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- Title
Comparison of initial patient setup accuracy between surface imaging and three point localization: A retrospective analysis.
- Authors
Stanley, Dennis N.; McConnell, Kristen A.; Kirby, Neil; Gutiérrez, Alonso N.; Papanikolaou, Nikos; Rasmussen, Karl
- Abstract
Purpose Historically, the process of positioning a patient prior to imaging verification used a set of permanent patient marks, or tattoos, placed subcutaneously. After aligning to these tattoos, plan specific shifts are applied and the position is verified with imaging, such as cone-beam computed tomography ( CBCT). Due to a variety of factors, these marks may deviate from the desired position or it may be hard to align the patient to these marks. Surface-based imaging systems are an alternative method of verifying initial positioning with the entire skin surface instead of tattoos. The aim of this study was to retrospectively compare the CBCT-based 3D corrections of patients initially positioned with tattoos against those positioned with the C- RAD Catalyst HD surface imager system. Methods A total of 6000 individual fractions (600-900 per site per method) were randomly selected and the post- CBCT 3D corrections were calculated and recorded. For both positioning methods, four common treatment site combinations were evaluated: pelvis/lower extremities, abdomen, chest/upper extremities, and breast. Statistical differences were evaluated using a paired sample Wilcoxon signed-rank test with significance level of <0.01. Results The average magnitudes of the 3D shift vectors for tattoos were 0.9 ± 0.4 cm, 1.0 ± 0.5 cm, 0.9 ± 0.6 cm and 1.4 ± 0.7 cm for the pelvis/lower extremities, abdomen, chest/upper extremities and breast, respectively. For the Catalyst HD, the average magnitude of the 3D shifts for the pelvis/lower extremities, abdomen, chest/upper extremities and breast were 0.6 ± 0.3 cm, 0.5 ± 0.3 cm, 0.5 ± 0.3 cm and 0.6 ± 0.2 cm, respectively. Statistically significant differences ( P < 0.01) in the 3D shift vectors were found for all four sites. Conclusion This study shows that the overall 3D shift corrections for patients initially aligned with the C- RAD Catalyst HD were significantly smaller than those aligned with subcutaneous tattoos. Surface imaging systems can be considered a viable option for initial patient setup and may be preferable to permanent marks for specific clinics and patients.
- Subjects
RADIOTHERAPY; ELECTROTHERAPEUTICS; IMAGING systems; ABDOMINAL abnormalities; CANCER treatment
- Publication
Journal of Applied Clinical Medical Physics, 2017, Vol 18, Issue 6, p58
- ISSN
1526-9914
- Publication type
Article
- DOI
10.1002/acm2.12183