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Zhang YX, Huan FK, Wan B, Li ZH, Li W, Zhu GQ, Wang ZW, Chen H, Hou L, Jing H, Wang SL, Lu NN. Optical Surface-guided Radiation Therapy for Upper and Lower Limb Sarcomas: An Analysis of Setup Errors and Clinical Target Volume-To-Planning Target Volume Margins. Adv Radiat Oncol 2024; 9:101526. [PMID: 39026611 PMCID: PMC11255107 DOI: 10.1016/j.adro.2024.101526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 04/19/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To assess the clinical benefits of surface-guided radiation therapy (SGRT) in terms of setup error, positioning time, and clinical target volume-to-planning target volume (CTV-PTV) margin in extremity soft tissue sarcoma (STS). Methods and Materials Fifty consecutive patients treated with radiation therapy were selected retrospectively. Treatment setup was performed with either laser-based imaging only (control group), or with laser-based and daily optical surface-based imaging (SGRT group). Pretreatment cone beam computed tomography images were acquired daily for the first 3 to 5 fractions and weekly thereafter, with the frequency adjusted as necessary. Translational and rotational errors were collected. CTV-PTV margin was calculated using the formula, 2.5Σ + 0.7σ. Results Each group consisted of 10 and 15 upper and lower limb STSs, respectively. For patients with upper limb sarcomas, the translation errors were 1.64 ± 1.34 mm, 1.10 ± 1.50 mm, and 1.24 ± 1.45 mm in the SGRT group, and 1.48 ± 3.16 mm, 2.84 ± 2.85 mm, and 3.14 ± 3.29 mm in control group in the left-right, supero-inferior, and antero-posterior directions, respectively. Correspondingly, for patients with lower limb sarcomas, the translation errors were 1.21 ± 1.65 mm, 1.39 ± 1.71 mm, and 1.48 ± 2.10 mm in the SGRT group, and 1.81 ± 2.60 mm, 2.93 ± 3.28 mm, and 3.53 ± 3.75 mm in control group, respectively. The calculated CTV-PTV margins of the SGRT group and control group were 5.0, 3.8, 4.1 versus 5.9, 9.1, 10.1 mm for upper limb sarcomas; and 4.2, 4.7, 5.2 mm versus 6.3, 9.6, and 11.4 mm for lower limb sarcomas in the left-right, supero-inferior, and antero-posterior directions, respectively. Conclusions Daily optical surface guidance can effectively improve the setup accuracy of extremity STS patients, and safely reduce the required CTV-PTV margins.
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Affiliation(s)
| | | | - Bao Wan
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zhao-Hui Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Wei Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Geng-Qiang Zhu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zhi-Wei Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Huan Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Lu Hou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Hao Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
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Saito M, Ueda K, Nemoto H, Onishi Y, Suzuki H, Suzuki T, Sano N, Komiyama T, Marino K, Onishi H. Development of a phantom for assessing the precision of setup in skin mark-less surface-guided radiotherapy. J Appl Clin Med Phys 2024:e14381. [PMID: 38696715 DOI: 10.1002/acm2.14381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/19/2024] [Accepted: 04/10/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Surface-guided radiotherapy (SGRT) is adopted by several institutions; however, reports on the phantoms used to assess the precision of the SGRT setup are limited. PURPOSE The purpose of this study was to develop a phantom to verify the accuracy of the irradiation position during skin mark-less SGRT. METHODS An acrylonitrile butadiene styrene (ABS) plastic cube phantom with a diameter of 150 mm on each side containing a dummy target of 15 mm and two types of body surface-shaped phantoms (breast/face shape) that could be attached to the cube phantom were fabricated. Films can be inserted on four sides of the cubic phantom (left, right, anterior and posterior), and the center of radiation can be calculated by irradiating the dummy target with orthogonal MV beams. Three types of SGRT using a VOXELAN-HEV600M (Electronics Research&Development Corporation, Okayama, Japan) were evaluated using this phantom: (i) SGRTCT-a SGRT set-up based solely on a computed tomography (CT)-reference image. (ii) SGRTCT + CBCT-a method where cone beam computed tomography (CBCT) matching was performed after SGRTCT. (iii) SGRTScan-a resetup technique using a scan reference image obtained after completing the (ii) step. RESULTS Both the breast and face phantoms were recognized in the SGRT system without problems. SGRTScan ensure precision within 1 mm/1° for breast and face verification, respectively. All SGRT methods showed comparable rotational accuracies with no significant disparities. CONCLUSIONS The developed phantom was useful for verifying the accuracy of skin mark-less SGRT position matching. The SGRTScan demonstrated the feasibility of achieving skin-mark less SGRT with high accuracy, with deviations of less than 1 mm. Additional research is necessary to evaluate the suitability of the developed phantoms for use in various facilities and systems. This phantom could be used for postal surveys in the future.
