Reproducibility of patient setup by surface image registration system in conformal radiotherapy of prostate cancer

Krengli, Marco; Gaiano, Simone; Monès, E.; Ballarè, Andrea; Beldì, Debora; Bolchini, Cesare; Loi, G.

doi:10.1186/1748-717x-4-9

Cited by 57 publications

(48 citation statements)

References 14 publications

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“…Surface imaging is capable of providing full 3D monitoring of patient position in near real time. The commercially available AlignRT (VisionRT, London, UK) 3D surface imaging system has shown the abilities to detect submillimeter changes in patient position 10 , 12 , 13 , 14 , 15 , 16 , 17 and to accurately localize breast patients for free breathing 18 , 19 , 20 , 21 and deep inspiration breath‐hold treatments 22 , 23 to better than 5 mm. These works have shown that AlignRT is capable of accurately and reproducibly positioning breast tissue relative to treatment isocenter for initial patient positioning and, prior to beam‐on, for breath‐hold treatments.…”

Section: Introductionmentioning

confidence: 99%

Surface imaging‐based analysis of intrafraction motion for breast radiotherapy patients

Wiant

Wentworth

Mäurer

et al. 2014

J Applied Clin Med Phys

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Breast treatments are becoming increasingly complex as the use of modulated and partial breast therapies becomes more prevalent. These methods are predicated on accurate and precise positioning for treatment. However, the ability to quantify intrafraction motion has been limited by the excessive dose that would result from continuous X‐ray imaging throughout treatment. Recently, surface imaging has offered the opportunity to obtain 3D measurements of patient position throughout breast treatments without radiation exposure. Thirty free‐breathing breast patients were monitored with surface imaging for 831 monitoring sessions. Mean translations and rotations were calculated over each minute, each session, and over all sessions combined. The percentage of each session that the root mean squares (RMS) of the linear translations were outside of defined tolerances was determined for each patient. Correlations between mean translations per minute and time, and between standard deviation per minute and time, were evaluated using Pearson's r value. The mean RMS translation averaged over all patients was 2.39.15emmm±1.88.15emmm. The patients spent an average of 34%, 17%, 9%, and 5% of the monitoring time outside of 2 mm, 3 mm, 4 mm, and 5 mm RMS tolerances, respectively. The RMS values averaged over all patients were 2.71.15emmm±1.83.15emmm, 2.76±2.27, and 2.98.15emmm±2.30.15emmm over the 5th, 10th, and 15th minutes of monitoring, respectively. The RMS values (r=0.73,p=0) and standard deviations (r=0.88,p=0) over all patients showed strong significant correlations with time. We see that the majority of patients' treatment time is spent within 5 mm of the isocenter and that patient position drifts with increasing treatment time. Treatment length should be considered in the planning process. An 8 mm margin on a target volume would account for 2 SDs of motion for a treatment up to 15 minutes in length.PACS numbers: 87.53.Jw, 87.53.Kn, 87.56.Da, 87.63.L‐

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Section: Introductionmentioning

confidence: 99%

Surface imaging‐based analysis of intrafraction motion for breast radiotherapy patients

Wiant

Wentworth

Mäurer

et al. 2014

J Applied Clin Med Phys

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“…70,71 The system has also been evaluated for respiratory gating in thoracic and abdominal tumor sites and in patient alignment for prostate cancer. 50,72 In such applications, the real-time 3D datasets are matched with corresponding reference images, obtained in the desired respiratory phase at the time of CT simulation. Another published application of this system has been for tracking and aligning the head for high-precision radiosurgery treatment.…”

Section: Ic2 Optical Systems (Alignrt and C-rad Sentinel)mentioning

confidence: 99%

Quality assurance for nonradiographic radiotherapy localization and positioning systems: Report of Task Group 147

