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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
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
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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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