A numerical simulation of organ motion and daily setup uncertainties: Implications for radiation therapy

Killoran, Joseph H.; Kooy, H.M.; Gladstone, David J.; Welte, Frank J.; Beard, Clair J.

doi:10.1016/s0360-3016(96)00477-4

Cited by 107 publications

(64 citation statements)

References 8 publications

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“…The Monte Carlo MCDOSE treatment planning system was used for this study to investigate breast treatment using parallel opposed 6MV tangential beams and MERT. The MERT treatment consisted of applying multiple beams consisting of 6, 9, 12,16,20 MeV energies to conform the prescription dose to the target. For the patient computed tomography scans used for initial treatment planning, the dose was normalized to 50 Gy.…”

Section: Implementation and Effects Of Organ Motionmentioning

confidence: 99%

“…The beamlet size is denned at 100 cm SSD. The isodose lines shown are 10, 20,30,40,50,60,70,80 and 90% of the maximum dose respectively. over traditional treatment modalities on a site by site basis is outside the scope of this work.…”

Section: Comparison Of Beamtet Distributionsmentioning

confidence: 99%

“…The beamlet size is denned at 100 cm SSD. The isodose lines shown are 10,20, 30, 40, 50, 60, 70, 80 and 90% of the maximum dose respectively. …”

mentioning

confidence: 99%

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Integrating Organ Motion and Setup Uncertainty into Optimization of Modulated Electron Beam Treatment of Breast Cancer

Pawlicki¹

2003

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503 AGENCY USE ONLY (Leave blank)2. REPORT DATE August 2002 REPORT TYPE AND DATES COVEREDAnnual Summary (1 Auq 00 -31 Jul 01) TITLE AND SUBTITLE Integrating Organ Motion and Setup Uncertainty into Optimization of Modulated Electron Beam Treatment of Breast Cancer6. AUTHOR(S) Todd A. Pawlicki, Ph.D. FUNDING NUMBERSDAMD17-00-1-0444 PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)Stanford University Stanford, California 94305-5401 E-Mail: tpaw@reyes.stanford.edu PERFORMING ORGANIZATION REPORT NUMBER SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) U.S. Army Medical Research and Materiel CommandFort Detrick, Maryland 21702-5012 SUPPLEMENTARY NOTESReport contains color. This project is to develop, implement, and evaluate models of organ motion and setup uncertainty for dose calculation of radiotherapy treatment of the breast. These models are applied to accurate dose calculation for breast treatment using energyand intensity-modulated electron radiotherapy (MERT). The premise is that MERT treatments will deliver a more conformal dose to the breast while minimizing the dose to normal tissues over conventional photon techniques. We have completed the following tasks: (1) developed theoretical models of organ motion and setup uncertainty based on published data, and (2) implemented those models into a Monte Carlo dose calculation code. We have developed a model of organ motion that correlates the dose in a static computed tomography scan to the actual case of patient breathing. A Gaussian model has been developed to account for setup uncertainty due to the random nature of setup uncertainty in radiotherapy, which has been demonstrated in published literature. These models have been implemented in a Monte Carlo code for radiotherapy dose calculations based on patient specific computed tomography scans. The successful completion of our goals now permits further study (specific aims 3 and 4) on the effect of these effects on MERT radiotherapy breast treatment. References 13 SUBJECT TERMSAppendices 15 IntroductionEnergy-and intensity-modulated radiotherapy (MERT) is the optimization of many small beamlets of different energies and intensities to produce a highly conformal dose distribution. Each individual beamlet's dose distribution must be calculated in a computed tomography based representation of the patient. The relative weight of e...

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Section: Implementation and Effects Of Organ Motionmentioning

confidence: 99%

Section: Comparison Of Beamtet Distributionsmentioning

confidence: 99%

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Integrating Organ Motion and Setup Uncertainty into Optimization of Modulated Electron Beam Treatment of Breast Cancer

Pawlicki¹

2003

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“…Increasing the accuracy of radiation dose delivery to the intended target should improve the tumor control probability and reduce treatment‐related morbidity. ( 1 – 8 ) …”

Section: Introductionmentioning

confidence: 99%

Patient‐specific daily pretreatment setup protocol using electronic portal imaging for radiation therapy

Wittmer

Pisansky

Kruse

et al. 2005

J Applied Clin Med Phys

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The purpose of this study was to evaluate electronic portal imaging (EPI) as a means of identifying and correcting field displacement in patients with problematic external beam radiotherapy setups. Fourteen patients with problematic setups were identified for pretreatment daily EPI beam monitoring as part of a physician‐directed therapist intervention protocol. Pretreatment EPIs were used to realign fields as necessary to bring the setup within the physician‐prescribed tolerance level. For comparison, daily EPIs were available for 12 control patients who had no particular setup difficulties and for whom online beam realignment was not made. Anatomy‐matching software was used to measure setup variation along medial‐lateral, superior‐inferior, and anterior‐posterior axes. Online field realignment yielded a significant false(p=0.001false) improvement when comparing initial and final setup variations. The mean standard deviation of setup displacement averaged over three axes was reduced from 6.4 mm to 3.1 mm after realignment. The final variation of protocol patients was comparable to that of control patients. In conclusion, EPI provided effective means to perform online beam realignment in a group of difficult‐to‐position patients. This procedure resulted in a reduction in setup displacement that was statistically significant, clinically relevant, and approached that of a more typical patient group.PACS number: 87.53.Oq

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“…The importance of accurate radiation beam delivery has been discussed theoretically 1 , 2 and demonstrated clinically 3 – 6 . The consequences of missing the target, even partially, are a reduction in tumor control probability and an increase in normal tissue complication probability.…”

Section: Introductionmentioning

confidence: 99%

Guide to clinical use of electronic portal imaging

Herman

Kruse

Hagness

2000

J Applied Clin Med Phys

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The Electronic Portal Imaging Device (EPID) provides localization quality images and computer‐aided analysis, which should in principal, replace portal film imaging. Modern EPIDs deliver superior image quality and an array of analysis tools that improve clinical decision making. It has been demonstrated that the EPID can be a powerful tool in the reduction of treatment setup errors and the quality assurance and verification of complex treatments. However, in many radiation therapy clinics EPID technology is not in routine clinical use. This low utilization suggests that the capability and potential of the technology alone do not guarantee its full adoption. This paper addresses basic considerations required to facilitate clinical implementation of the EPID technology and gives specific examples of successful implementations. © 2000 American College of Medical Physics. PACS number(s): 87.53.–j, 87.57.–s

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A numerical simulation of organ motion and daily setup uncertainties: Implications for radiation therapy

Cited by 107 publications

References 8 publications

Integrating Organ Motion and Setup Uncertainty into Optimization of Modulated Electron Beam Treatment of Breast Cancer

Integrating Organ Motion and Setup Uncertainty into Optimization of Modulated Electron Beam Treatment of Breast Cancer

Patient‐specific daily pretreatment setup protocol using electronic portal imaging for radiation therapy

Guide to clinical use of electronic portal imaging

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