Improved setup and positioning accuracy using a three-point customized cushion/mask/bite-block immobilization system for stereotactic reirradiation of head and neck cancer.
Improved setup and positioning accuracy using a three-point customized cushion/mask/bite-block immobilization system for stereotactic reirradiation of head and neck cancer.
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DOI：
10.1120/jacmp.v17i3.6038
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发表时间：
2016-05-08
影响因子：
2.1
通讯作者：
Phan J
中科院分区：
文献类型：
--
作者：
Wang H;Wang C;Tung S;Dimmitt AW;Wong PF;Edson MA;Garden AS;Rosenthal DI;Fuller CD;Gunn GB;Takiar V;Wang XA;Luo D;Yang JN;Wong J;Phan J
本研究的目的是研究定制垫/面罩/咬合块（CMB）固定系统的设置和定位不确定性，并确定图像引导头颈部立体定向消融放疗（HN‐SABR）的PTV边缘。我们分析了使用定制CMB固定系统接受HN‐SABR治疗的21例复发性头颈癌患者的105次治疗。使用ExacTrac红外（IR）跟踪系统进行初始患者设置，初始设置误差基于ExacTrac IR跟踪系统与治疗计划配准的校正在线ExacTrac X射线图像的比较。使用重复验证X射线确定剩余设置误差。在治疗前将在线ExacTrac校正与锥形束CT（CBCT）进行比较，以评估一致性。使用预射束X射线确定分次内定位误差。分析了系统误差和随机误差。在AP、CC和LR方向上的初始平移设置误差分别为、和，三维（3D）矢量为。如果6D治疗床不可用，则初始旋转误差高达2.4°。CBCT与ExacTrac X射线图像一致，在2 mm和2.5°范围内。分次内不确定度在AP、CC和LR方向分别为、和，在偏航、滚转和俯仰方向分别为、和。翻译载体为。当使用图像引导进行在线设置校正时，计算的PTV边缘在1.6 mm范围内。使用图像引导进行在线设置校正，结合我们的定制CMB器械，在治疗期间高度限制靶区运动，并提供稳健的固定，以确保HN‐SABR靶区的最小剂量为95%，PTV裕度为2.0 mm。PACS编号：87.55.ne
The purpose of this study was to investigate the setup and positioning uncertainty of a custom cushion/mask/bite‐block (CMB) immobilization system and determine PTV margin for image‐guided head and neck stereotactic ablative radiotherapy (HN‐SABR). We analyzed 105 treatment sessions among 21 patients treated with HN‐SABR for recurrent head and neck cancers using a custom CMB immobilization system. Initial patient setup was performed using the ExacTrac infrared (IR) tracking system and initial setup errors were based on comparison of ExacTrac IR tracking system to corrected online ExacTrac X‐rays images registered to treatment plans. Residual setup errors were determined using repeat verification X‐ray. The online ExacTrac corrections were compared to cone‐beam CT (CBCT) before treatment to assess agreement. Intrafractional positioning errors were determined using prebeam X‐rays. The systematic and random errors were analyzed. The initial translational setup errors were , , and in AP, CC, and LR directions, respectively, with a three‐dimensional (3D) vector of . The initial rotational errors were up to 2.4° if 6D couch is not available. CBCT agreed with ExacTrac X‐ray images to within 2 mm and 2.5°. The intrafractional uncertainties were , , and in AP, CC, and LR directions, respectively, and , , and in yaw, roll, and pitch direction, respectively. The translational vector was . The calculated PTV margins were within 1.6 mm when using image guidance for online setup correction. The use of image guidance for online setup correction, in combination with our customized CMB device, highly restricted target motion during treatments and provided robust immobilization to ensure minimum dose of 95% to target volume with 2.0 mm PTV margin for HN‐SABR. PACS number(s): 87.55.ne
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DOI：
10.1016/j.ijrobp.2006.11.010
发表时间：
2007-03-15
影响因子：
7
作者：
Meyer, Juergen;Wilbert, Juergen;Flentje, Michael
通讯作者：
Flentje, Michael
影响因子：
3.5
作者：
van Herk, M
通讯作者：
van Herk, M
DOI：
10.1016/s0958-3947(00)00059-5
发表时间：
2001-01-01
期刊：
Medical dosimetry : official journal of the American Association of Medical Dosimetrists
影响因子：
--
作者：
Saw, C B;Yakoob, R;Ayyangar, K M
通讯作者：
Ayyangar, K M
影响因子：
1.2
作者：
Jin, Jian-Yue;Yin, Fang-Fang;Solberg, Timothy D.
通讯作者：
Solberg, Timothy D.
DOI：
10.1016/j.ijrobp.2010.06.022
发表时间：
2011-05-01
影响因子：
7
作者：
Tryggestad, Erik;Christian, Matthew;Kleinberg, Lawrence
通讯作者：
Kleinberg, Lawrence