, F. Hamza-lup, L. Davis, J. Daly, Y. Ha, G. Martin, J. Norfleet, R. Thumann, C. Imielinska, "Development of a training tool for endotracheal intubation: Distributed augmented reality," Medicine Meets Virtual Reality (2003) pp. 288-294.
  24. A. Rodriguez, M. Foglia, J. P. Rolland, "Embedded training display technology for the army's future combat vehicles," Proc. 24th Army Sci. Conf. (2003) pp. 1-6.
  25. J. P. Rolland, F. Biocca, H. Hua, Y. Ha, C. Gao, O. Harryson, Virtual and Augmented Reality Applications in Manufacturing (Springer-Verlag, 2004) pp. 179-200.

2008

J. Geng, "Volumetric 3D display radiation therapy planning," IEEE J. Display Technol. 4, (2008).

A. Santhanam, C. Imielinska, P. Davenport, P. Kupelian, J. P. Rolland, "Modeling and simulation of real-time 3D lung dynamics," IEEE Trans. Inf. Technol. Biomed. 12, 257-270 (2008).

2007

O. Cakmakci, J. P. Rolland, "Design and fabrication of a dual-element off-axis near-eye optical magnifier," Opt. Lett. 32, 1363-1365 (2007).

J. P. Rolland, O. Cakmakci, J. Covelli, C. Fidopiastis, F. Fournier, R. Martins, F. Hamza-lup, D. Nicholson, "Beyond the desktop: Emerging technologies for supporting 3D colloborative teams," Int. J. Interact. Des. Manuf. 4, 239-241 (2007).

F. Hamza-lup, A. Santhanam, C. Imielinska, S. L. Meeks, J. P. Rolland, "Distributed augmented reality with 3D lung models—A planning tool concept," IEEE Trans. Inf. Technol. Biomed. 11, 40-46 (2007).

B. Kanagaki, P. W. Read, J. A. Molloy, J. M. Larner, K. Sheng, "A motion phantom study on helical tomotherapy: The dosimetric impacts of delivery technique and motion," Phys. in Medicine and Biol. 52, 243-255 (2007).

R. Kashani, K. Lam, D. Litzenberg, J. M. Balter, "Technical note: A deformable phantom for dynamic modeling in radiation therapy," Med. Phys. 34, 199-201 (2007).

2006

O. Cakmakci, J. P. Rolland, "Head-worn display," IEEE J. Display Technol. 2, 199-216 (2006).

W. Lu, K. J. Ruchala, M.-L. Chen, Q. Chen, G. Olivera, "Real-time respiration monitoring using the radiotherapy treatment beam and four dimensional computed tomography (4DCT)—A conceptual study," Phys. in Medicine and Biol. 51, 4469-4495 (2006).

P. J. Keall, G. S. Mageras, J. M. Balter, R. S. Emery, K. M. Forster, S. B. Jiang, J. M. Kapatoes, D. A. Low, M. J. Murphy, B. R. Murray, C. R. Ramsey, M. B. Van Herk, S. S. Vedam, J. W. Wong, E. Yorke, "The management of respiratory motion in radiation oncology report of AAPM Task Group 76," Med. Phys. 33, 3874-3900 (2006).

2005

S. A. Naqvi, W. D. D'Souza, "A stochastic convolution/superposition method with isocenter sampling to evaluate intrafraction motion effects in IMRT," Med. Phys. 32, 1156-1163 (2005).

W. D. D'Souza, S. A. Naqvi, C. X. Yu, "Real-time intra-fraction-motion tracking using the treatment couch: A feasibility study," Phys. in Medicine and Biol. 50, 4021-4033 (2005).

J. P. Rolland, F. Biocca, F. Hamza-lup, Y. Ha, R. Martins, "Development of head-mounted projection displays for distributed collaborative augmented reality applications," Presence: SI Immersive Projection Technol. 14, 528-549 (2005).

D. A. Low, P. J. Parikh, W. Lu, J. F. Dempsey, S. H. Wahab, J. P. Hubenschmidt, M. M. Nystrom, M. Handoko, J. D. Bradley, "Novel breathing motion model for radiotherapy," Int. J. Rad. Oncol Biol. Phys. 63, 921-929 (2005).

2004

M. van Herk, "Errors and margins in radiotherapy," Seminaire on Radiation Oncol. 14, 52-64 (2004).

T. Pan, T. Y. Lee, E. Rietzel, G. T. Chen, "4D-CT imaging of a volume influenced by respiratory motion on multi-slice CT," Med. Phys. 31, 333-340 (2004).

M. Schaefer, M. W. Munter, C. Thilmann, F. Sterzing, P. Haering, S. E. Combs, J. Debus, "Influence of intra-fractional breathing movement in step-and-shoot IMRT," Phys. in Medicine and Biol. 49, N175-N179 (2004).

2003

D. A. Low, M. Nystrom, E. Kalinin, P. Parikh, "A method for the re-construction of four dimensional synchronized CT scans acquired during free breathing," Med. Phys. 30, 1254-1263 (2003).

I. J. Chetty, M. Rosu, N. Tyagi, L. H. Marsh, D. L. McShan, J. M. Balter, B. A. Fraass, R. K. Ten Haken, "A fluence convolution method to account for respiratory motion in three-dimensional dose calculations of the liver: A Monte Carlo study," Med. Phys. 30, 1776-1780 (2003).

IEEE J. Display Technol.

J. Geng, "Volumetric 3D display radiation therapy planning," IEEE J. Display Technol. 4, (2008).

O. Cakmakci, J. P. Rolland, "Head-worn display," IEEE J. Display Technol. 2, 199-216 (2006).

IEEE Trans. Inf. Technol. Biomed.

