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Title: Using kV-kV and CBCT imaging to evaluate rectal cancer patient position when treated prone on a newly available belly board

Journal Article · · Medical Dosimetry
 [1];  [2];  [1];  [3];  [2];  [1]
  1. Department of Medical Physics, Saskatchewan Cancer Agency (Canada)
  2. Department of Radiation Oncology, Saskatchewan Cancer Agency (Canada)
  3. Department of Radiation Therapy, Saskatchewan Cancer Agency (Canada)

The goal of this work was to use daily kV-kV imaging and weekly cone-beam CT (CBCT) to evaluate rectal cancer patient position when treated on a new couch top belly board (BB). Quality assurance (QA) of the imaging system was conducted weekly to ensure proper performance. The positional uncertainty of the combined kV-kV image match and subsequent couch move was found to be no more than {+-} 1.0 mm. The average (1 SD) CBCT QA phantom match was anterior-posterior (AP) = -0.8 {+-} 0.2 mm, superior-inferior (SI) = 0.9 {+-} 0.2 mm, and left-right (LR) = -0.1 {+-} 0.1 mm. For treatment, a set of orthogonal kV-kV images were taken and a bony anatomy match performed online. Moves were made along each axis (AP, SI, and LR) and recorded for analysis. CBCT data were acquired once every 5 fractions for a total of 5 images per patient. The images were all taken after the couch move but before treatment. A 3-dimensional (3D-3D) bony anatomy auto-match was performed offline and the residual difference in position recorded for analysis. The average ({+-} 1 SD) move required from skin marks, calculated over all 375 fractions (15 patients Multiplication-Sign 25 fractions/patient), were AP = -2.6 {+-} 3.7 mm, SI = -0.3 {+-} 4.9 mm, and LR = 1.8 {+-} 4.5 mm. The average residual difference in patient position calculated from the weekly CBCT data (75 total) were AP = -1.7 {+-} 0.4 mm, SI = 1.1 {+-} 0.6 mm, and LR = -0.5 {+-} 0.2 mm. These results show that the BB does provide simple patient positioning that is accurate to within {+-} 2.0 mm when using online orthogonal kV-kV image matching of the pelvic bony anatomy.

OSTI ID:
22130389
Journal Information:
Medical Dosimetry, Vol. 37, Issue 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0958-3947
Country of Publication:
United States
Language:
English