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Yan L, Xu Y, Dai J. A generalized fit index for evaluating treatment plans of multiple target volumes with different prescribed dose: Generalized dose distribution fit index. Med Dosim 2023; 49:143-149. [PMID: 37919107 DOI: 10.1016/j.meddos.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/20/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND PURPOSE The differential fit index (dFI) and cumulative fit index (cFI) were defined in our previous study to evaluate the fit of isodose surfaces to the target volume. They were only applicable to plans for a single target volume. Therefore, this study aimed to generalize these indices for evaluating plans for multiple target volumes and different prescribed doses. MATERIALS AND METHODS dFI was redefined as the ratio of the integral dose of the volume occupied by an isodose surface to that of the union of all target volumes. cFI was defined as the integral of dFI from a certain dose level of interest to the prescribed dose to be evaluated. To evaluate the performance of the generalized fit index, brain metastasis, head and neck, lung cancer, liver cancer, and cervical cancer cases were selected. For each case, a pair of plans was designed, with one plan having a better fitting dose distribution. The dose fit of these plans was investigated using cFI, the dose gradient index (GI), and the conformity index (CI). RESULTS In total, 26 pairs of evaluations were performed. The correct evaluation rates for cFI, GI, and CI were 96%, 26.92%, and 92.31%, respectively, illustrating that GI was not valid for evaluating complex plans. CONCLUSIONS The generalized fit index proved effective for evaluating the dose fit of plans for multiple target volumes with different prescribed doses.
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Affiliation(s)
- Lingling Yan
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10021, China
| | - Yingjie Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10021, China
| | - Jianrong Dai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10021, China.
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Comparative analysis of setup margin calculation in cone beam CT, by van Herk formula, using two different image registration methods. JOURNAL OF RADIOTHERAPY IN PRACTICE 2023. [DOI: 10.1017/s1460396923000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
ABSTRACT
Introduction:
This study aimed to quantify the difference in setup margin in cone beam computed tomography (CBCT) setup imaging, utilising the van Herk formula for two different image registration methods. Two alternative techniques of registration, bony landmark (BL) matching and soft tissue matching (ST) for head and neck cancer patients, were investigated.
Methods:
This study included 30 head and neck cancer patients who received a simultaneous integrated boost of 54–60–66 Gy in 30 fractions, using volumetric modulated arc treatment. A total of 867 CBCT images were acquired during patient setup and further analysed for setup margin calculation. A region of interest was described using a clip box between the reference and CBCT image to calculate the patient’s positional inaccuracy in three translational directions, X, Y and Z, where X was mediolateral, Y was the cranial-caudal, and Z was the anterior-posterior direction in the patient-based coordinate system, respectively. The shifts were captured by altering the BL and ST matching, and the setup margin was calculated using the van Herk formula (=2·5Σ + 0·7σ where Σ was the systematic and σ was the random error).
Results:
The difference between bony and ST matching in most cases was observed to be 1·4 mm in all translational directions at a 95% confidence interval and <1° in all rotational directions. The rotational error was found to be below the action level (±3°); hence, no corrections related to rotational error were made. The translational setup margin for bone and ST-based registration was X (BL) = 4·6 mm, X (ST) = 4·4 mm, Y (BL) = 6·3 mm, Y (ST) = 4·7 mm, Z (BL) = 3·0 mm, Z (ST) = 3·6mm.
Conclusion:
Two distinct registration approaches for head-neck patient setup did not yield any significant difference in the setup margin calculation. A suitable approach for CBCT and reference CT registration technique was required for the setup margin calculation. Confusion in selecting the correct image registration procedure can result in incorrect treatment execution. The compatibility of the two registration approaches was established in this study. Image fusion was neutralised before the second match (ST) to avoid hysteresis. For setup verification using CBCT for the head and neck region, both bone and ST registration were compatible for setup verification.
