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Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer
The purpose of this study was to investigate the setup and positioning uncertainty of a custom cushion/mask/bite‐block (CMB) immobilization system and determine PTV margin for image‐guided head and neck stereotactic ablative radiotherapy (HN‐SABR). We analyzed 105 treatment sessions among 21 patient...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690911/ https://www.ncbi.nlm.nih.gov/pubmed/27167275 http://dx.doi.org/10.1120/jacmp.v17i3.6038 |
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author | Wang, He Wang, Congjun Tung, Samuel Dimmitt, Andrew Wilson Wong, Pei Fong Edson, Mark A. Garden, Adam S. Rosenthal, David I. Fuller, Clifton D. Gunn, Gary B. Takiar, Vinita Wang, Xin A. Luo, Dershan Yang, James N. Wong, Jennifer Phan, Jack |
author_facet | Wang, He Wang, Congjun Tung, Samuel Dimmitt, Andrew Wilson Wong, Pei Fong Edson, Mark A. Garden, Adam S. Rosenthal, David I. Fuller, Clifton D. Gunn, Gary B. Takiar, Vinita Wang, Xin A. Luo, Dershan Yang, James N. Wong, Jennifer Phan, Jack |
author_sort | Wang, He |
collection | PubMed |
description | The purpose of this study was to investigate the setup and positioning uncertainty of a custom cushion/mask/bite‐block (CMB) immobilization system and determine PTV margin for image‐guided head and neck stereotactic ablative radiotherapy (HN‐SABR). We analyzed 105 treatment sessions among 21 patients treated with HN‐SABR for recurrent head and neck cancers using a custom CMB immobilization system. Initial patient setup was performed using the ExacTrac infrared (IR) tracking system and initial setup errors were based on comparison of ExacTrac IR tracking system to corrected online ExacTrac X‐rays images registered to treatment plans. Residual setup errors were determined using repeat verification X‐ray. The online ExacTrac corrections were compared to cone‐beam CT (CBCT) before treatment to assess agreement. Intrafractional positioning errors were determined using prebeam X‐rays. The systematic and random errors were analyzed. The initial translational setup errors were [Formula: see text] , [Formula: see text] , and [Formula: see text] in AP, CC, and LR directions, respectively, with a three‐dimensional (3D) vector of [Formula: see text]. The initial rotational errors were up to 2.4° if 6D couch is not available. CBCT agreed with ExacTrac X‐ray images to within 2 mm and 2.5°. The intrafractional uncertainties were [Formula: see text] , [Formula: see text] , and [Formula: see text] in AP, CC, and LR directions, respectively, and [Formula: see text] , [Formula: see text] , and [Formula: see text] in yaw, roll, and pitch direction, respectively. The translational vector was [Formula: see text]. The calculated PTV margins [Formula: see text] were within 1.6 mm when using image guidance for online setup correction. The use of image guidance for online setup correction, in combination with our customized CMB device, highly restricted target motion during treatments and provided robust immobilization to ensure minimum dose of 95% to target volume with 2.0 mm PTV margin for HN‐SABR. PACS number(s): 87.55.ne |
format | Online Article Text |
id | pubmed-5690911 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56909112018-04-02 Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer Wang, He Wang, Congjun Tung, Samuel Dimmitt, Andrew Wilson Wong, Pei Fong Edson, Mark A. Garden, Adam S. Rosenthal, David I. Fuller, Clifton D. Gunn, Gary B. Takiar, Vinita Wang, Xin A. Luo, Dershan Yang, James N. Wong, Jennifer Phan, Jack J Appl Clin Med Phys Radiation Oncology Physics The purpose of this study was to investigate the setup and positioning uncertainty of a custom cushion/mask/bite‐block (CMB) immobilization system and determine PTV margin for image‐guided head and neck stereotactic ablative radiotherapy (HN‐SABR). We analyzed 105 treatment sessions among 21 patients treated with HN‐SABR for recurrent head and neck cancers using a custom CMB immobilization system. Initial patient setup was performed using the ExacTrac infrared (IR) tracking system and initial setup errors were based on comparison of ExacTrac IR tracking system to corrected online ExacTrac X‐rays images registered to treatment plans. Residual setup errors were determined using repeat verification X‐ray. The online ExacTrac corrections were compared to cone‐beam CT (CBCT) before treatment to assess agreement. Intrafractional positioning errors were determined using prebeam X‐rays. The systematic and random errors were analyzed. The initial translational setup errors were [Formula: see text] , [Formula: see text] , and [Formula: see text] in AP, CC, and LR directions, respectively, with a three‐dimensional (3D) vector of [Formula: see text]. The initial rotational errors were up to 2.4° if 6D couch is not available. CBCT agreed with ExacTrac X‐ray images to within 2 mm and 2.5°. The intrafractional uncertainties were [Formula: see text] , [Formula: see text] , and [Formula: see text] in AP, CC, and LR directions, respectively, and [Formula: see text] , [Formula: see text] , and [Formula: see text] in yaw, roll, and pitch direction, respectively. The translational vector was [Formula: see text]. The calculated PTV margins [Formula: see text] were within 1.6 mm when using image guidance for online setup correction. The use of image guidance for online setup correction, in combination with our customized CMB device, highly restricted target motion during treatments and provided robust immobilization to ensure minimum dose of 95% to target volume with 2.0 mm PTV margin for HN‐SABR. PACS number(s): 87.55.ne John Wiley and Sons Inc. 2016-05-08 /pmc/articles/PMC5690911/ /pubmed/27167275 http://dx.doi.org/10.1120/jacmp.v17i3.6038 Text en © 2016 The Authors. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Radiation Oncology Physics Wang, He Wang, Congjun Tung, Samuel Dimmitt, Andrew Wilson Wong, Pei Fong Edson, Mark A. Garden, Adam S. Rosenthal, David I. Fuller, Clifton D. Gunn, Gary B. Takiar, Vinita Wang, Xin A. Luo, Dershan Yang, James N. Wong, Jennifer Phan, Jack Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
title | Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
title_full | Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
title_fullStr | Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
title_full_unstemmed | Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
title_short | Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
title_sort | improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer |
topic | Radiation Oncology Physics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690911/ https://www.ncbi.nlm.nih.gov/pubmed/27167275 http://dx.doi.org/10.1120/jacmp.v17i3.6038 |
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