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Dreher C, Oechsner M, Mayinger M, Beierl S, Duma MN, Combs SE, Habermehl D. Evaluation of the tumor movement and the reproducibility of two different immobilization setups for image-guided stereotactic body radiotherapy of liver tumors. Radiat Oncol 2018; 13:15. [PMID: 29378624 PMCID: PMC5789593 DOI: 10.1186/s13014-018-0962-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/22/2018] [Indexed: 01/24/2023] Open
Abstract
Background The purpose of this study is to evaluate the tumor movement and accuracy of patient immobilization in stereotactic body radiotherapy of liver tumors with low pressure foil or abdominal compression. Methods Fifty-four liver tumors treated with stereotactic body radiotherapy were included in this study. Forty patients were immobilized by a vacuum couch with low pressure foil, 14 patients by abdominal compression. We evaluated the ratio of gross tumor volume/internal target volume, the tumor movement in 4D-computed tomography scans and daily online adjustments after cone beam computed tomography scans. Results The ratio of gross tumor volume/internal target volume was smaller with low pressure foil. The tumor movement in 4D-computed tomography scans was smaller with abdominal compression, the cranial movement even significantly different (p = 0.02). The mean online adjustments and their mean absolute values in the vertical, lateral and longitudinal axis were smaller with abdominal compression. The online adjustments were significantly different (p < 0.013), their absolute values in case of the longitudinal axis (p = 0.043). There was no significant difference of the adjustments’ 3D vectors. Conclusions In comparison to low pressure foil, abdominal compression leads to a reduction of the tumor movement. Online adjustments decreased significantly, thus leading to higher accuracy in patient positioning.
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Affiliation(s)
- Constantin Dreher
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Markus Oechsner
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Michael Mayinger
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Stefanie Beierl
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Marciana-Nona Duma
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany.,Institute of Innovative Radiotherapy, Helmholtzzentrum München, Munich, Germany
| | - Daniel Habermehl
- Department of Radiation Oncology, University Hospital Rechts der Isar, Technical University München, Ismaningerstr. 22, 81675, Munich, Germany. .,Institute of Innovative Radiotherapy, Helmholtzzentrum München, Munich, Germany.
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