Optical Surface Management System for Patient Positioning in Interfractional Breast Cancer Radiotherapy

Ma, Zhiyong; Zhang, Wei; Su, Yi; Liu, Peiji; Pan, Yinghua; Zhang, Gang; Song, Yipeng

doi:10.1155/2018/6415497

Cited by 26 publications

(36 citation statements)

References 17 publications

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“…In this work we have shown the advantages of using SGRT for initial setup of cranial treatments using the Halcyon linac. However there are other sites that could also benefit from this technique such as head and neck, extremities, breast and prostate as has been shown for C‐arm linacs . We identified two limitations of the current SGRT setup.…”

Section: Discussionmentioning

confidence: 99%

“…Surface Guided Radiation Therapy (SGRT) provides an option for improved patient setup and real‐time monitoring and has been used previously for intracranial and extracranial regions . SGRT is a nonradiographic localization technique that uses a system of 3D cameras to detect a light pattern projected onto the patient and use the information to reconstruct a 3D surface image.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the use of different imaging and delivery techniques for cranial treatments on the Halcyon linac

Flores‐Martinez

Cerviño

Pawlicki

et al. 2019

J Applied Clin Med Phys

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Purpose: In this work, we investigated the effect on the workflow and setup accuracy of using surface guided radiation therapy (SGRT) for patient setup, megavoltage cone beam CT (MVCBCT) or kilovoltage cone beam CT (kVCBCT) for imaging and fixed IMRT or volumetric-modulated arc therapy (VMAT) for treatment delivery with the Halcyon linac. Methods:We performed a retrospective investigation of 272 treatment fractions, using three different workflows. The first and second workflows used MVCBCT and fixed IMRT for imaging and treatment delivery, and the second one also used SGRT for patient setup. The third workflow used SGRT for setup, kVCBCT for imaging and VMAT for delivery. Workflows were evaluated by comparing the number of fractions requiring repeated imaging acquisitions and the time required for setup, imaging and treatment delivery. Setup position accuracy was assessed by comparing the daily kV-or MV-CBCT with the planning CT and measuring the residual rotational errors for pitch, yaw and roll angles.Results: Without the use of SGRT, the imaging fields were delivered more than once on 11.1% of the fractions, while re-imaging was necessary in 5.5% of the fractions using SGRT. The total treatment time, including setup, imaging, and delivery, for the three workflows was 531 ± 157 s, 503 ± 130 s and 457 ± 91 s, respectively. A statistically significant difference was observed when comparing the third workflow with the first two. The total residual rotational errors were 1.96 ± 1.29°, 1.28 ± 0.67°and 1.22 ± 0.76°and statistically significant differences were observed when comparing workflows with and without SGRT. Conclusions:The use of SGRT allowed for a reduction of re-imaging during patient setup and improved patient position accuracy by reducing residual rotational errors.A reduction in treatment time using kVCBCT with SGRT was observed. The most efficient workflow was the one including kVCBCT and SGRT for setup and VMAT for delivery. K E Y W O R D SAlignRT, Halcyon, rotational errors, SGRT, surface guided radiotherapy ---

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of the use of different imaging and delivery techniques for cranial treatments on the Halcyon linac

Flores‐Martinez

Cerviño

Pawlicki

et al. 2019

J Applied Clin Med Phys

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“…The Optical Surface Management System (OSMS) constitutes more advanced tools (e.g., AlignRT, Vision RT Ltd., London, United Kingdom; Sentinel, C-RAD, Uppsala, Sweden) in vDIBH (16). As we reported previously (17), in the OSMS, threedimensional (3D) surface reconstruction can be visualized by the stereovision to align to the isocenter, providing a real-time position monitoring. Breast intensity-modulated radiation therapy (IMRT) has gained interest that resulted from its feasibility, dosimetric superiority, decreased acute side effects, few late complications, and reduced skin toxicity (18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Dosimetry and Feasibility Studies of Volumetric Modulated Arc Therapy With Deep Inspiration Breath-Hold Using Optical Surface Management System for Left-Sided Breast Cancer Patients

Zhang

You

et al. 2020

Front. Oncol.

