Reproducibility of Deep-Inspiration Breath Hold treatments on Halcyon™ performed using the first clinical version of AlignRT InBore™: Results of CYBORE study

Lorchel, F.; Nguyen, D.; Mamou, A.; Barbet, N.; Camoesas, J.; Degluaire, Y.; Pouchard, I.; Queffelec, Y.; Renoult, F.; Khodri, M.; Farah, Jad

doi:10.1016/j.ctro.2022.05.002

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…Lorchel et al. reported reproducibility of breath holds within 3 mm when using a surface scanner [ 25 ]. The DIBH reproducibility may be increased by decreasing the gating window for visual guidance.…”

Section: Discussionmentioning

confidence: 99%

Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold

Buschmann,

Kauer-Dorner,

Konrad

et al. 2023

Strahlenther Onkol

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Purpose To investigate the feasibility of a thermo-optical surface imaging (SGRT) system combined with room-based stereoscopic X‑ray image guidance (IGRT) in a dedicated breast deep inspiration breath-hold (DIBH) irradiation workflow. In this context, benchmarking of portal imaging (EPID) and cone-beam CT (CBCT) against stereoscopic X‑rays was performed. Methods SGRT + IGRT data of 30 left-sided DIBH breast patients (1 patient with bilateral cancer) treated in 351 fractions using thermo-optical surface imaging and X-ray IGRT were retrospectively analysed. Patients were prepositioned based on a free-breathing surface reference derived from a CT scan. Once the DIBH was reached using visual feedback, two stereoscopic X‑ray images were acquired and registered to the digitally reconstructed radiographs derived from the DIBH CT. Based on this registration, a couch correction was performed. Positioning and monitoring by surface and X-ray imaging were verified by protocol-based EPID or CBCT imaging at selected fractions and the calculation of residual geometric deviations. Results The median X‑ray-derived couch correction vector was 4.9 (interquartile range [IQR] 3.3–7.1) mm long. Verification imaging was performed for 134 fractions (216 RT field verifications) with EPID and for 37 fractions with CBCT, respectively. The median 2D/3D deviation vector length over all verification images was 2.5 (IQR 1.6–3.9) mm/3.4 (IQR 2.2–4.8) mm for EPID/CBCT, both being well within the planning target volume (PTV) margins (7 mm). A moderate correlation (0.49–0.65) was observed between the surface signal and X-ray position in DIBH. Conclusion DIBH treatments using thermo-optical SGRT and X-ray IGRT were feasible for breast cancer patients. Stereoscopic X‑ray positioning was successfully verified by standard IGRT techniques.

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Section: Discussionmentioning

confidence: 99%

Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold

Buschmann,

Kauer-Dorner,

Konrad

et al. 2023

Strahlenther Onkol

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show abstract

“…When the deviations were within 5 mm, they were corrected by moving the couch. These scans were registered to the planning CT using three degrees of freedom and a grey-value algorithm, with the ROI including the ipsilateral breast and spine [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Optimal fractionation and timing of weekly cone-beam CT in daily surface-guided radiotherapy for breast cancer

et al. 2023

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Purpose Surface-guided radiotherapy (SGRT) has been demonstrated to be a promising supplement to cone-beam computed tomography (CBCT) in adjuvant breast cancer radiotherapy, but a rational combination mode is lacking in clinical practice. The aim of this study was to explore this mode and investigate its impact on the setup and dose accuracy. Methods and materials Daily SGRT and weekly CBCT images were acquired for 23 patients with breast cancer who received conventional fractionated radiotherapy after lumpectomy. Sixteen modes were acquired by randomly selecting one (CBCT1), two (CBCTij), three (CBCTijk), four (CBCTijkl), and five (CBCT12345) images from the CBCT images for fusion with the SGRT. The CTV-PTV margins, OAR doses, and dose coverage (V95%) of PTV and CTV was calculated based on SGRT setup errors with different regions of interest (ROIs). Dose correlations between these modalities were investigated using Pearson and Spearman’s methods. Patient-specific parameters were recorded to assess their impact on dose. Results The CTV-PTV margins decreased with increasing CBCT frequencies and were close to 5 mm for CBCTijkl and CBCT12345. For the ipsilateral breast ROI, SGRT errors were larger in the AP direction, and target doses were higher in all modes than in the whole breast ROI (P < 0.05). In the ipsilateral ROI, the target dose correlations between all modes increased with increasing CBCT time intervals, decreased, and then increased with increasing CBCT frequencies, with the inflection point being CBCT participation at week 5. The dose deviations in CBCT123, CBCT124, CBCT125, CBCTijkl, and CBCT12345 were minimal and did not differ significantly (P > 0.05). There was excellent agreement between CBCT124 and CBCT1234, and between (CBCTijkl, CBCT12345) and CBCT125 in determining the classification for the percentage of PTV deviation (Kappa = 0.704–0.901). In addition, there were weak correlations between the patient’s Dips_b (ipsilateral breast diameter with bolus) and CTV doses in modes with CBCT participation at week 4 (R = 0.270 to 0.480). Conclusions Based on weekly CBCT, these modes with ipsilateral ROI and a combination of daily SGRT and a CBCT frequency of ≥ 3 were recommended, and CBCT was required at weeks 1 and 2 for CBCTijk.

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Evaluation of surface image guidance and Deep inspiration Breath Hold technique for breast treatments with Halcyon

Crop¹,

Laffarguette²,

Achag³

et al. 2023

Physica Medica

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Reproducibility of Deep-Inspiration Breath Hold treatments on Halcyon™ performed using the first clinical version of AlignRT InBore™: Results of CYBORE study

Cited by 6 publications

References 27 publications

Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold

Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold

Optimal fractionation and timing of weekly cone-beam CT in daily surface-guided radiotherapy for breast cancer

Evaluation of surface image guidance and Deep inspiration Breath Hold technique for breast treatments with Halcyon

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