Clinical results of a pilot study on stereovision-guided stereotactic radiotherapy and intensity modulated radiotherapy.
Real-time stereovision-guidance has been introduced for efficient and convenient fractionated stereotactic radiotherapy (FSR) and image-guided intensity-modulated radiation therapy (IMRT). This first pilot study is to clinically evaluate its accuracy and precision as well as impact on treatment doses. Sixty-one FSR patients wearing stereotactic masks (SMs) and nine IMRT patients wearing flexible masks (FMs), were accrued. Daily target reposition was initially based-on biplane-radiographs and then adjusted in six degrees of freedom under real-time stereovision guidance. Mean and standard deviation of the head displacements measured the accuracy and precision. Head positions during beam-on times were measured with real-time stereovisions and used for determination of delivered doses. Accuracy ± ± precision in direction with the largest errors shows improvement from 0.4 ± 2.3 mm to 0.0 ± 1.0 mm in the inferior-to-superior direction for patients wearing SM or from 0.8 ± 4.3 mm to 0.4 ± 1.7 mm in the posterior-to-anterior direction for patients wearing FM. The image-guidance increases target volume coverage by >30% for small lesions. Over half of head position errors could be removed from the stereovision-guidance. Importantly, the technique allows us to check head position during beam-on time and makes it possible for having frameless head refixation without tight masks.
Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA. Shidong.Li@tuhs.temple.edu
Shidong
S
Li
Lawrence R
LR
Kleinberg
Daniele
D
Rigamonti
Moody D
MD
Wharam
Abdul
A
Rashid
Juan
J
Jackson
David
D
Djajaputra
Shenjen
S
He
Tunisia
T
Creasey
Theodore L
TL
DeWeese
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003199:Computer Systems; D005260:Female; D006257:Head / Q000000981:diagnostic imaging; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008579:Meningioma / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000532:radiotherapy* / Q000601:surgery*; D056888:Patient Positioning / Q000379:methods; D010865:Pilot Projects; D011859:Radiography; D016634:Radiosurgery / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D055815:Young Adult