Image-Guided Stereotactic Body Radiotherapy for Lung Tumors Using BodyLoc With Tomotherapy: Clinical Implementation and Set-Up Accuracy

Zhou, Jining; Uhl, Barry M.; DeWitt, Kelly D.; Young, Mark; Taylor, Brian; Fei, Ding-Yu; Lo, Yeh-Chi

doi:10.1016/j.meddos.2008.12.003

Cited by 15 publications

(15 citation statements)

References 22 publications

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“…Multiple studies have reported on the uncertainty of target localization 14 , 28 , 45 , 46 and of immobilization systems 14 , 30 for T&A using CBCT image guidance. A number of common factors may affect the setup error in T&A treatment, which includes internal respiratory motion, patient movement, tumor location, tumor shrinkage, registration technique, and the use of different immobilization systems.…”

Section: Discussionmentioning

confidence: 99%

“…However, acquisition of CBCT images is a time‐consuming process compared to the acquisition of conventional, two‐dimensional (2D) portal imaging scans, and the total time needed for IMRT treatment including setup, pretreatment CBCT, repositioning, verification, and beam delivery is approximately 60 minutes (30) . The prolonged treatment time may increase patient setup errors and intrafractional variations (31) …”

Section: Introductionmentioning

confidence: 99%

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Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Baek

Kim

et al. 2014

J Applied Clin Med Phys

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The aim of this study was assess the patient setup errors for various tumor sites based on clinical data from a sufficient number of treatments with volumetric‐modulated arc therapy (VMAT) using daily pretreatment CBCT imaging guidance. In addition, we calculated and compared the planning target volume (PTV) margins for all disease sites based on an analysis of specific systematic and random errors in our institution. All patients underwent pretreatment kV‐CBCT imaging. The various tumor sites were divided into four categories; 21 brain (438 fractions), 35 head‐and‐neck tumors (H&N, 933 fractions), 19 thorax and abdomen tumors (T&A, 313 fractions), and 17 prostate cancer tumors (546 fractions). Overall distributions of setup corrections in all directions, frequencies of 3D vector lengths, institution‐specific setup error, and PTV margins were analyzed. The longitudinal distribution for the T&A site represented an asymmetric offset in the negative direction. Rotational distributions were comparable for all treatment sites, and the prostate site had the narrowest distribution of ≤±2∘. The cumulative frequencies of 3D vector length of ≥ 7 mm were rare for brain lesions and H&N, but more common for T&A and prostate lesions at 25.6% and 12.1%, respectively. The overall mean error for all treatment sites were within ±1 mm and ±0.1∘, with the exception of the T&A site, which had overall mean error of 2 mm in the negative longitudinal direction. The largest magnitude of systematic error and random error for the brain lesions and H&N was 1.4 mm in the translational directions, and 3.3 mm for T&A and prostate lesions. The PTV margins required in this analysis are ≤ 4 mm for the brain lesions and H&N in all translational directions, but ranged from 4 to 10 mm for T&A and prostate lesions. Analysis of each institution's specific setup errors using daily CBCT is essential for determining PTV margins and reducing setup uncertainties, because setup errors vary according to each immobilization system and patient.PACS number: 87.55.km

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Baek

Kim

et al. 2014

J Applied Clin Med Phys

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“…Several studies have reported on the accuracy of stereotactic frames and patient setup uncertainties with various forms of image guidance. 4,6,9,10 In our institution, we have previously reported our SBRT experience using a BodyFIX (Elekta, Stockholm, Sweden) immobilization system for a study of 36 patients and showed a mean displacement vector of 5.7 Ϯ 3.7 mm. 4 Specifically with TomoTherapy, Hodge et al reported using the BodyFIX immobilization system in conjunction with the MVCT image guidance of TomoTherapy in 9 SBRT patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of an Immbolization System for Stereotactic Body Radiotherapy Using Helical Tomotherapy

et al. 2011

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“…The intrafractional setup error is defined as displacement of distance of the patient trunk during the irradiation therapy. Historically, various rigid immobilization devices were introduced to stabilize the patient on the treatment coach during lung SRT [1–2], which eventually minimizes intrafractional setup errors. However, rigid immobilization devices tend to be costly, to cause pain to the patients, and to limit patient respiration.…”

Section: Introductionmentioning

confidence: 99%

“…Most of them provide quality assurance, shorten treatment time, and increase safety and consistency [2–3]. With the respiration-synchronizing device, controlling target movement during irradiation is achieved by breath-holding.…”

Section: Introductionmentioning

confidence: 99%

Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors

Watanabe

Oda

Kuriyama

et al. 2013

Journal of Radiation Research

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Intrafractional setup errors during hypofractionated stereotactic radiotherapy (SRT) were investigated on the patient under voluntary breath-holding conditions with non-invasive immobilization on the CT-linac treatment table. A total of 30 patients with primary and metastatic lung tumors were treated with the hypofractionated SRT with a total dose of 48–60 Gy with four treatment fractions. The patient was placed supine and stabilized on the table with non-invasive patient fixation. Intrafractional setup errors in Right/Left (R.L.), Posterior/Anterior (P.A.), and Inferior/Superior (I.S.) dimensions were analyzed with pre- and post-irradiation CT images. The means and one standard deviation of the intrafractional errors were 0.9 ± 0.7mm (R.L.), 0.9 ± 0.7mm (P.A.) and 0.5 ± 1.0 mm (I.S.). Setup errors in each session of the treatment demonstrated no statistically significant difference in the mean value between any two sessions. The frequency within 3mm displacement was 98% in R.L., 98% in P.A. and 97% in I.S. directions. SRT under the non-invasive patient fixation immobilization system with a comparatively loose vacuum pillow demonstrated satisfactory reproducibility of minimal setup errors with voluntary breath-holding conditions that required a small internal margin.

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Image-Guided Stereotactic Body Radiotherapy for Lung Tumors Using BodyLoc With Tomotherapy: Clinical Implementation and Set-Up Accuracy

Cited by 15 publications

References 22 publications

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments

Clinical Evaluation of an Immbolization System for Stereotactic Body Radiotherapy Using Helical Tomotherapy

Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors

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