Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions

Kitamura, Kei; Shirato, Hiroki; Seppenwoolde, Yvette; Onimaru, Rikiya; Oda, Makoto; Fujita, Katsuhisa; Shimizu, Satoru; Shinohara, Nobuo; Harabayashi, Toru; Miyasaka, Kazuo

doi:10.1016/s0360-3016(02)02882-1

Cited by 181 publications

(127 citation statements)

References 20 publications

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“…Although only displacements in the superior–inferior plane were ever sufficient to initiate patient realignment (Table 3, 0.6% of the time), net vector displacements

> 5 mm

occurred 1.9% of the time. Our results agree with the report of Kitamura et al, ( 6 ) but their study's average prone position displacements for 10 patients in the SI and AP directions were considerably greater, while the standard deviations were similar to what we report here. The Kitamura study data were acquired during five 2‐minute sessions at 30 Hz, and the data were smoothed with a 30‐point rolling filter to reduce the noise.…”

Section: Discussionsupporting

confidence: 93%

“…There is abundant experience with real‐time tracking of patients in the supine position ( 10 ) and reports of tracking behavior in patients treated prone, ( 11 ) but there has been only two comparisons of tracking behavior in patients monitored in both positions. ( 6 , 12 ) These two studies treated patients in the supine position and then repositioned the patients prone for a short interval of time. Our work not only intends to verify the results of Shah et al ( 12 ) and Kitamura et al ( 6 ) for patients planned and treated supine with patients planned and treated prone, but also to extend their work by separately evaluating long‐term and short‐term displacements by Poincaré analysis.…”

Section: Introductionmentioning

confidence: 99%

“…( 6 , 12 ) These two studies treated patients in the supine position and then repositioned the patients prone for a short interval of time. Our work not only intends to verify the results of Shah et al ( 12 ) and Kitamura et al ( 6 ) for patients planned and treated supine with patients planned and treated prone, but also to extend their work by separately evaluating long‐term and short‐term displacements by Poincaré analysis.…”

Section: Introductionmentioning

confidence: 99%

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Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Butler

Merrick

Reed

et al. 2013

J Applied Clin Med Phys

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Implanted radiofrequency transponders were used for real‐time monitoring of the intrafraction prostate displacement between patients in the prone position and the same patients in the supine position. Thirteen patients had three transponders implanted transperineally and were treated prone with a custom‐fitted thermoplastic immobilization device. After collecting data from the last fraction, patients were realigned in the supine position and the displacements of the transponders were monitored for 5–7 minutes. Fourier transforms were applied to the data from each patient to determine periodicity and its amplitude. To remove auto correlation from the stream of displacement data, the distribution of short‐term and long‐term velocity components were calculated from Poincaré plots of paired sequential vector displacements. The mean absolute displacement was significantly greater prone than supine in the superior–inferior (SI) plane (1.2±0.6mm vs. 0.6±0.4mm, p=0.015), but not for the lateral or anterior–posterior (AP) planes. Displacements were least in the lateral direction. Fourier analyses showed the amplitude of respiratory oscillations was much greater for the SI and AP planes in the prone versus the supine position. Analysis of Poincaré plots confirmed greater short‐term variance in the prone position, but no difference in the long‐term variance. The centroid of the implanted transponders was offset from the treatment isocenter by > 5 mm for 1.9% of the time versus 0.8% of the time for supine. These results confirmed significantly greater net intrafraction prostate displacement of patients in the prone position than in the supine position, but most of the difference was due to respiration‐induced motion that was most pronounced in the SI and AP directions. Because the respiratory motion remained within the action threshold and also within our 5 mm treatment planning margins, there is no compelling reason to choose one treatment position over the other.PACS number: 87.50.st

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“…Although only displacements in the superior–inferior plane were ever sufficient to initiate patient realignment (Table 3, 0.6% of the time), net vector displacements

> 5 mm

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Butler

Merrick

Reed

et al. 2013

J Applied Clin Med Phys

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show abstract

“…An important issue in prostate radiotherapy is the toxicity of the rectum and bladder, which can be improved by the accurate localization of the treatment target and the reduction of the treatment margins. The displacement and deformation of the prostate and surrounding organs are important factors in the consideration of treatment margins for external radiotherapy of prostate cancer 1 , 2 , 3 . The effects of inter‐ and intrafractional motion and deformation of the treatment target during prostate radiotherapy have been investigated using various imaging techniques in order to develop practical margin recipes for commonly available treatment setup and target localization techniques.…”

Section: Introductionmentioning

confidence: 99%

Intrafractional prostate motion during external beam radiotherapy monitored by a real‐time target localization system

Chen

et al. 2015

J Applied Clin Med Phys

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This paper investigates the clinical significance of real‐time monitoring of intrafractional prostate motion during external beam radiotherapy using a commercial 4D localization system. Intrafractional prostate motion was tracked during 8,660 treatment fractions for 236 patients. The following statistics were analyzed: 1) the percentage of fractions in which the prostate shifted 2−7 mm for a certain duration; 2) the proportion of the entire tracking time during which the prostate shifted 2−7 mm; and 3) the proportion of each minute in which the shift exceeded 2−7 mm. The ten patients exhibiting maximum intrafractional‐motion patterns were analyzed separately. Our results showed that the percentage of fractions in which the prostate shifted by >2,3,5,and 7 mm off the baseline in any direction for >30 normals was 56.8%, 27.2%, 4.6%, and 0.7% for intact prostate and 68.7%, 35.6%, 10.1%, and 1.8% for postprostatectomy patients, respectively. For the ten patients, these percentages were 91.3%, 72.4%, 36.3%, and 6%, respectively. The percentage of tracking time during which the prostate shifted >2,3,5,and 7 mm was 27.8%, 10.7%, 1.6%, and 0.3%, respectively, and it was 56.2%, 33.7%, 11.2%, and 2.1%, respectively, for the ten patients. The percentage of tracking time for a >3 mm posterior motion was four to five times higher than that in other directions. For treatments completed in 5 min (VMAT) and 10 min (IMRT), the proportion for the prostate to shift by >3 mm was 4% and 12%, respectively. Although intrafractional prostate motion was generally small, caution should be taken for patients who exhibit frequent large intrafractional motion. For those patients, adjustment of patient positioning may be necessary or a larger treatment margin may be used. After the initial alignment, the likelihood of prostate motion increases with time. Therefore, it is favorable to use advanced techniques (e.g., VMAT) that require less delivery time in order to reduce the treatment uncertainty resulting from intrafractional prostate motion.PACS number: 87.50.S‐, 87.53.Kn, 87.55.N‐, 87.55.ne

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“…Generally the time frames used were very short (10-20secs) (26,27,28,29) except for one study where the time frame was 2-3 mins(30).…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

McNair

Hansen

Parker

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions

Cited by 181 publications

References 20 publications

Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Intrafractional prostate motion during external beam radiotherapy monitored by a real‐time target localization system

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

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