A phantom study to evaluate three different registration platform of 3D/3D, 2D/3D, and 3D surface match with 6D alignment for precise image‐guided radiotherapy

Kuo, Hsiang-Chi; Lovelock, Michael; Li, Guang; Ballangrud, Åse M.; Wolthuis, B.; Biancia, Cesar Della; Hunt, Margie A.; Berry, Sean L.

doi:10.1002/acm2.13086

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…After all, the couch-angle dependency error is difficult to correct but can be minimized to within 1.0 mm. Previously, we have compared the AlignRT accuracy with 2DkV and CBCT using a system that does not have MV cube calibration capability, 21 and the sub-mm differences are consistent with the MV cube calibration.…”

Section: Resultsmentioning

confidence: 90%

“…Together with other advancements in SRS treatment, including VMAT SRS planning for multi-lesion treatment using single T A B L E 3 Gated dosimetry equivalency in reference to non-gated delivery using the electronic portal imaging device (EPID) for portal dosimetry measurement. isocenter 21 , the SGRT SRS/SRT procedure has allowed us to treat substantially more cranial lesions and patients as the standard of care in our clinic.…”

Section: C | Clinical Benefits Of the Commissioning In Srs Treatmentmentioning

confidence: 99%

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Commissioning of optical surface imaging systems for cranial frameless stereotactic radiosurgery

Zhang

Vijayan

Huang

et al. 2021

J Applied Clin Med Phys

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Purpose: This study aimed to evaluate and compare different system calibration methods from a large cohort of systems to establish a commissioning procedure for surface-guided frameless cranial stereotactic radiosurgery (SRS) with intrafractional motion monitoring and gating. Using optical surface imaging (OSI) to guide noncoplanar SRS treatments, the determination of OSI couch-angle dependency, baseline drift, and gated-delivered-dose equivalency are essential.Methods: Eleven trained physicists evaluated 17 OSI systems at nine clinical centers within our institution. Three calibration methods were examined, including 1level (2D), 2-level plate (3D) calibration for both surface image reconstruction and isocenter determination, and cube phantom calibration to assess OSI-megavoltage (MV) isocenter concordance. After each calibration, a couch-angle dependency error was measured as the maximum registration error within the couch rotation range. A head phantom was immobilized on the treatment couch and the isocenter was set in the middle of the brain, marked with the room lasers. An on-site reference image was acquired at couch zero, the facial region of interest (ROI) was defined, and static verification images were captured every 10°for 0°-90°and 360°-270°. The baseline drift was assessed with real-time monitoring of the motionless phantom over 20 min. The gated-delivered-dose equivalency was assessed using the electron portal imaging device and gamma test (1%/1mm) in reference to non-gated delivery.Results: The maximum couch-angle dependency error occurs in longitudinal and lateral directions and is reduced significantly (P < 0.05) from 1-level (1.3 ± 0.4 mm) to 2-level (0.8 ± 0.3 mm) calibration. The MV cube calibration does not further reduce the couch-angle dependency error (0.8 ± 0.2 mm) on average. The baseline drift error plateaus at 0.3 ± 0.1 mm after 10 min. The gated-delivered-dose equivalency has a >98% gamma-test passing rate. Conclusion:A commissioning method is recommended using the 3D plate calibration, which is verified by radiation isocenter and validated with couch-angle

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Section: Resultsmentioning

confidence: 90%

Section: C | Clinical Benefits Of the Commissioning In Srs Treatmentmentioning

confidence: 99%

Commissioning of optical surface imaging systems for cranial frameless stereotactic radiosurgery

Zhang

Vijayan

Huang

et al. 2021

J Applied Clin Med Phys

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“…Kuo et al reported a phantom study using CBCT, on-board and ceiling-floormounted 2DkV, as well as OSI based on both anatomic-based and point-based registration. 23 Both isocenter and target registration errors were reported and a maximum of 2.5 mm OSI uncertainty was found. To apply SGRT-only patient setup in the clinic to treat brain and HN patient with standard fractionation, a thorough evaluation of SGRT setup accuracy and other advantages is needed with a large clinical dataset.…”

Section: Introductionmentioning

confidence: 99%

“…However, as the study does not involve OSI imaging, it was not under clinical conditions as any interference items, such as facial masks, were excluded. Kuo et al reported a phantom study using CBCT, on‐board and ceiling‐floor‐mounted 2DkV, as well as OSI based on both anatomic‐based and point‐based registration 23 . Both isocenter and target registration errors were reported and a maximum of 2.5 mm OSI uncertainty was found.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of surface‐guided patient setup for conventional radiotherapy of brain and nasopharynx cancer

