Physical aspects of a real-time tumor-tracking system for gated radiotherapy

Shirato, Hiroki; Shimizu, Satoru; Kunieda, Tatsuya; Kitamura, Kei; Herk, Marcel van; Kagei, Kenji; Nishioka, Takeshi; Hashimoto, S; Fujita, Katsuhisa; Aoyama, Hidefumi; Tsuchiya, Kunihiko; Kudo, Kohsuke; Miyasaka, Kazuo

doi:10.1016/s0360-3016(00)00748-3

Cited by 602 publications

(471 citation statements)

References 23 publications

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“…Our method using fiducial markers and two sets of fluoroscopy was also shown to be useful to reduce set-up error compared to the skin-based setting (5,13,15). In this study, we focused on intra-fraction displacement according to treatment time, from the beginning of each treatment session after the daily set-up procedure was finished.…”

Section: Discussionmentioning

confidence: 99%

“…The marker position is transferred from 3DRTP and superimposed on the fluoroscopic image on the display unit of the RTRT system. Details of the calculation of the parallel and rotational set-up error have already been reported (15). In short, the position of the patient can be corrected by adjusting the patient table position by a remote-control bar on the treatment console.…”

Section: Methodsmentioning

confidence: 99%

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Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Shimizu

Osaka

Shinohara

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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Purpose: Interportal adjustment was applied to patients with prostate cancer using three fiducial markers and two sets of fluoroscopy in a real-time tumor-tracking radiotherapy (RTRT) system. The incidence of table position adjustment required to keep intrafractional uncertainty within 2.0 mm was investigated in this study. Methods and Materials:The coordinates of the center of gravity of the three fiducial markers were measured at the start of every portal irradiation in intensity-modulated radiotherapy (IMRT) with seven ports. The table position was adjusted to the planned position if the discrepancy was larger than 2.0 mm in the anterior-posterior (AP), cranio-caudal (CC), or left-right (LR) directions. In total, we analyzed 4541 observations in 20 patients who received 70 Gy in 30 fractions (7.6 times a day in average). Results:The incidence of table position adjustment at 10 minutes from the initial set-up of each treatment was 14.2%, 12.3%, and 5.0% of the observations in the AP, CC, and LR directions, respectively. The accumulated incidence of the table position adjustment was significantly higher at 10 minutes compared to that at 2 minutes for AP (p=0.0033) and CC (p=0.0110) but not LR (p=0.4296). An adjustment greater than 5 mm was required at least once in the treatment period in 11 (55%) patients. Conclusions:Interportal adjustment of table position was required in more than 10% of portal irradiations during the 10-minute period after initial set-up to maintain treatment accuracy within 2.0 mm.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Shimizu

Osaka

Shinohara

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…One of the options is to control for tumour motion with respiration, and two main strategies to achieve this exist. Tumour motion can be unrestricted and monitored, with delivery of RT gated to a pre-defined phase of the respiratory cycle [13][14][15] or following the moving tumour [16]. Alternatively motion can be Brock 5 minimized by planning and treating in passive [17][18][19][20][21] or active [22,23] breathhold.…”

Section: Introductionmentioning

confidence: 99%

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Brock

McNair

Panakis

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…TrueBeam is a new linear accelerator (linac) model that has the capacity to deliver both traditional flattened (FF) photon beams and flattening filter‐free (FFF) photon beams. The concepts of SyncTraX are almost the same as those of the previous Mitsubishi‐developed RTRT system (Mitsubishi Electronics Co., Ltd., Tokyo, Japan) (11) . This system consists of two color image intensifiers (I.I.s) and X‐ray tubes.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a combined respiratory‐gating system comprising the TrueBeam linear accelerator and a new real‐time tumor‐tracking radiotherapy system: a preliminary study

Shiinoki

Kawamura

Uehara

et al. 2016

J Applied Clin Med Phys

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A combined system comprising the TrueBeam linear accelerator and a new real‐time, tumor‐tracking radiotherapy system, SyncTraX, was installed in our institution. The goals of this study were to assess the capability of SyncTraX in measuring the position of a fiducial marker using color fluoroscopic images, and to evaluate the dosimetric and geometric accuracy of respiratory‐gated radiotherapy using this combined system for the simple geometry. For the fundamental evaluation of respiratory‐gated radiotherapy using SyncTraX, the following were performed: 1) determination of dosimetric and positional characteristics of sinusoidal patterns using a motor‐driven base for several gating windows; 2) measurement of time delay using an oscilloscope; 3) positional verification of sinusoidal patterns and the pattern in the case of a lung cancer patient; 4) measurement of the half‐value layer (HVL in mm AL), effective kVp, and air kerma, using a solid‐state detector for each fluoroscopic condition, to determine the patient dose. The dose profile in a moving phantom with gated radiotherapy having a gating window ≤4 mm was in good agreement with that under static conditions for each photon beam. The total time delay between TrueBeam and SyncTraX was <227 ms for each photon beam. The mean of the positional tracking error was <0.4 mm for sinusoidal patterns and for the pattern in the case of a lung cancer patient. The air‐kerma rates from one fluoroscopy direction were 1.93±0.01, 2.86±0.01, 3.92±0.04, 5.28±0.03, and 6.60±0.05 mGy/min for 70, 80, 90, 100, and 110 kV X‐ray beams at 80 mA, respectively. The combined system comprising TrueBeam and SyncTraX could track the motion of the fiducial marker and control radiation delivery with reasonable accuracy; therefore, this system provides significant dosimetric improvement. However, patient exposure dose from fluoroscopy was not clinically negligible.PACS number(s): 87.53.Bn, 87.55.km, 87.55.Qr

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Physical aspects of a real-time tumor-tracking system for gated radiotherapy

Cited by 602 publications

References 23 publications

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Evaluation of a combined respiratory‐gating system comprising the TrueBeam linear accelerator and a new real‐time tumor‐tracking radiotherapy system: a preliminary study

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