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Shih TY, Chen WT, Kuo WC, Wu J. Application of Polarization-sensitive Optical Coherence Tomography in Measurement of Gel Dosimeters. J Med Biol Eng 2022. [DOI: 10.1007/s40846-022-00711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Deshazer G, Narayanasamy G, Bimali M, Galhardo E, Kalantari F, Xia F, Penagaricano JA, Morrill S. A dosimetric comparative analysis of Brainlab elements and Eclipse RapidArc for spine SBRT treatment planning. Biomed Phys Eng Express 2022; 8. [PMID: 35086071 DOI: 10.1088/2057-1976/ac4f97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/27/2022] [Indexed: 11/12/2022]
Abstract
Purpose:This is a dosimetric study comparing stereotactic body radiotherapy (SBRT) plans of spine tumors using Brainlab Elements Spine planning module against Eclipse RapidArc plans. Dose conformity, dose gradient, dose fall-off, and patient-specific quality assurance (QA) metrics were evaluated.Methods:Twenty patients were immobilized in supine position using half Vac-Lok. A prescription dose of 16 Gy in a single fraction was planned for Varian TrueBeam. Conformal arc plans were generated with Pencil beam (PB), MonteCarlo (MC) in Elements, and RapidArc with Acuros XB algorithm in Eclipse using identical treatment geometry.Results:Eclipse, Elements PB, and Elements MC generated dosimetrically conformal plans having Inverse Paddick Conformity Index (IPCI) <1.3. All plans satisfied the dose constraints to target and OARs. Elements PB had a sharper gradient than Elements MC with average GI of 3.67(95% CI: 3.52-3.82) and 4.06 (95% CI: 3.93-4.20) respectively. Eclipse plans were more homogeneous with mean HI= 1.22 (95% CI: 1.20-1.23) that is lower than others. Average maximum clinical target volume (CTV) doses were higher in Elements MC with 22.31Gy (95% CI: 21.87-22.74), while PB plans have 21.15Gy (95% CI: 20.36-21.96), respectively. Elements MC and PB plans had lower average dose to 0.35 cc of spinal cord (D0.35cc) of 7.60Gy (95% CI: 7.18-8.02) and 8.42Gy (95% CI: 7.83-9.01). All plans had >95% points passing the gamma QA criteria at 3%/2 mm.Conclusion:All treatment plans achieved clinically acceptable target coverage >95% and meet spinal cord dose limits. Smart optimization in Brainlab Elements spine module produced dosimetrically superior plans by better spinal cord sparing.
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Affiliation(s)
- Garron Deshazer
- FirstHealth of the Carolinas, 155 Memorial Dr, Pinehurst, North Carolina, 28374-3000, UNITED STATES
| | - Ganesh Narayanasamy
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St Slot 771, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Milan Bimali
- Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Edvaldo Galhardo
- Radiation Oncology Center, University of Arkansas for Medical Sciences, 4301 W Markham St Slot 771, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Faraz Kalantari
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St Slot 771, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Fen Xia
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Jose A Penagaricano
- Department of Radiation Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida, 33612-9416, UNITED STATES
| | - Steven Morrill
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, Arkansas, 72205-7101, UNITED STATES
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Munshi A, Sarkar B, Paul S, Chaudhari BB, Chauhan RS, Ganesh T, Mohanti BK. A mathematical formulation for volume expansions in contouring for radiotherapy planning. J Cancer Res Ther 2021; 17:1125-1131. [PMID: 34528577 DOI: 10.4103/jcrt.jcrt_614_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context This research describe the characteristic volume expansion of a moving target as a function of differential margins. Aim We aimed to ascertain the volume change after giving margin for clinical and set up uncertainties including generating internal target volume (ITV) for moving target. Materials and Methods Settings and Design - Spheres of diameter (0.5-10 cm) with differential expansion of 1-15 mm were generated using a mathematical formula. Moving targets of radius 1-5 cm were generated, and the resultant volume envelopes with incremental motion from 1 to 20 mm were obtained. All relative volume change results were fitted with mathematical functions to obtain a generalized mathematical formula. Statistical Analysis Used None. Results The percentage increase in volume (%ΔVp) was much more pronounced for smaller radius target. For moving target with relatively smaller radius, %ΔVp is predominant over the absolute volume change and vice versa in case of larger radius. Mathematical formulae were obtained for %ΔVp as a function of radius and expansion and for %ΔVp in ITV volume as a function of radius and tumor movement. Conclusions This study provides an idea of volume change for various expansions for various size targets and/or moving target for different range of movements. It establishes a correlation of these volume changes with the changing target size and range of movements. Finally, a clinically useful mathematical formulation on volume expansion has been developed for rapid understanding of the consequence of volume expansion.
