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Refinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy.

Publication ,  Journal Article
Wang, Z; Nelson, JW; Yoo, S; Wu, QJ; Kirkpatrick, JP; Marks, LB; Yin, F-F
Published in: Int J Radiat Oncol Biol Phys
February 1, 2009

PURPOSES: To quantitatively compare two-dimensional (2D) orthogonal kV with three-dimensional (3D) cone-beam CT (CBCT) for target localization; and to assess intrafraction motion with kV images in patients undergoing stereotactic body radiotherapy (SBRT). METHODS AND MATERIALS: A total of 50 patients with 58 lesions received 178 fractions of SBRT. After clinical setup using in-room lasers and skin/cradle marks placed at simulation, patients were imaged and repositioned according to orthogonal kV/MV registration of bony landmarks to digitally reconstructed radiographs from the planning CT. A subsequent CBCT was registered to the planning CT using soft tissue information, and the resultant "residual error" was measured and corrected before treatment. Posttreatment 2D kV and/or 3D CBCT images were compared with pretreatment images to determine any intrafractional position changes. Absolute averages, statistical means, standard deviations, and root mean square (RMS) values of observed setup error were calculated. RESULTS: After initial setup to external marks with laser guidance, 2D kV images revealed vector mean setup deviations of 0.67 cm (RMS). Cone-beam CT detected residual setup deviations of 0.41 cm (RMS). Posttreatment imaging demonstrated intrafractional variations of 0.15 cm (RMS). The individual shifts in three standard orthogonal planes showed no obvious directional biases. CONCLUSIONS: After localization based on superficial markings in patients undergoing SBRT, orthogonal kV imaging detects setup variations of approximately 3 to 4 mm in each direction. Cone-beam CT detects residual setup variations of approximately 2 to 3 mm.

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Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

February 1, 2009

Volume

73

Issue

2

Start / End Page

571 / 577

Location

United States

Related Subject Headings

  • Radiotherapy Planning, Computer-Assisted
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Neoplasms
  • Neoplasm Recurrence, Local
  • Movement
  • Male
  • Humans
  • Female
  • Dose Fractionation, Radiation
 

Citation

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Wang, Z., Nelson, J. W., Yoo, S., Wu, Q. J., Kirkpatrick, J. P., Marks, L. B., & Yin, F.-F. (2009). Refinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys, 73(2), 571–577. https://doi.org/10.1016/j.ijrobp.2008.09.040
Wang, Zhiheng, John W. Nelson, Sua Yoo, Q Jackie Wu, John P. Kirkpatrick, Lawrence B. Marks, and Fang-Fang Yin. “Refinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy.Int J Radiat Oncol Biol Phys 73, no. 2 (February 1, 2009): 571–77. https://doi.org/10.1016/j.ijrobp.2008.09.040.
Wang Z, Nelson JW, Yoo S, Wu QJ, Kirkpatrick JP, Marks LB, et al. Refinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):571–7.
Wang, Zhiheng, et al. “Refinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy.Int J Radiat Oncol Biol Phys, vol. 73, no. 2, Feb. 2009, pp. 571–77. Pubmed, doi:10.1016/j.ijrobp.2008.09.040.
Wang Z, Nelson JW, Yoo S, Wu QJ, Kirkpatrick JP, Marks LB, Yin F-F. Refinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):571–577.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

February 1, 2009

Volume

73

Issue

2

Start / End Page

571 / 577

Location

United States

Related Subject Headings

  • Radiotherapy Planning, Computer-Assisted
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Neoplasms
  • Neoplasm Recurrence, Local
  • Movement
  • Male
  • Humans
  • Female
  • Dose Fractionation, Radiation