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Set-up errors in head and neck cancer patients treated with intensity modulated radiation therapy: Quantitative comparison between three-dimensional cone-beam CT and two-dimensional kilovoltage images
- Source :
- Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). 31(8)
- Publication Year :
- 2015
-
Abstract
- To compare the patient set-up error detection capabilities of three-dimensional cone beam computed tomography (3D-CBCT) and two-dimensional orthogonal kilovoltage (2D-kV) techniques.3D-CBCT and 2D-kV projections were acquired on 29 head-and-neck (HN) patients undergoing Intensity Modulated Radiotherapy (IMRT) on the first day of treatment (time 0) and after the delivery of 40 Gy and 50 Gy. Set-up correction vectors were analyzed after fully automatic image registration as well as after revision by radiation oncologists. The dosimetric effects of the different sensitivities of the two image guidance techniques were assessed.A statistically significant correlation among detected set-up deviations by the two techniques was found along anatomical axes (0.60 ρ 0.72, p 0.0001); no correlation was found for table rotation (p = 0.41). No evidence of statistically significant differences between the indications provided along the course of the treatment was found; this was also the case when full automatic versus manually refined correction vectors were compared. The dosimetric effects analysis revealed slight statistically significant differences in the median values of the maximum relative dose to mandible, spinal cord and its 5 mm Planning Organ at Risk Volume (0.95%, 0.6% and 2.45%, respectively), with higher values (p 0.01) observed when 2D-kV corrections were applied.A similar sensitivity to linear set-up errors was observed for 2D-kV and 3D-CBCT image guidance techniques in our HN patient cohort. Higher rotational deviations around the table vertical axis were detected by the 3D-CBCT with respect to the 2D-kV method, leading to a consistent better sparing of organs at risk.
- Subjects :
- Adult
Male
Cone beam computed tomography
medicine.medical_specialty
Time Factors
Adolescent
Biophysics
General Physics and Astronomy
Radiotherapy Setup Errors
Physics and Astronomy (all)
Young Adult
Imaging, Three-Dimensional
Dosimetry
Nuclear Medicine and Imaging
medicine
Humans
Radiology, Nuclear Medicine and imaging
Head and neck cancer
Radiometry
IGRT
Cone beam ct
Image-guided radiation therapy
Set-up verification
Radiology, Nuclear Medicine and Imaging
Aged
Aged, 80 and over
business.industry
General Medicine
Intensity-modulated radiation therapy
Cone-Beam Computed Tomography
Middle Aged
medicine.disease
Head and Neck Neoplasms
Female
Radiology
Radiotherapy, Intensity-Modulated
Nuclear medicine
business
Rotation (mathematics)
Subjects
Details
- ISSN :
- 1724191X
- Volume :
- 31
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)
- Accession number :
- edsair.doi.dedup.....90166a03131b34e5c3bcc758946b5e37