TY - JOUR
T1 - Evaluation of residual patient position variation for spinal radiosurgery using the Novalis image guided system
AU - Jin, Jian Yue
AU - Ryu, Samuel
AU - Rock, Jack
AU - Faber, Kathleen
AU - Chen, Qing
AU - Ajlouni, Munther
AU - Movsas, Benjamin
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2008
Y1 - 2008
N2 - Purpose: The Novalis system has been demonstrated to achieve accurate target localization on anthropomorphic phantoms. However, other factors, such as rotational deviation, patient intrafraction motion, and image fusion uncertainty due to patient body deformation, could contribute additional position uncertainty for actual patients. This study evaluates such position uncertainty for spinal radiosurgery patients. Materials and Methods: Fifty-two consecutive spinal radiosurgery patients were included in the study. Rotational deviation was evaluated from 6-deg of freedom (6D) fusion results for all patients. The combined uncertainty of patient motion and image fusion was determined from fusion results of additional kV x-ray images acquired before, during, and after treatment for 25 of the 52 patients. The uncertainty of image fusion was also evaluated by performing 6D fusion ten different times with various regions of interest in the images selected for fusion. This was performed for two patients with L3 and T2 lesions, respectively, for comparison. Results: The mean rotational deviation was 0.7±1.8, 0.7±1.5, and 0.7±1.6 deg along the yaw, roll, and pitch directions, respectively. The combined uncertainty from patient motion and image fusion was 0.1±0.9, 0.2±1.2, and 0.2±1.0 mm in the anteroposterior (AP), longitudinal, and lateral directions, respectively. The uncertainty (standard deviation) due to image fusion was less than 0.28 mm in any direction for the L3 lesion and 0.8 mm in the AP direction for the T2 lesion. Conclusion: Overall position uncertainty for spinal radiosurgery patients has been evaluated. Rotational deviation and patient motion were the main factors contributed to position uncertainty for actual patient treatment.
AB - Purpose: The Novalis system has been demonstrated to achieve accurate target localization on anthropomorphic phantoms. However, other factors, such as rotational deviation, patient intrafraction motion, and image fusion uncertainty due to patient body deformation, could contribute additional position uncertainty for actual patients. This study evaluates such position uncertainty for spinal radiosurgery patients. Materials and Methods: Fifty-two consecutive spinal radiosurgery patients were included in the study. Rotational deviation was evaluated from 6-deg of freedom (6D) fusion results for all patients. The combined uncertainty of patient motion and image fusion was determined from fusion results of additional kV x-ray images acquired before, during, and after treatment for 25 of the 52 patients. The uncertainty of image fusion was also evaluated by performing 6D fusion ten different times with various regions of interest in the images selected for fusion. This was performed for two patients with L3 and T2 lesions, respectively, for comparison. Results: The mean rotational deviation was 0.7±1.8, 0.7±1.5, and 0.7±1.6 deg along the yaw, roll, and pitch directions, respectively. The combined uncertainty from patient motion and image fusion was 0.1±0.9, 0.2±1.2, and 0.2±1.0 mm in the anteroposterior (AP), longitudinal, and lateral directions, respectively. The uncertainty (standard deviation) due to image fusion was less than 0.28 mm in any direction for the L3 lesion and 0.8 mm in the AP direction for the T2 lesion. Conclusion: Overall position uncertainty for spinal radiosurgery patients has been evaluated. Rotational deviation and patient motion were the main factors contributed to position uncertainty for actual patient treatment.
KW - Image fusion
KW - Image guided radiotherapy
KW - Intrafraction motion
KW - Position uncertainty
KW - Spinal radiotherapy
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U2 - 10.1118/1.2839097
DO - 10.1118/1.2839097
M3 - Article
C2 - 18404943
AN - SCOPUS:40049112446
VL - 35
SP - 1087
EP - 1093
JO - Medical Physics
JF - Medical Physics
SN - 0094-2405
IS - 3
ER -