Objective: This study is conducted to explore the development of a noninvasive and nonradiative guided radiotherapy positioning system based on augmented reality (AR) technology to increase positioning accuracy and completely eradicate positioning errors.Method: The development system includes three monitors and supporting equipment. The 3D virtual model is obtained by 3D reconstruction of the radiotherapy plan data set and is superimposed on the correct treatment position of the real treatment environment by using augmented reality production software. This approach provides the standard for the patient's positioning and guides the patient. The position of the patient then coincides with the 3D virtual model through the visual image method, and positioning error of the radiotherapy position is reduced.Results: A total of nine cases are included in this study, namely, three patients who require head and neck radiotherapy and six patients who require chest and abdomen radiotherapy. According to experimental results, no statistical difference exists between AR-guided positioning and manual positioning for patients requiring head and neck radiotherapy. However, AR-guided positioning can keep errors of x-axis, y-axis and z-axis within small ranges, such as -0.092–0.072, -0.052–0.228, and -0.192–0.05 cm, respectively. For patients requiring chest and abdomen radiotherapy, AR-guided positioning is not statistically different from manual positioning on the x-axis, but statistical differences were found on the y-axis and z-axis. The errors of AR-guided positioning on y-axis and z-axis are much smaller than those of manual positioning.Conclusions: The AR visual image guided radiotherapy set-up system can increase radiotherapy positioning accuracy well, especially for patients requiring chest and abdomen radiotherapy.
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