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Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hikaru Nemoto
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yoshiko Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
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Oku Y, Toyota M, Saigo Y. Characteristics of detection accuracy of the patient setup using InBore optical patient positioning system. Radiol Phys Technol 2023; 16:532-542. [PMID: 37812309 DOI: 10.1007/s12194-023-00741-2] [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: 06/16/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
This study aimed to evaluate the detection accuracy of the AlignRT-InBore system in surface-guided radiation therapy using a phantom and to determine the feasibility of the system by conducting a comparative analysis with cone-beam computed tomography (CBCT) registration. The AlignRT-InBore system integrated with the ETHOS Therapy was used. A phantom and a QUASAR phantom were employed to examine the specific areas of interest relevant to clinical cases. The evaluation involved monitoring translations for approximately 30 min and assessing the position detection accuracy for static and moving objects. Fifty clinical cases were used to evaluate the position detection accuracy and its relationship with the localization accuracy of CBCT before treatment. The detection accuracy of static and moving objects was within 1.0 mm using the phantom. However, the longitudinal direction tended to be larger than the other directions. Regarding the accuracy of localization in clinical cases, a strong and statistically significant (p < 0.01) correlation was observed in each direction. A detection accuracy within 1.0 mm is possible for static and moving objects. The detection accuracy of the patient setup using the InBore optical patient positioning system was extremely high, and the patient could be detected with high precision, suggesting its usefulness.
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Affiliation(s)
- Yoshifumi Oku
- Division of Radiology, Department of Clinical Technology, Kagoshima University Hospital, 8-35-1, Sakuragaoka, Kagoshima-City, Kagoshima, 890-8520, Japan.
| | - Masahiko Toyota
- Division of Radiology, Department of Clinical Technology, Kagoshima University Hospital, 8-35-1, Sakuragaoka, Kagoshima-City, Kagoshima, 890-8520, Japan
| | - Yasumasa Saigo
- Division of Radiology, Department of Clinical Technology, Kagoshima University Hospital, 8-35-1, Sakuragaoka, Kagoshima-City, Kagoshima, 890-8520, Japan
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Saito T, Hayashi N, Amma H, Onishi K, Muraki Y, Nozue M. Development of a new coordinate calibration phantom for a light-section-based optical surface monitoring system. Radiol Phys Technol 2023; 16:366-372. [PMID: 37248443 DOI: 10.1007/s12194-023-00726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023]
Abstract
A calibration phantom made of Derlin requires manual translational and rotational adjustments when calibrating a light-section-based optical surface monitoring system (VOXELAN) with a phantom material that insufficiently reflects the red-slit laser of the system. This study aimed to develop a new calibration phantom using different materials and to propose a procedure that minimizes setup errors. The new phantom, primarily made of PET100, which exhibits good reflectivity without scattering or attenuating the red-slit laser at the phantom surface, was shaped in a manner similar to that of previous designs. The detection accuracy and stability were evaluated using six different regions of interest (ROIs) and compared with previous phantom designs. The coordinate coincidence between the machine and VOXELAN was compared for both phantom designs. The detection accuracy and stability of the new phantom in the reference ROI setting were found to be better than those of previous phantoms. In the lateral, longitudinal, and vertical directions, the coordinate coincidences in translational directions for the previous phantom were obtained at 1.07 ± 0.66, 1.46 ± 0.47, and 0.26 ± 0.83 mm, whereas those for the new phantom were obtained at 0.28 ± 0.21, 0.18 ± 0.30, and - 0.30 ± 0.29 mm, respectively. The rotational errors of the two phantoms were identical. The new phantom exhibited improved detection stability because of its good reflectivity. Additionally, the new placement procedure was linked to the six-degrees-of-freedom couch. A combination of the new phantom and its new placement procedure is suitable for coordinate calibration of VOXELAN.
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Affiliation(s)
- Tatsunori Saito
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Naoki Hayashi
- School of Medical Sciences, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
| | - Hiroshi Amma
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Kazuki Onishi
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Yuta Muraki
- Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Masashi Nozue
- Department of Radiation Oncology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-Ward, Hamamatsu, Shizuoka, 430-8558, Japan
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