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Comprehensive Treatment Uncertainty Analysis and PTV Margin Estimation for fiducial tracking in Robotic Liver Stereotactic Body Radiation Therapy

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当代医学科学(英文) 2023年第3期43卷 572-578页

作者： Zhi-wen LIANG Meng-lan ZHAI Biao TU Xin NIE Xiao-hui ZHU Jun-ping CHENG Guo-quan LI Dan-dan YU Tao ZHANG Sheng ZHANG Cancer Center Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

Objective This study aims to quantify the uncertainties of CyberKnife Synchrony fiducial tracking for liver stereotactic body radiation therapy(SBRT)cases,and evaluate the required planning target volume(PTV)*** A total of 11 liver tumor patients with a total of 57 fractions,who underwent SBRT with synchronous fiducial tracking,were enrolled for the present *** correlation/prediction model error,geometric error,and beam targeting error were quantified to determine the patient-level and fraction-level individual composite treatment *** composite uncertainties and multiple margin recipes were compared for scenarios with and without rotation correction during *** The correlation model error-related uncertainty was 4.3±1.8,1.4±0.5 and 1.8±0.7 mm in the superior-inferior(SI),left-right,and anterior-posterior directions,*** were the primary contributors among all uncertainty *** geometric error significantly increased for treatments without rotation *** fraction-level composite uncertainties had a long tail ***,the generally used 5-mm isotropic margin covered all uncertainties in the left-right and anterior-posterior directions,and only 75%of uncertainties in the SI *** order to cover 90%of uncertainties in the SI direction,an 8-mm margin would be *** scenarios without rotation correction,additional safety margins should be added,especially in the superior-inferior and anterior-posterior *** The present study revealed that the correlation model error contributes to most of the uncertainties in the *** patients/fractions can be covered by a 5-mm *** with large treatment uncertainties might need a patient-specific margin.

关键词： CyberKnife fiducial tracking liver cancer stereotactic body radiation therapy margin expansion

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