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Affiliation(s)
- Anusheel Munshi
- Department of Radiation Oncology, Manipal Hospitals, New Delhi, India
| | - Biplab Sarkar
- Department of Radiation Oncology, Manipal Hospitals, New Delhi, India
| | - Sayan Paul
- Department of Radiation Oncology, Fortis Memorial Research Institute, Guragon, Haryana, India
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Chea M, Fezzani K, Jacob J, Cuttat M, Croisé M, Simon JM, Feuvret L, Valery CA, Maingon P, Benadjaoud MA, Jenny C. Dosimetric study between a single isocenter dynamic conformal arc therapy technique and Gamma Knife radiosurgery for multiple brain metastases treatment: impact of target volume geometrical characteristics. Radiat Oncol 2021; 16:45. [PMID: 33639959 PMCID: PMC7912819 DOI: 10.1186/s13014-021-01766-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose To compare linac-based mono-isocentric radiosurgery with Brainlab Elements Multiple Brain Mets (MBM) SRS and the Gamma Knife using a specific statistical method and to analyze the dosimetric impact of the target volume geometric characteristics. A dose fall-off analysis allowed to evaluate the Gradient Index relevancy for the dose spillage characterization. Material and methods Treatments were planned on twenty patients with three to nine brain metastases with MBM 2.0 and GammaPlan 11.0. Ninety-five metastases ranging from 0.02 to 9.61 cc were included. Paddick Index (PI), Gradient Index (GI), dose fall-off, volume of healthy brain receiving more than 12 Gy (V12Gy) and DVH were used for the plan comparison according to target volume, major axis diameter and Sphericity Index (SI). The multivariate regression approach allowed to analyze the impact of each geometric characteristic keeping all the others unchanged. A parallel study was led to evaluate the impact of the isodose line (IDL) prescription on the MBM plan quality. Results For mono-isocentric linac-based radiosurgery, the IDL around 70–75% was the best compromise found. For both techniques, the GI and the dose fall-off decreased with the target volume. In comparison, PI was slightly improved with MBM for targets < 1 cc or SI > 0.78. GI was improved with GP for targets < 2.5 cc. The V12Gy was higher with MBM for lesions > 0.4 cc or SI < 0.84 and exceeded 10 cc for targets > 5 cc against 6.5 cc with GP. The presence of OAR close to the PTV had no impact on the dose fall off values. The dose fall-off was higher for volumes < 3.8 cc with GP which had the sharpest dose fall-off in the infero-superior direction up to 30%/mm. The mean beam-on time was 94 min with GP against 13 min with MBM. Conclusions The dose fall-off and the V12Gy were more relevant indicators than the GI for the low dose spillage assessment. Both evaluated techniques have comparable plan qualities with a slightly improved selectivity with MBM for smaller lesions but with a healthy tissues sparing slightly favorable to GP at the expense of a considerably longer irradiation time. However, a higher healthy tissue exposure must be considered for large volumes in MBM plans.
