Time-Resolved Intrafraction Target Translations and Rotations During Stereotactic Liver Radiation Therapy: Implications for Marker-based Localization Accuracy

Bertholet, Jenny; Worm, E.; Fledelius, Walther; Høyer, Morten; Poulsen, Per Rugaard

doi:10.1016/j.ijrobp.2016.01.033

Cited by 46 publications

(65 citation statements)

References 24 publications

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“…Only a few studies have investigated the intrafraction rotation of implanted liver markers 25, 26. Bertholet et al26 evaluated the rotations using CBCT projections and found that the population‐based means of intrafraction rotations were 3.9° (LR), 2.9° (SI) and 4.0° (AP).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the intra‐ and interfractional tumor motion and variability by fiducial‐based real‐time tracking in liver stereotactic body radiation therapy

Liang

Liu

Xue

et al. 2018

J Applied Clin Med Phys

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PurposeTumor motion amplitude varies during treatment. The purpose of the study was to evaluate the intra‐ and interfraction tumor motion and variability in patients with liver cancer treated with fiducial‐based real‐time tracking stereotactic body radiotherapy (SBRT).MethodsFourteen liver patients were treated with SBRT using a CyberKnife. Two to four fiducial markers implanted near the tumor were used for real‐time monitoring using the Synchrony system. The tumor motion information during treatment was extracted from the log files recorded by the Synchrony system. Logfile‐based amplitudes in the superior–posterior (SI), left–right (LR) and anterior–posterior (AP) directions were compared to the 4DCT‐based amplitudes. The intra‐ and interfraction amplitude variations and the incidence of baseline shifts were analyzed for 66 fractions administered to 14 patients.ResultsThe median (range) logfile‐based liver motion amplitudes for all patients were 11.9 (5.1–17.3) mm, 1.3 (0.4–4) mm and 3.8 (0.9–7.7) mm in the SI, LR and AP directions, respectively. Compared with the logfile‐based amplitude, the 4DCT‐based amplitude was underestimated (P < 0.05). The median (range) intra‐ and interfraction liver motion amplitude variations were 4.3 (1.6–6.0) mm (SI), 0.5 (0.2–2.2) mm(LR) and 1.5 (0.3–3.3) mm (AP) and 1.7 (0.5–4.6) mm (SI), 0.3 (0.1–3.0) mm (LR) and 0.7 (0.3–2.7) mm (AP), respectively. Baseline shifts exceeding 2 mm, 3 mm and 5 mm were observed in 27.3%, 7.6% and 3% of the measurements, respectively, within 10 min, and in 66.7%, 38.1% and 19%, respectively, within 30 min for the square root of the sum of the squares of the distances in the SI, LR and AP directions (3D). The tumor motion amplitude was found to be correlated with the baseline shift.ConclusionsMost patients showed significant intra‐ and interfraction liver motion amplitude variations over the entire course of radiation. More caution is needed for patients with large tumor motion amplitudes.

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Section: Discussionmentioning

confidence: 99%

“…Bertholet et al26 evaluated the rotations using CBCT projections and found that the population‐based means of intrafraction rotations were 3.9° (LR), 2.9° (SI) and 4.0° (AP). However, intrafraction rotations were not included in this study, which is a limitation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the intra‐ and interfractional tumor motion and variability by fiducial‐based real‐time tracking in liver stereotactic body radiation therapy

Liang

Liu

Xue

et al. 2018

J Applied Clin Med Phys

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“…There is increasing evidence to demonstrate the importance of accounting for translational and rotational (6DoF) tumor motion during prostate radiotherapy [19][20][21][22][23][24]. The magnitude of rotational motion during radiotherapy has been quantified for lung, liver and prostate cancer patients [20,[25][26][27]. Ignoring 15 the rotational motion was shown to result in a significant underdosing effect even if the translational tumor motion was properly managed [19].…”

Section: Management Of Intrafraction Tumor Motion Is Particularly Impmentioning

confidence: 99%

“…Ignoring 15 the rotational motion was shown to result in a significant underdosing effect even if the translational tumor motion was properly managed [19]. Appropriate management of the rotational tumor motion can improve the accuracy of the tumor positional estimates [25] and further reduce the treatment margins by 4-6 mm, while maintaining target coverage given the controllability of rotation motion within 1° [23]. 20…”

Section: Management Of Intrafraction Tumor Motion Is Particularly Impmentioning

confidence: 99%

The accuracy and precision of Kilovoltage Intrafraction Monitoring (KIM) six degree-of-freedom prostate motion measurements during patient treatments

Kim

Nguyen

Booth

et al. 2018

Radiotherapy and Oncology

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The results demonstrate that KIM is capable of providing the real-time 6DoF prostate target motion during patient treatments with an accuracy ± precision of within 0.2 ± 1.3° and 0.1 ± 0.5 mm for rotation and translation, respectively. As KIM only requires a single X-ray imager, which is available on most modern cancer radiotherapy devices, there is potential for widespread adoption of this technology.

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“…Breathing-dependent fiducial rotations in the liver were reported only recently [36] and residual rotation errors were unreported for robotic liver SBRT until now [18,28]. This may very likely be due to the fact that the information is not easily accessible in the system log files and due to a large number of patients in general being treated with less than four fiducials.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Dosimetric Implications of Residual Tracking Errors During Robotic SBRT of Liver Metastases

Chan

Grehn

Cremers

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

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Time-Resolved Intrafraction Target Translations and Rotations During Stereotactic Liver Radiation Therapy: Implications for Marker-based Localization Accuracy

Cited by 46 publications

References 24 publications

Evaluation of the intra‐ and interfractional tumor motion and variability by fiducial‐based real‐time tracking in liver stereotactic body radiation therapy

Evaluation of the intra‐ and interfractional tumor motion and variability by fiducial‐based real‐time tracking in liver stereotactic body radiation therapy

The accuracy and precision of Kilovoltage Intrafraction Monitoring (KIM) six degree-of-freedom prostate motion measurements during patient treatments

Dosimetric Implications of Residual Tracking Errors During Robotic SBRT of Liver Metastases

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