Sonography has good topographic accuracy for superficial lymph node assessment in patients with head and neck
cancers. It is therefore an ideal non-invasive tool for precise inter-fraction volumetric analysis of enlarged cervical
nodes. In addition, when registered with computed tomography (CT) images, ultrasound information may improve target
volume delineation and facilitate image-guided adaptive radiation therapy. A feasibility study was developed to evaluate
the use of a prototype ultrasound system capable of three dimensional visualization and multi-modality image fusion for
cervical node geometry. A ceiling-mounted optical tracking camera recorded the position and orientation of a transducer
in order to synchronize the transducer's position with respect to the room's coordinate system. Tracking systems were
installed in both the CT-simulator and radiation therapy treatment rooms. Serial images were collected at the time of
treatment planning and at subsequent treatment fractions. Volume reconstruction was performed by generating surfaces
around contours. The quality of the spatial reconstruction and semi-automatic segmentation was highly dependent on the
system's ability to track the transducer throughout each scan procedure. The ultrasound information provided enhanced
soft tissue contrast and facilitated node delineation. Manual segmentation was the preferred method to contour structures
due to their sonographic topography.
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