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Affiliation(s)
- Michel Chea
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France.
| | - Karen Fezzani
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Julian Jacob
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Marguerite Cuttat
- Neurosurgery Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Mathilde Croisé
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Jean-Marc Simon
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Loïc Feuvret
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Charles-Ambroise Valery
- Neurosurgery Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Philippe Maingon
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Mohamed-Amine Benadjaoud
- PSE-SANTE/SERAMED, Radiation Protection and Nuclear Safety Institute, Fontenay aux Roses, France
| | - Catherine Jenny
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
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Feasibility and potential advantages using VMAT in SRS metastasis treatments. ACTA ACUST UNITED AC 2021; 26:119-127. [PMID: 34046222 DOI: 10.5603/rpor.a2021.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022]
Abstract
Background Utilization of stereotactic radiosurgery (SRS) for brain metastases (BM) has become the technique of choice as opposed to whole brain radiation therapy (WBRT). The aim of this work is to evaluate the feasibility and potential benefits in terms of normal tissue (NT) and dose escalation of volumetric modulated arc therapy (VMAT) in SRS metastasis treatment. A VMAT optimization procedure has therefore been developed for internal dose scaling which minimizes planner dependence. Materials and methods Five patient-plans incorporating treatment with frame-based SRS with dynamic conformal arc technique (DA) were re-planned for VMAT. The lesions selected were between 4-6 cm3. The same geometry used in the DA plans was maintained for the VMAT cases. A VMAT planning procedure was performed attempting to scale the dose in inner auxiliary volumes, and to explore the potential for dose scaling with this technique. Comparison of dose-volume histogram (DVH) parameters were obtained. Results VMAT allows a superior NT sparing plus conformity and dose scaling using the auxiliary volumes. The VMAT results were significantly superior in NT sparing, improving both the V10 and V12 values in all cases, with a 2-3 cm3 saving. In addition, VMAT improves the dose coverage D95 by about 0.5 Gy. The objective of dose escalation was achieved with VMAT with an increment of the Dmean and the Dmedian of about 2 Gy. Conclusions This work shows a benefit of VMAT in SRS treatment with significant NT sparing. A VMAT optimization procedure, based on auxiliary inner volumes, has been developed, enabling internal dose escalation.
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Stereotactic radiotherapy for small and very small tumours (≤1 to ≤3 cc): evaluation of the influence of volumetric-modulated arc therapy in comparison to dynamic conformal arc therapy and 3D conformal radiotherapy as a function of flattened and unflattened beam models. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s146039691900102x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractPurpose:The objective of this article is to evaluate the dosimetric efficacy of volumetric modulated arc therapy (VMAT) in comparison to dynamic conformal arc therapy (DCAT) and 3D conformal radiotherapy (3DCRT) for very small volume (≤1 cc) and small volume (≤3 cc) tumours for flattened (FF) and unflattened (FFF) 6 MV beams.Materials and methods:A total of 21 patients who were treated with single-fraction stereotactic radiosurgery, using either VMAT, DCAT or 3DCRT, were included in this study. The volume categorisation was seven patients each in <1, 1–2 and 2–3 cc volume. The treatment was planned with 6 MV FF and FFF beams using three different techniques: VMAT/Rapid Arc (RA) (RA_FF and RA_FFF), dynamic conformal arc therapy (DCA_FF and DCA_FFF) and 3DCRT (Static_FF and Static_FFF). Plans were evaluated for target coverage (V100%), conformity index, homogeneity index, dose gradient for 50% dose fall-off, total MU and MU/dose ratio [intensity-modulated radiotherapy (IMRT) factor], normal brain receiving >12 Gy dose, dose to the organ at risk (OAR), beam ON time and dose received by 12 cc of the brain.Result:The average target coverage for all plans, all tumour volumes (TVs) and delivery techniques is 96·4 ± 4·5 (range 95·7 ± 6·1–97·5 ± 2·9%). The conformity index averaged over all volume ranges <1, 2, 3 cc> varies between 0·55 ± 0·08 and 0·68 ± 0·04 with minimum and maximum being exhibited by DCA_FFF for 1 cc and Static_FFF/RA_FFF for 3 cc tumours, respectively. Mean IMRT factor averaged over all volume ranges for RA_FF, DCA_FF and Static_FF are 3·5 ± 0·8, 2·0 ± 0·2 and 2·0 ± 0·2, respectively; 50% dose fall-off gradient varies in the range of 0·33–0·42, 0·35–0·40 and 0·38–0·45 for 1, 2 and 3 cc tumours, respectively.Conclusion:This study establishes the equivalence between the FF and FFF beam models and different delivery techniques for stereotactic radiosurgery in small TVs in the range of ≤1 to ≤3 cc. Dose conformity, heterogeneity, dose fall-off characteristics and OAR doses show no or very little variation. FFF could offer only limited time advantage due to excess dose rate over an FF beam.
