Localization correction of setup function for thoracic tumors using the helical tomother-apy system and analysis of error sources

Update:Nov. 10, 2021Total Views:403Total Downloads:216 DownloadMobile

Author: Shi-Fei XU 1, 2 Huan FENG 1 Hai-Yang LIU 2 Jie HU 2 Lu MA 1

Affiliation: 1. Wuhan University School of Health Sciences, Wuhan 430071, China 2. Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China

Keywords: Helical tomotherapy system Localization error Setup function Body mass index

DOI:10.12173/j.issn.1004-5511.202012002

  • Abstract
  • Full-text
  • Figures and Tables
  • References
Abstract

Objective  To discuss the role of the helical tomotherapy(HT) system setup function to correct positional errors and analyze error sources.
Methods  The mega-voltage computed tomography (MVCT) image information of 36 patients with thoracic tumors were investigated. The scanned images obtained from the initial resetting and the second setup resetting were aligned using kilo-voltage com-puted tomography (KVCT), and localization errors were recorded. The localization errors between the initial and the second fractionated resetting were evaluated, and a model of repeated measurement mixed linear regression was developed to analyze error sources.
Results  Except for the translation error in the lateral directions, the average error of the setup function after reset was generally smaller than that of the initial reset. Especially in the vertical direction, the error of the setup function after re-set was significantly smaller than that of the first reset (0.17±1.14 mm vs. 5.04±2.43 mm, P< 0.001). Multi-factor statistical analysis showed that BMI might induce translation and rotation in the vertical direction and Roll angle, the regression coefficient β were 0.191 (P=0.001) and 0.034 (P=0.040), re-spectively. Moreover, translational errors in the vertical direction might be influenced by fractionated dose and resetting approaches. Gender, age and clinical diagnosis were not found to result in obvious effects in localization errors in this study (P>0.05).
Conclusion  Setup function can correct localization errors, especially translational errors in the vertical direction. The localization accuracy in the vertical direction may be influenced by BMI, fractionated dose and resetting approaches for patients with tho-racic tumors having radiotherapy.

Full-text
Please download the PDF version to read the full text: download
References

1. Sterzing F, Uhl M, Hauswald H, et al. Dynamic jaws and dynamic couch in helical tomotherapy[J]. Int J Radiat Oncol Biol Phys, 2010, 76(4): 1266-1273. DOI: 10.1016/j.ijrobp.2009.07.1686.

2. Sterpin E, Janssens G, Orban DX, et al. Helical tomotherapy for SIB and hypo-fractionated treatments in lung carcinomas: a 4D Monte Carlo treatment planning study[J]. Radiother Oncol, 2012, 104(2): 173-180. DOI: 10.1016/j.radonc.2012.06.005.

3. Schubert LK, Westerly DC, Tomé WA, et al. A comprehensive assessment by tumor site of patient setup using daily MVCT imaging from more than 3,800 helical tomotherapy treatments[J]. Int J Radiat Oncol Biol Phys, 2009, 73(4): 1260-1269. DOI: 10.1016/j.ijrobp. 2008.11.054.

4. Contesini M, Guberti M, Saccani R, et al. Setup errors in patients with head-neck cancer (HNC), treat-ed using the Intensity Modulated Radiation Therapy (IMRT) technique: how it influences the custom-ised immobilisation systems, patient's pain and anxiety[J]. Radiat Oncol, 2017, 12(1): 72. DOI: 10.1186/s13014-017-0807-y.

5. 尚凯, 迟子峰, 王军, 等. 胸段食管癌IGRT中摆位误差分析[J]. 中华放射肿瘤学杂志, 2015, 24(1): 70-73. DOI: 10.3760/cma.j.issn.1004-4221.2015.01.019. [Shang K, Chi ZF, Wang J, et al. The analysis of setup error in imaging-guided radiotherapy with thoracic esophageal carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(1): 70-73.]

6. Bol GH, Lagendijk JJ, Raaymakers BW. Virtual couch shift (VCS): accounting for patient translation and rotation by online IMRT re-optimization[J]. Phys Med Biol, 2013, 58(9): 2989-3000. DOI: 10.1088/0031-9155/58/9/2989.

7. Murray J, Griffin C, Gulliford S, et al. A randomised assessment of image guided radiotherapy within a phase 3 trial of conventional or hypofractionated high dose intensity modulated radiotherapy for prostate cancer[J]. Radiother Oncol, 2020, 142: 62-71. DOI: 10.1016/j.radonc.2019. 10.017.

8. Shah A, Aird E, Shekhdar J. Contribution to normal tissue dose from concomitant radiation for two common kV-CBCT systems and one MVCT system used in radiotherapy[J]. Radiother Oncol, 2012, 105(1): 139-144. DOI: 10.1016/j.radonc.2012.04.017.

9. Trivedi G, Dixit CK, Oinam AS, et al. Kilovoltage cone-beam computed tomography imaging dose es-timation and optimization: need of daily cone-beam computed tomography[J]. J Cancer Res Ther, 2019, 15(3): 470-474. DOI: 10.4103/jcrt.JCRT-949-17.

10.  Hirata K, Yoshimura M, Mukumoto N, et al. Three-dimensional intrafractional internal target motions in accelerated partial breast irradiation using three-dimensional conformal external beam radiothera-py[J]. Radiother Oncol, 2017, 124(1): 118-123. DOI: 10.1016/j.radonc.2017.04.023.

11.  Lee J, Liu SH, Lin JB, et al. Image-guided study of inter-fraction and intra-fraction set-up variability and margins in reverse semi-decubitus breast radiotherapy[J]. Radiat Oncol, 2018, 13(1): 254. DOI: 10.1186/s13014-018-1200-1.

12.  李兴德, 翟福山, 张明云, 等.胸部肿瘤患者体重指数对摆位误差的影响[J]. 中华放射肿瘤学杂志, 2015, 24(1): 40-41. DOI: 10.3760/cma.j.issn.1004- 4221.2015.01.011. [Li XD, Zhai FS, Zhang MY, et al. Effect of BMI on setup error in patients with thoracic tumor[J]. Chinese Journal of Radiation Oncology, 2015, 24(1): 40-41.]

Hot Papers