F. Hamza-lup, A. Santhanam, C. Imielinska, S. L. Meeks, J. P. Rolland, "Distributed augmented reality with 3D lung models—A planning tool concept," IEEE Trans. Inf. Technol. Biomed. 11, 40-46 (2007).

A. Santhanam, C. Imielinska, P. Davenport, P. Kupelian, J. P. Rolland, "Modeling and simulation of real-time 3D lung dynamics," IEEE Trans. Inf. Technol. Biomed. 12, 257-270 (2008).

Int. J. Interact. Des. Manuf.

J. P. Rolland, O. Cakmakci, J. Covelli, C. Fidopiastis, F. Fournier, R. Martins, F. Hamza-lup, D. Nicholson, "Beyond the desktop: Emerging technologies for supporting 3D colloborative teams," Int. J. Interact. Des. Manuf. 4, 239-241 (2007).

Int. J. Rad. Oncol Biol. Phys.

D. A. Low, P. J. Parikh, W. Lu, J. F. Dempsey, S. H. Wahab, J. P. Hubenschmidt, M. M. Nystrom, M. Handoko, J. D. Bradley, "Novel breathing motion model for radiotherapy," Int. J. Rad. Oncol Biol. Phys. 63, 921-929 (2005).

Med. Phys.

I. J. Chetty, M. Rosu, N. Tyagi, L. H. Marsh, D. L. McShan, J. M. Balter, B. A. Fraass, R. K. Ten Haken, "A fluence convolution method to account for respiratory motion in three-dimensional dose calculations of the liver: A Monte Carlo study," Med. Phys. 30, 1776-1780 (2003).

P. J. Keall, G. S. Mageras, J. M. Balter, R. S. Emery, K. M. Forster, S. B. Jiang, J. M. Kapatoes, D. A. Low, M. J. Murphy, B. R. Murray, C. R. Ramsey, M. B. Van Herk, S. S. Vedam, J. W. Wong, E. Yorke, "The management of respiratory motion in radiation oncology report of AAPM Task Group 76," Med. Phys. 33, 3874-3900 (2006).

T. Pan, T. Y. Lee, E. Rietzel, G. T. Chen, "4D-CT imaging of a volume influenced by respiratory motion on multi-slice CT," Med. Phys. 31, 333-340 (2004).

S. A. Naqvi, W. D. D'Souza, "A stochastic convolution/superposition method with isocenter sampling to evaluate intrafraction motion effects in IMRT," Med. Phys. 32, 1156-1163 (2005).

D. A. Low, M. Nystrom, E. Kalinin, P. Parikh, "A method for the re-construction of four dimensional synchronized CT scans acquired during free breathing," Med. Phys. 30, 1254-1263 (2003).

R. Kashani, K. Lam, D. Litzenberg, J. M. Balter, "Technical note: A deformable phantom for dynamic modeling in radiation therapy," Med. Phys. 34, 199-201 (2007).

Opt. Lett.

Phys. in Medicine and Biol.

W. D. D'Souza, S. A. Naqvi, C. X. Yu, "Real-time intra-fraction-motion tracking using the treatment couch: A feasibility study," Phys. in Medicine and Biol. 50, 4021-4033 (2005).

B. Kanagaki, P. W. Read, J. A. Molloy, J. M. Larner, K. Sheng, "A motion phantom study on helical tomotherapy: The dosimetric impacts of delivery technique and motion," Phys. in Medicine and Biol. 52, 243-255 (2007).

M. Schaefer, M. W. Munter, C. Thilmann, F. Sterzing, P. Haering, S. E. Combs, J. Debus, "Influence of intra-fractional breathing movement in step-and-shoot IMRT," Phys. in Medicine and Biol. 49, N175-N179 (2004).

W. Lu, K. J. Ruchala, M.-L. Chen, Q. Chen, G. Olivera, "Real-time respiration monitoring using the radiotherapy treatment beam and four dimensional computed tomography (4DCT)—A conceptual study," Phys. in Medicine and Biol. 51, 4469-4495 (2006).

Presence: SI Immersive Projection Technol.

J. P. Rolland, F. Biocca, F. Hamza-lup, Y. Ha, R. Martins, "Development of head-mounted projection displays for distributed collaborative augmented reality applications," Presence: SI Immersive Projection Technol. 14, 528-549 (2005).

Seminaire on Radiation Oncol.

M. van Herk, "Errors and margins in radiotherapy," Seminaire on Radiation Oncol. 14, 52-64 (2004).

Other

A. Santhanam, S. P. Mudur, J. P. Rolland, "An inverse 3D lung deformation analysis for medical visualization," IEEE Computer Graphics Soc. Computer Animation and Social Agents (CASA) (2006) pp. 229-242.

A. Santhanam, Modeling Simulation and Visualization of 3D Lung Dynamics PhD Dissertation College of engineering and computer science Univ. Central FloridaOrlando (2006).

D. H. Griffel, Applied Functional Analysis (Dover , 2002).

J. P. Rolland, F. Hamza-lup, L. Davis, J. Daly, Y. Ha, G. Martin, J. Norfleet, R. Thumann, C. Imielinska, "Development of a training tool for endotracheal intubation: Distributed augmented reality," Medicine Meets Virtual Reality (2003) pp. 288-294.

A. Rodriguez, M. Foglia, J. P. Rolland, "Embedded training display technology for the army's future combat vehicles," Proc. 24th Army Sci. Conf. (2003) pp. 1-6.

J. P. Rolland, F. Biocca, H. Hua, Y. Ha, C. Gao, O. Harryson, Virtual and Augmented Reality Applications in Manufacturing (Springer-Verlag, 2004) pp. 179-200.

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