Medical Dosimetry
Volume 35, Issue 4 , Pages 287-296 , Winter 2010

Setup Reproducibility for Thoracic and Upper Gastrointestinal Radiation Therapy: Influence of Immobilization Method and On-Line Cone-Beam CT Guidance

Presented in part at the 49th Annual Meeting of American Society for Therapeutic Radiology and Oncology, October 27–31, 2007, Los Angeles, CA.

  • Winnie Li, B.Sc (Hons), R.T.T.

      Affiliations

    • Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
    • Corresponding Author InformationReprint requests to: Winnie Li, BSc.(Hons), R.T.T., Radiation Therapy, Radiation Medicine Program, Suite 8-125, Princess Margaret Hospital, 610 University Avenue, Toronto, ON, Canada M5G 2M9
    • ,
  • Douglas J. Moseley, Ph.D.

      Affiliations

    • Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
    • Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Jean-Pierre Bissonnette, Ph.D.

      Affiliations

    • Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
    • Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Thomas G. Purdie, Ph.D.

      Affiliations

    • Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
    • Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Andrea Bezjak, M.D.

      Affiliations

    • Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
    • Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
    • ,
  • David A. Jaffray, Ph.D.

      Affiliations

    • Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
    • Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
    • Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada

Received 27 November 2008 ,Accepted 10 September 2009.