Willoughby

Lehmann

Bencomo³

et al. 2012

Medical Physics

109

126

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New technologies continue to be developed to improve the practice of radiation therapy. As several of these technologies have been implemented clinically, the Therapy Committee and the Quality Assurance and Outcomes Improvement Subcommittee of the American Association of Physicists in Medicine commissioned Task Group 147 to review the current nonradiographic technologies used for localization and tracking in radiotherapy. The specific charge of this task group was to make recommendations about the use of nonradiographic methods of localization, specifically; radiofrequency, infrared, laser, and video based patient localization and monitoring systems. The charge of this task group was to review the current use of these technologies and to write quality assurance guidelines for the use of these technologies in the clinical setting. Recommendations include testing of equipment for initial installation as well as ongoing quality assurance. As the equipment included in this task group continues to evolve, both in the type and sophistication of technology and in level of integration with treatment devices, some of the details of how one would conduct such testing will also continue to evolve. This task group, therefore, is focused on providing recommendations on the use of this equipment rather than on the equipment itself, and should be adaptable to each user's situation in helping develop a comprehensive quality assurance program.

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“…While there have been previously published studies of image‐guided prostate radiation therapy using AlignRT 9 , 10 these studies have primarily used EPID imaging for comparison, with emphasis placed on bony anatomy registration. Our study differs significantly from these studies in that we were able to exploit the superior image contrast of fan‐beam CT to allow for direct and accurate registration of the targeted soft tissue anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of the AlignRT system are its provision of real‐time tracking of patient surface location by monitoring of a region of interest during radiation therapy, its noninvasive imaging methodology, and its delivery of no extra radiation dose. It has been reported by multiple studies 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 that AlignRT can be an effective image guidance method for certain sites of radiation therapy treatment, including breast, intracranial stereotactic radiosurgery, thorax, and prostate.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surface matching and target matching for image‐guided pelvic radiation therapy for both supine and prone patient positions

Zhao

Wang

Sarkar

et al. 2016

J Applied Clin Med Phys

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We investigate the difference between surface matching and target matching for pelvic radiation image guidance. The uniqueness of our study is that all patients have multiple CT‐on‐rails (CTOR) scans to compare to corresponding AlignRT images. Ten patients receiving pelvic radiation were enrolled in this study. Two simulation CT scans were performed in supine and prone positions for each patient. Body surface contours were generated in treatment planning system and exported to AlignRT to serve as reference images. During treatment day, the patient was aligned to treatment isocenter with room lasers, and then scanned with both CTOR and AlignRT. Image‐guidance shifts were calculated for both modalities by comparison to the simulation CT and the differences between them were analyzed for both supine and prone positions, respectively. These procedures were performed for each patient once per week for five weeks. The difference of patient displacement between AlignRT and CTOR was analyzed. For supine position, five patients had an average difference of displacement between AlignRT and CTOR along any direction (vertical, longitudinal, and lateral) greater than 0.5 cm, and one patient greater than 1 cm. Four patients had a maximum difference greater than 1 cm. For prone position, seven patients had an average difference greater than 0.5 cm, and three patients greater than 1 cm. Nine patients had a maximum difference greater than 1 cm. The difference of displacement between AlignRT and CTOR was greater for the prone position than for the supine position. For the patients studied here, surface matching does not appear to be an advisable image‐guidance approach for pelvic radiation therapy for patients with either supine or prone position. There appears to be a potential for large alignment discrepancies (up to 2.25 cm) between surface matching and target matching.PACS number(s): 87.55.‐x

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Reproducibility of patient setup by surface image registration system in conformal radiotherapy of prostate cancer

Cited by 57 publications

References 14 publications

Surface imaging‐based analysis of intrafraction motion for breast radiotherapy patients

Surface imaging‐based analysis of intrafraction motion for breast radiotherapy patients

Quality assurance for nonradiographic radiotherapy localization and positioning systems: Report of Task Group 147

Comparison of surface matching and target matching for image‐guided pelvic radiation therapy for both supine and prone patient positions

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