Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables
Background and purpose: Spinal stereotactic ablative body radiotherapy (SABR) requires high precision. We evaluate the intrafraction motion during cone-beam computed tomography (CBCT) guided SABR with different immobilization techniques. Material and methods: Fifty-seven consecutive patients were tr...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-04-01
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| Series: | Physics and Imaging in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631622000355 |
| _version_ | 1818469611272667136 |
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| author | Charlotte Billiet Wim Vingerhoed Steven Van Laere Ines Joye Carole Mercier Piet Dirix Daan Nevens Peter Vermeulen Paul Meijnders Dirk Verellen |
| author_facet | Charlotte Billiet Wim Vingerhoed Steven Van Laere Ines Joye Carole Mercier Piet Dirix Daan Nevens Peter Vermeulen Paul Meijnders Dirk Verellen |
| author_sort | Charlotte Billiet |
| collection | DOAJ |
| description | Background and purpose: Spinal stereotactic ablative body radiotherapy (SABR) requires high precision. We evaluate the intrafraction motion during cone-beam computed tomography (CBCT) guided SABR with different immobilization techniques. Material and methods: Fifty-seven consecutive patients were treated for 62 spinal lesions with SABR with positioning corrected in six degrees of freedom. A surface monitoring system was used for patient set up and to ensure patient immobilization in 65% of patients. Intrafractional motion was defined as the difference between the last CBCT before the start of treatment and the first CT afterwards. Results: For all 194 fractions, the mean intrafractional motion was 0.1 cm (0–1.1 cm) in vertical direction, 0.1 cm (0–1.1 cm) in longitudinal direction and 0.1 cm (0–0.5 cm) in lateral direction. A mean pitch of 0.6° (0–4.3°), a roll of 0.5° (0–3.4°) and a rotational motion of 0.4° (0–3.9°) was observed. 95.5% of the translational errors and 95.4% of the rotational errors were within safety range. There was a significantly higher rotational motion for patients with arms along the body (p = 0.01) and without the use of the body mask (p = 0.05). For cervical locations a higher rotational motion was seen, although not significant (p = 0.1). The acquisition of an extra CBCT was correlated with a higher rotational (pitch) motion (p = 0 < 0.01). Conclusion: Very high precision in CBCT guided and surface-guided spinal SABR was observed in this cohort. The lowest intrafraction motion was seen in patients treated with arms above their head and a body mask. The use of IGRT with surface monitoring is an added value for patient monitoring leading to treatment interruption if necessary. |
| first_indexed | 2024-04-13T21:26:59Z |
| format | Article |
| id | doaj.art-63552a859f114380bea014e19f29932a |
| institution | Directory Open Access Journal |
| issn | 2405-6316 |
| language | English |
| last_indexed | 2024-04-13T21:26:59Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj.art-63552a859f114380bea014e19f29932a2022-12-22T02:29:18ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162022-04-01227376Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variablesCharlotte Billiet0Wim Vingerhoed1Steven Van Laere2Ines Joye3Carole Mercier4Piet Dirix5Daan Nevens6Peter Vermeulen7Paul Meijnders8Dirk Verellen9Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Belgium; Corresponding author at: Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium.Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, BelgiumCenter for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumDepartment of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumDepartment of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumDepartment of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumDepartment of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumCenter for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumDepartment of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumDepartment of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, BelgiumBackground and purpose: Spinal stereotactic ablative body radiotherapy (SABR) requires high precision. We evaluate the intrafraction motion during cone-beam computed tomography (CBCT) guided SABR with different immobilization techniques. Material and methods: Fifty-seven consecutive patients were treated for 62 spinal lesions with SABR with positioning corrected in six degrees of freedom. A surface monitoring system was used for patient set up and to ensure patient immobilization in 65% of patients. Intrafractional motion was defined as the difference between the last CBCT before the start of treatment and the first CT afterwards. Results: For all 194 fractions, the mean intrafractional motion was 0.1 cm (0–1.1 cm) in vertical direction, 0.1 cm (0–1.1 cm) in longitudinal direction and 0.1 cm (0–0.5 cm) in lateral direction. A mean pitch of 0.6° (0–4.3°), a roll of 0.5° (0–3.4°) and a rotational motion of 0.4° (0–3.9°) was observed. 95.5% of the translational errors and 95.4% of the rotational errors were within safety range. There was a significantly higher rotational motion for patients with arms along the body (p = 0.01) and without the use of the body mask (p = 0.05). For cervical locations a higher rotational motion was seen, although not significant (p = 0.1). The acquisition of an extra CBCT was correlated with a higher rotational (pitch) motion (p = 0 < 0.01). Conclusion: Very high precision in CBCT guided and surface-guided spinal SABR was observed in this cohort. The lowest intrafraction motion was seen in patients treated with arms above their head and a body mask. The use of IGRT with surface monitoring is an added value for patient monitoring leading to treatment interruption if necessary.http://www.sciencedirect.com/science/article/pii/S2405631622000355SABRSpinal metastasesIntrafraction motion |
| spellingShingle | Charlotte Billiet Wim Vingerhoed Steven Van Laere Ines Joye Carole Mercier Piet Dirix Daan Nevens Peter Vermeulen Paul Meijnders Dirk Verellen Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables Physics and Imaging in Radiation Oncology SABR Spinal metastases Intrafraction motion |
| title | Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables |
| title_full | Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables |
| title_fullStr | Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables |
| title_full_unstemmed | Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables |
| title_short | Precision of image-guided spinal stereotactic ablative radiotherapy and impact of positioning variables |
| title_sort | precision of image guided spinal stereotactic ablative radiotherapy and impact of positioning variables |
| topic | SABR Spinal metastases Intrafraction motion |
| url | http://www.sciencedirect.com/science/article/pii/S2405631622000355 |
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