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Background: During radiotherapy (RT) procedure of breast cancer, portions of the heart and lung will receive some radiation dose, which may result in acute and late toxicities. In the current study, we report the experience of our single institution with organs at risk (OARs)-sparing RT with deep inspiration breath hold (DIBH) using an Optical Surface Management System (OSMS) and compare the dosimetric parameters with that of free breathing (FB). Patients and Methods: Forty-eight cases diagnosed as early stage left-sided breast cancer scheduled for postoperative RT were enrolled. The OSMS was used to monitor the breathing magnitude and track the real-time respiratory status, which can control a stable lung and heart volume during RT delivery under DIBH. We did the dosimetric analysis of the heart, left anterior descending (LAD) coronary artery, lungs, and contralateral breast under FB and DIBH plans. Results: Compared with FB-volumetric-modulated arc therapy (FB-VMAT), DIBH-VMAT resulted in significantly changed volumes to the heart and lungs receiving irradiation dose. The average mean heart dose and average D2%, V 5 , and V 10 showed significant differences between the DIBH and FB techniques. For the LAD coronary artery, we found significantly reduced average mean dose, D2%, and V 10 with DIBH. Similar results were also found in the lungs and contralateral breast. The use of flattening-filter-free decreased treatment time compared with the flat beam mode in our VMAT (p < 0.05). For the 48 patients, there were no significant differences in the lateral, longitudinal, and vertical directions between OSMS and cone beam CT.

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“…During delivery, the treatment is adapted to account for the motion of the target by either gating or tracking the treatment beam. 8,9 Numerous imaging modalities have been utilized to monitor target motion including optical surface tracking, 10,11 magnetic resonance imaging (MRI) guidance, 12,13 ultrasound guidance, [14][15][16] and fluoroscopy. 17,18 Both interfractional and intrafractional motion management strategies have led to the reduction of treatment margins used for a variety of tumor types seen clinically.…”

Section: Introductionmentioning

confidence: 99%

Deformable abdominal phantom for the validation of real‐time image guidance and deformable dose accumulation

Matrosic

Hull

Palmer

et al. 2019

J Applied Clin Med Phys

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Purpose End‐to‐end testing with quality assurance (QA) phantoms for deformable dose accumulation and real‐time image‐guided radiotherapy (IGRT) has recently been recommended by American Association of Physicists in Medicine (AAPM) Task Groups 132 and 76. The goal of this work was to develop a deformable abdominal phantom containing a deformable three‐dimensional dosimeter that could provide robust testing of these systems. Methods The deformable abdominal phantom was fabricated from polyvinyl chloride plastisol and phantom motion was simulated with a programmable motion stage and plunger. A deformable normoxic polyacrylamide gel (nPAG) dosimeter was incorporated into the phantom apparatus to represent a liver tumor. Dosimeter data were acquired using magnetic resonance imaging (MRI). Static measurements were compared to planned dose distributions. Static and dynamic deformations were used to simulate inter‐ and intrafractional motion in the phantom and measurements were compared to baseline measurements. Results The statically irradiated dosimeters matched the planned dose distribution with an average γ pass rates of 97.0 ± 0.5% and 97.5 ± 0.2% for 3%/5 mm and 5%/5 mm criteria, respectively. Static deformations caused measured dose distribution shifts toward the phantom plunger. During the dynamic deformation experiment, the dosimeter that utilized beam gating showed an improvement in the γ pass rate compared to the dosimeter that did not. Conclusions A deformable abdominal phantom apparatus which incorporates a deformable nPAG dosimeter was developed to test real‐time IGRT systems and deformable dose accumulation algorithms. This apparatus was used to benchmark simple static irradiations in which it was found that measurements match well to the planned distributions. Deformable dose accumulation could be tested by directly measuring the shifts and blurring of the target dose due to interfractional organ deformation and motion. Dosimetric improvements were achieved from the motion management during intrafractional motion.

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Optical Surface Management System for Patient Positioning in Interfractional Breast Cancer Radiotherapy

Cited by 26 publications

References 17 publications

Assessment of the use of different imaging and delivery techniques for cranial treatments on the Halcyon linac

Assessment of the use of different imaging and delivery techniques for cranial treatments on the Halcyon linac

Dosimetry and Feasibility Studies of Volumetric Modulated Arc Therapy With Deep Inspiration Breath-Hold Using Optical Surface Management System for Left-Sided Breast Cancer Patients

Deformable abdominal phantom for the validation of real‐time image guidance and deformable dose accumulation

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