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Effectiveness of a Patient-Specific Immobilization and Positioning System to Limit Interfractional Translation and Rotation Setup Errors in Radiotherapy of Prostate Cancers

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2016年第3期5卷 184-195页

作者： Gilbert Law Ronnie Leung Frankle Lee hollis luk Ka Chai Lee Frank Wong Matthew Wong Steven Cheung Venus Lee Wing Ho Mui Mark Chan Department of Clinical Oncology Tuen Mun Hospital Hong Kong China

Objective: To evaluate the effectiveness of a patient-specific immobilization and positioning device in prostate radiotherapy. Methods: Eighty patients were immobilized and positioned by a patient-specific device. Prostate translations and rotations were estimated from daily cone beam computed tomography scans using a contour-based approach assisted by auto-registration and quantified by the group mean GM, systematic Σ and random σ' errors. Dosimetric impacts of residual prostate rotations where the translation errors were corrected were evaluated by robustness plan analysis. Results: Using the patient-specific immobilization alone without online image-guidance, the GM, Σ and σ' of the prostate translations were 0.8, 1.7, and 1.5 mm (left-right;LR), 0.8, 2.1, and 1.9 mm (superior-inferior;SI), and 0.5, 1.7 and 1.5 mm (anterior-posterior;AP), while for the prostate rotations they were 0.0°, 0.6°, and 0.7°(pitch), 0.2°, 0.5°, and 0.6°(roll), and 0.2°, 0.5°, and 0.6°(yaw). The resulting van Herk’s margin was 5.8 (LR), 7.3 (SI) and 5.8 (AP) mm. With adaptive online image-guidance based on estimates from the first 5 fractions, Σ were reduced by 0.7 - 1.2 mm for the prostate translations, resulting in a margin reduction by 2 - 3.5 mm. Changes of Σ and σ' in the prostate rotations were insignificant regardless of translation corrections. Dosimetric impacts of residual rotation errors were negligible if a 2 mm margin was applied. Conclusions: Our patient-specific immobilization system can effectively limit the prostate translations and rotations, which is important without 6D treatment couches or using ultrasound image-guidance without rotational corrections.

关键词： Immobilization Prostate CBCT Margin Interfractional Motion

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A Technical Note: Inter-Observer and Inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第4期6卷 392-400页

作者： Ronnie W. K. Leung Matthew Y. P. Wong Venus W. Y. Lee Steven K. T. Cheung Aray K. L. Wong hollis S. L. luk Francesca K. L. Ng Gilbert M. L. Law Frankle K. H. Lee W. H. Mui Dennis Y. K. Ngar Department of Clinical Oncology Tuen Mun Hospital Hong Kong China

Introduction: To investigate the inter-observer and inter-modality variabilities of two imaging guided equipments—cone-beam computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body radiotherapy. Methods: A renal metastasis case implanted with three gold anchor fiducial markers was firstly scanned by US to acquire a 3-dimension US image and followed by 4-dimension CBCT in every fraction. Seven observers retrospectively registered the pre-treatment images with the corresponding reference images based on the gold markers. Registration uncertainty of the observers between two imaging modalities was evaluated. Results: The uncertainties over whole treatment course in CBCT were 0.88 mm, 1.94 mm and 0.86 mm in lateral, longitudinal and vertical directions respectively;while 0.8 mm, 0.97 mm and 1.36 mm were found in US. Conclusion: The greatest uncertainty was found in longitudinal direction in CBCT due to the fact that the respiration motion is the most rigorous in cranial-caudal direction. In US, since the probe was hold almost in upright position, the strong echo in vertical direction was attributed to the greatest uncertainty for such direction.

关键词： Inter-Observer Inter-Modality Variability CBCT US Kidney SBRT

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