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Sarkar B, Munshi A, Ganesh T, Manikandan A, Krishnankutty S, Chitral L, Pradhan A, Kalyan Mohanti B. Technical Note: Rotational positional error corrected intrafraction set-up margins in stereotactic radiotherapy: A spatial assessment for coplanar and noncoplanar geometry. Med Phys 2019; 46:4749-4754. [PMID: 31495931 DOI: 10.1002/mp.13810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/26/2019] [Accepted: 08/26/2019] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of this study is to calculate setup margin based on six-dimensional (6D) corrected residual positional errors from kV cone beam computed tomography (CBCT) and from intrafraction projection kV imaging in coplanar and in noncoplanar couch positions in stereotactic radiotherapy. METHODS Six dimensional positional corrections were carried out before patient treatments, using a robotic couch and CBCT matching. A CBCT and stereoscopic ExacTrac image were acquired post-table position correction. Further, a series of intrafraction ExacTrac images were obtained for the variable couch position. Translational and rotational errors were identified as lateral (X), longitudinal (Y), vertical (Z); roll (Ɵ°), pitch (Φ°) and yaw (Ψ°). A total of 699 intrafraction image sets (361 coplanar and 338 noncoplanar) for 51 SRS/SRT patients were analysed. Rotational errors were corrected in terms of translational coordinates. Residual set-up margins were calculated from CBCT shifts. ExacTrac shifts give residual + intrafraction setup margins as a function of coplanar and noncoplanar couch positions. RESULTS The average residual positional error obtained from CBCT in X, Y, Z, Ɵ, Φ, Ψ were 0.1 ± 0.4 mm, 0.0 ± 0.6 mm, 0.0 ± 0.5 mm, 0.2 ± 0.8°, 0.1 ± 0.6° and -0.1 ± 0.7° respectively. For ExacTrac, the shits were -0.5 ± 0.9 mm, -0.0 ± 1mm, -0.6 ± 1.0mm, 0.4 ± 0.9°, -0.2 ± 0.6°, and -0.0 ± 0.8°. CBCT calculated linear setup margins in X, Y, Z direction were 0.5, 1.2, and 1 mm respectively. ExacTrac yielded coplanar and noncoplanar linear setup margins were 1.2, 1.3, 1.5, 1.4, 1.5, and 2.1 mm respectively. CONCLUSION CBCT-based gross residual set-up margin is equal to 1 mm. ExacTrac calculated residual plus intrafraction setup margin falls within a 2 mm range; attributed to intrafraction patient movement, table position inaccuracies, and poor image fusion in noncoplanar geometry. There could be variations in the required additional margin between centers and between machines, which require further studies.
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Affiliation(s)
- Biplab Sarkar
- Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, 110070, India
| | - Anusheel Munshi
- Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, 110070, India
| | - Tharmarnadar Ganesh
- Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, 110070, India
| | - Arjunan Manikandan
- Department of Medical Physics, Apollo Proton Cancer Centre, Chennai, 600096, Tamil Nadu, India
| | - Saneg Krishnankutty
- Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, 122002, Haryana, India
| | - Latika Chitral
- Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, 110070, India
| | - Anirudh Pradhan
- Department of Mathematics, Institute of Applied Sciences & Humanities, GLA University, Mathura, 281406, Uttar Pradesh, India
| | - Bidhu Kalyan Mohanti
- Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, 110070, India
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Standardization of volumetric modulated arc therapy‐based frameless stereotactic technique using a multidimensional ensemble‐aided knowledge‐based planning. Med Phys 2019; 46:1953-1962. [DOI: 10.1002/mp.13470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/31/2022] Open
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