Comparison of setup accuracy and intrafraction motion using stereotactic frame versus 3-point thermoplastic mask-based immobilization for fractionated cranial image guided radiation therapy

Rosenfelder, N.; Corsini, L.; McNair, Helen; Pennert, Kjell; Aitken, A.; Lamb, C.; Long, Michelle; Clarke, Enrico; Murcia, M.; Schick, Ulrike; Burke, K.; Ashley, S.; Khoo, Vincent; Brada, Michael

doi:10.1016/j.prro.2012.06.004

Cited by 14 publications

(12 citation statements)

References 18 publications

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“…This formulation was used in this study account for the rotational error in the set‐up margin calculation. This study is the first of its kind which accounts for the rotational error in the set‐up margin hence it is more robust than any other residual and (or) intrafraction set‐up error determination technique . Modern linear accelerators are equipped with the robotic couch, which offers six‐dimensional patient position corrections .…”

Section: Discussionmentioning

confidence: 99%

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Technical Note: Rotational positional error corrected intrafraction set‐up margins in stereotactic radiotherapy: A spatial assessment for coplanar and noncoplanar geometry

et al. 2019

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Purpose: The aim of this study is to calculate setup margin based on six-dimensional (6D) corrected residual positional errors from kV cone beam computed tomography (CBCT) and from intrafraction projection kV imaging in coplanar and in noncoplanar couch positions in stereotactic radiotherapy. Methods: Six dimensional positional corrections were carried out before patient treatments, using a robotic couch and CBCT matching. A CBCT and stereoscopic ExacTrac image were acquired posttable position correction. Further, a series of intrafraction ExacTrac images were obtained for the variable couch position. Translational and rotational errors were identified as lateral (X), longitudinal (Y), vertical (Z); roll (Ɵ°), pitch (Φ°) and yaw (Ψ°). A total of 699 intrafraction image sets (361 coplanar and 338 noncoplanar) for 51 SRS/SRT patients were analysed. Rotational errors were corrected in terms of translational coordinates. Residual set-up margins were calculated from CBCT shifts. ExacTrac shifts give residual + intrafraction setup margins as a function of coplanar and noncoplanar couch positions. Results: The average residual positional error obtained from CBCT in X, Y, Z, Ɵ, Φ, Ψ were 0.1 AE 0.4 mm, 0.0 AE 0.6 mm, 0.0 AE 0.5 mm, 0.2 AE 0.8°, 0.1 AE 0.6°and À0.1 AE 0.7°respectively. For ExacTrac, the shits were À0.5 AE 0.9 mm, À0.0 AE 1mm, À0.6 AE 1.0mm, 0.4 AE 0.9°, À0.2 AE 0.6°, and À0.0 AE 0.8°.CBCT calculated linear setup margins in X, Y, Z direction were 0.5, 1.2, and 1 mm respectively. ExacTrac yielded coplanar and noncoplanar linear setup margins were 1.2, 1.3, 1.5, 1.4, 1.5, and 2.1 mm respectively. Conclusion: CBCT-based gross residual set-up margin is equal to 1 mm. ExacTrac calculated residual plus intrafraction setup margin falls within a 2 mm range; attributed to intrafraction patient movement, table position inaccuracies, and poor image fusion in noncoplanar geometry. There could be variations in the required additional margin between centers and between machines, which require further studies.

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Section: Discussionmentioning

confidence: 99%

“…Several research groups have tried to calculate the intrafraction set‐up error for different sites using different imaging modalities . Intrafraction positional errors have been calculated using CBCT 12,29,30 stereoscopic x‐ray imaging like ExacTrac, Cyberknife (CK) imaging Synchrony, and surface guidance .…”

Section: Introductionmentioning

confidence: 99%

Technical Note: Rotational positional error corrected intrafraction set‐up margins in stereotactic radiotherapy: A spatial assessment for coplanar and noncoplanar geometry

et al. 2019

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“…Several researchers reported the positional errors of frameless radiosurgery of intracranial lesions. Rosenfelder et al [ 13 ] prospectively investigated the uncertainties using frame-based immobilization and TM. They concluded that fixation using TM with daily online correction provides similar uncertainty compared with frame-based immobilization.…”

Section: Discussionmentioning

confidence: 99%

Positional uncertainties of cervical and upper thoracic spine in stereotactic body radiotherapy with thermoplastic mask immobilization

Jeon

Kim

2018

Radiat Oncol J

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PurposeTo investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization.Materials and MethodsA total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration.ResultsThe three-dimensional (3D) magnitudes of translational uncertainties (mean ± 2 standard deviation) were 3.7±3.5 mm (SE), 0.9±0.9 mm (preRE), 1.2±1.5 mm (postRE), 1.4±2.4 mm (IM1), and 0.9±1.0 mm (IM2), and average angular differences were 1.1°±1.2° (SE), 0.9°±1.1° (preRE), 0.9°±1.1° (postRE), 0.6°±0.9° (IM1), and 0.5°±0.5° (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test).ConclusionIn spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

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“…A follow-up from this study also showed that the incidence of post-treatment gastrostomy dependence and oesophageal stricture was lower with reduced margins. 44 These results are reflected in a number of other dosimetric studies which have found that without daily IGRT, PTV margins need to be larger to account for set-up errors [45][46][47][48][49][50] and that the improved setup accuracy with IGRT can potentially lead to improved sparing of normal tissue structures. 51 Frequent volumetric imaging also allows for the detection of soft tissue changes during treatment.…”

Section: Igrt For Head and Neck Cancersmentioning

confidence: 99%

Faculty of Radiation Oncology Position Paper on the use of Image–Guided Radiation Therapy

et al. 2016

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The development of technology such as intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT) and stereotactic ablative body radiotherapy (SABR) has resulted in highly conformal radiotherapy treatments. While such technology has allowed for improved dose delivery, it has also meant that improved accuracy in the treatment room is required. Image-guided radiotherapy (IGRT), the use of imaging prior to or during treatment delivery, has been shown to improve the accuracy of treatment delivery and in some circumstances, clinical outcomes. Allied with the adoption of highly conformal treatments, there is a need for stringent quality assurance processes in a multidisciplinary environment. In 2015, the Royal Australian and New Zealand College of Radiologist (RANZCR) updated its position paper on IGRT. The draft document was distributed through the membership of the Faculty of Radiation Oncology (FRO) for review and the final version was endorsed by the board of FRO. This article describes issues that radiotherapy departments throughout Australia and New Zealand should consider. It outlines the role of IGRT and reviews current clinical evidence supporting the benefit of IGRT in genitourinary, head and neck, and lung cancers. It also highlights important international publications which provide guidance on implementation and quality assurances for IGRT. A set of key recommendations are provided to guide safe and effective IGRT implementation and practice in the Australian and New Zealander context.

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Comparison of setup accuracy and intrafraction motion using stereotactic frame versus 3-point thermoplastic mask-based immobilization for fractionated cranial image guided radiation therapy

Cited by 14 publications

References 18 publications

Technical Note: Rotational positional error corrected intrafraction set‐up margins in stereotactic radiotherapy: A spatial assessment for coplanar and noncoplanar geometry

Technical Note: Rotational positional error corrected intrafraction set‐up margins in stereotactic radiotherapy: A spatial assessment for coplanar and noncoplanar geometry

Positional uncertainties of cervical and upper thoracic spine in stereotactic body radiotherapy with thermoplastic mask immobilization

Faculty of Radiation Oncology Position Paper on the use of Image–Guided Radiation Therapy

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