Lee

Huang

Zhang

et al. 2021

J Applied Clin Med Phys

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To evaluate the accuracy of surface-guided radiotherapy (SGRT) in cranial patient setup by direct comparison between optical surface imaging (OSI) and conebeam computed tomography (CBCT), before applying SGRT-only setup for conventional radiotherapy of brain and nasopharynx cancer. Methods and Materials: Using CBCT as reference, SGRT setup accuracy was examined based on 269 patients (415 treatments) treated with frameless cranial stereotactic radiosurgery (SRS) during 2018-2019. Patients were immobilized in customized head molds and open-face masks and monitored using OSI during treatment. The facial skin area in planning CT was used as OSI region of interest (ROI)for automatic surface alignment and the skull was used as the landmark for automatic CBCT/CT registration. A 6 degrees of freedom (6DOF) couch was used.Immediately after CBCT setup, an OSI verification image was captured, recording the SGRT setup differences. These differences were analyzed in 6DOFs and as a function of isocenter positions away from the anterior surface to assess OSI-ROI bias. The SGRT in-room setup time was estimated and compared with CBCT and orthogonal 2D kilovoltage (2DkV) setups. Results:The SGRT setup difference (magnitude) is found to be 1.0 AE 2.5 mm and 0.1˚AE1.4˚on average among 415 treatments and within 5 mm/3˚with greater than 95% confidence level (P < 0.001). Outliers were observed for very-posterior isocenters: 15 differences (3.6%) are >5.0mm and 9 (2.2%) are >3.0˚. The setup differences show minor correlations (|r| < 0.45) between translational and rotational DOFs and a minor increasing trend (<1.0 mm) in the anterior-to-posterior direction.The SGRT setup time is 0.8 AE 0.3 min, much shorter than CBCT (5 AE 2 min) and 2DkV (2 AE 1 min) setups. Conclusion:This study demonstrates that SGRT has sufficient accuracy for fast inroom patient setup and allows real-time motion monitoring for beam holding during treatment, potentially useful to guide radiotherapy of brain and nasopharynx cancer with standard fractionation.

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“…Image guidance is used to ensure accurate treatment delivery, accurate target positioning and avoidance of organs at risk. There is a significant body of evidence showing that the use of 2D–2D, combined with 3D–3D match offered by the use of CBCT is associated with increased accuracy of the treatment [ 17 ]. However, this can result in increased time per fraction time, which can lead to increased patient discomfort, and potential movement of the patient.…”

Section: Discussionmentioning

confidence: 99%

Implementation of advanced radiotherapy techniques: stereotactic body radiotherapy (SBRT) for oligometastatic patients with lung metastasis - a single institution experience

Pop¹,

Hopîrtean²,

Coşer³

et al. 2022

Medicine and Pharmacy Reports

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Background and purpose. The treatment of oligometastatic disease has become common practice as advanced radiotherapy techniques became more available. Lung is one of the main metastatic sites for a majority of cancers and many of these patients present with a limited metastatic disease burden. For these patients, SBRT (Stereotactic Body Radiation Therapy) represents a non-invasive treatment alternative. In this report we present our experience with our first series of patients with limited metastatic disease treated with lung SBRT. The purpose of this paper is to provide a qualitative and quantitative assessment of the lung SBRT treatment process and algorithm leading up to treatment delivery in a community-based radiotherapy department. Methods. We have retrospectively reviewed our first series of 41 patients with lung oligometastases from various malignancies, treated using SBRT between March 2019 and December 2020. Demographic, technical and outcome data were analyzed. Results. A number of 45 lung metastases (in 41 patients) were treated with SBRT during the specified time period. The median age was 65.7 years old (range 33-83). 16 patients (39%) were treated for multiple lesions and the mean number of treated lesions was 1 (range1-3). Median dose prescribed was 50 Gy /5 fractions (median BED10 =77 Gy). The median intra-fraction displacements were: Vertical (0.23cm), Longitudinal (-0.27 cm), Lateral (-0.1 cm), Pitch [0.22°], Roll [0.15°], Rotation [0.32°]. The median session time was 40 minutes. All patients completed the prescribed course of treatment. Preliminary clinical data were recorded. With a median follow-up of 9 months, local control was recorded in all but one patient. At the last known follow-up, local control was recorded for 39 (85%) out of 45 treated lesions. Conclusion. For lung SBRT, the required corrections at the time of treatment delivery are small, as long as strict protocols are implemented. Preliminary data for lung metastasis in oligometastatic patients support SBRT as a viable method of achieving high rates of early local control. These results need to be further confirmed in a larger cohort of patients with longer follow-up.

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A phantom study to evaluate three different registration platform of 3D/3D, 2D/3D, and 3D surface match with 6D alignment for precise image‐guided radiotherapy

Cited by 9 publications

References 30 publications

Commissioning of optical surface imaging systems for cranial frameless stereotactic radiosurgery

Commissioning of optical surface imaging systems for cranial frameless stereotactic radiosurgery

Accuracy of surface‐guided patient setup for conventional radiotherapy of brain and nasopharynx cancer

Implementation of advanced radiotherapy techniques: stereotactic body radiotherapy (SBRT) for oligometastatic patients with lung metastasis - a single institution experience

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