References 

  1. Canadian Cancer Society/National Cancer Institute of Canada. Canadian Cancer Statistics 2006. Toronto, Canada In: 2006;p. 1–113
  2. Nelson C, Starkschall G, Chang JY. The potential for dose escalation in lung cancer as a result of systematically reducing margins used to generate planning target volume. Int. J. Radiat. Oncol. Biol. Phys. 2006;65:573–586
  3. de Boer HC, van Sornsen de Koste JR, Senan S, et al. Analysis and reduction of 3D systematic and random setup errors during the simulation and treatment of lung cancer patients with CT-based external beam radiotherapy dose planning. Int. J. Radiat. Oncol. Biol. Phys. 2001;49:857–868
  4. Erridge SC, Seppenwoolde Y, Muller SH, et al. Portal imaging to assess set-up errors, tumor motion and tumor shrinkage during conformal radiotherapy of non-small cell lung cancer. Radiother. Oncol. 2003;66:75–85
  5. Halperin R, Roa W, Field M, et al. Setup reproducibility in radiation therapy for lung cancer: A comparison between T-bar and expanded foam immobilization devices. Int. J. Radiat. Oncol. Biol. Phys. 1999;43:211–216
  6. Bentel GC, Marks LB, Krishnamurthy R. Impact of cradle immobilization on setup reproducibility during external beam radiation therapy for lung cancer. Int. J. Radiat. Oncol. Biol. Phys. 1997;38:527–531
  7. Rosenthal SA, Roach M3rd, Goldsmith BJ, et al. Immobilization improves the reproducibility of patient positioning during six-field conformal radiation therapy for prostate carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 1993;27:921–926
  8. Mitine C, Hoornaert MT, Dutreix A, et al. Radiotherapy of pelvic malignancies: Impact of two types of rigid immobilisation devices on localisation errors. Radiother. Oncol. 1999;52:19–27
  9. Song PY, Washington M, Vaida F, et al. A comparison of four patient immobilization devices in the treatment of prostate cancer patients with three dimensional conformal radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 1996;34:213–219
  10. Nutting CM, Khoo VS, Walker V, et al. A randomized study of the use of a customized immobilization system in the treatment of prostate cancer with conformal radiotherapy. Radiother. Oncol. 2000;54:1–9
  11. Samson MJ, van Sornsen de Koste JR, de Boer HC, et al. An analysis of anatomic landmark mobility and setup deviations in radiotherapy for lung cancer. Int. J. Radiat. Oncol. Biol. Phys. 1999;43:827–832
  12. Jaffray DA. Emergent technologies for 3-dimensional image-guided radiation delivery. Semin. Radiat. Oncol. 2005;15:208–216
  13. Jaffray DA, Siewerdsen JH. Cone-beam computed tomography with a flat-panel imager: initial performance characterization. Med. Phys. 2000;27:1311–1323
  14. Jaffray DA, Siewerdsen JH, Wong JW, et al. Flat-panel cone-beam computed tomography for image-guided radiation therapy. Int. J. Radiat. Oncol. Biol. Phys. 2002;53:1337–1349
  15. Groh BA, Siewerdsen JH, Drake DG, et al. A performance comparison of flat-panel imager-based MV and kV cone-beam CT. Med. Phys. 2002;29:967–975
  16. Oldham M, Letourneau D, Watt L, et al. Cone-beam-CT guided radiation therapy: A model for on-line application. Radiother. Oncol. 2005;75:271–278
  17. Vedam SS, Keall PJ, Kini VR, et al. Acquiring a four-dimensional computed tomography dataset using an external respiratory signal. Phys. Med. Biol. 2003;48:45–62
  18. Islam MK, Purdie TG, Norrlinger BD, et al. Patient dose from kilovoltage cone beam computed tomography imaging in radiation therapy. Med. Phys. 2006;33:1573–1582
  19. Smitsmans MH, de Bois J, Sonke JJ, et al. Automatic prostate localization on cone-beam CT scans for high precision image-guided radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2005;63:975–984
  20. Zeger SL, Liang KY, Albert PS. Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988;44:1049–1060
  21. van Herk M. Errors and margins in radiotherapy. Semin. Radiat. Oncol. 2004;14:52–64
  22. van Herk M, Remeijer P, Rasch C, et al. The probability of correct target dosage: Dose-population histograms for deriving treatment margins in radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2000;47:1121–1135
  23. Purdie TG, Bissonnette JP, Franks K, et al. Cone-beam computed tomography for on-line image guidance of lung stereotactic radiotherapy: Localization, verification, and intrafraction tumor position. Int. J. Radiat. Oncol. Biol. Phys. 2007;68:243–252
  24. Guckenberger M, Meyer J, Wilbert J, et al. Intra-fractional uncertainties in cone-beam CT based image-guided radiotherapy (IGRT) of pulmonary tumors. Radiother. Oncol. 2007;83:57–64
  25. Van de Steene J, Van den Heuvel F, Bel A, et al. Electronic portal imaging with on-line correction of setup error in thoracic irradiation: Clinical evaluation. Int. J. Radiat. Oncol. Biol. Phys. 1998;40:967–976
  26. Wu J, Haycocks T, Alasti H, et al. Positioning errors and prostate motion during conformal prostate radiotherapy using on-line isocentre set-up verification and implanted prostate markers. Radiother. Oncol. 2001;61:127–133
  27. White EA, Cho J, Vallis KA, et al. Cone beam computed tomography guidance for setup of patients receiving accelerated partial breast irradiation. Int. J. Radiat. Oncol. Biol. Phys. 2007;68:547–554
  28. Bissonnette JP, Purdie TG, Higgins JA, et al. Cone-beam CT image-guidance for lung cancer radiation therapy. Int. J. Radiat. Oncol. Biol. Phys. 2009;73:927–934
  29. de Boer HC, Heijmen BJ. A protocol for the reduction of systematic patient setup errors with minimal portal imaging workload. Int. J. Radiat. Oncol. Biol. Phys. 2001;50:1350–1365
  30. Bel A, van Herk M, Bartelink H, et al. A verification procedure to improve patient set-up accuracy using portal images. Radiother. Oncol. 1993;29:253–260
  31. Murphy MJ. Image-guided patient positioning: If one cannot correct for rotational offsets in external-beam radiotherapy setup, how should rotational offsets be managed?. Med. Phys. 2007;34:1880–1883
  32. Kupelian PA, Ramsey C, Meeks SL, et al. Serial megavoltage CT imaging during external beam radiotherapy for non-small-cell lung cancer: Observations on tumor regression during treatment. Int. J. Radiat. Oncol. Biol. Phys. 2005;63:1024–1028
  33. Siker ML, Tome WA, Mehta MP. Tumor volume changes on serial imaging with megavoltage CT for non-small-cell lung cancer during intensity-modulated radiotherapy: How reliable, consistent, and meaningful is the effect?. Int. J. Radiat. Oncol. Biol. Phys. 2006;66:135–141
  34. Guckenberger M, Meyer J, Wilbert J, et al. Precision of image-guided radiotherapy (IGRT) in six degrees of freedom and limitations in clinical practice. Strahlenther. Onkol. 2007;183:307–313

 This work was performed in conjunction with the Elekta Synergy Research Group.

PII: S0958-3947(09)00093-4

doi: 10.1016/j.meddos.2009.09.003

Medical Dosimetry
Volume 35, Issue 4 , Pages 287-296 , Winter 2010

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