Accuracy of robotic radiosurgery in renal cell carcinoma.

Autor: Hofmann T; European Radiosurgery Center Munich, Max-Lebsche-Platz 31, 81377 Munich, Germany. Electronic address: theresa.hofmann@erc-munich.com., Kohlhase N; European Radiosurgery Center Munich, Max-Lebsche-Platz 31, 81377 Munich, Germany., Eftimova D; European Radiosurgery Center Munich, Max-Lebsche-Platz 31, 81377 Munich, Germany., Eder MM; European Radiosurgery Center Munich, Max-Lebsche-Platz 31, 81377 Munich, Germany., Staehler M; University Hospital of Munich, Department of Urology, Marchioninistr. 15, 81377 Munich, Germany., Ruge MI; University Hospital Cologne, Medical Faculty of the University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Albertus Magnus Platz, 50923 Cologne, Germany., Muacevic A; European Radiosurgery Center Munich, Max-Lebsche-Platz 31, 81377 Munich, Germany., Fürweger C; European Radiosurgery Center Munich, Max-Lebsche-Platz 31, 81377 Munich, Germany; University Hospital Cologne, Medical Faculty of the University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Albertus Magnus Platz, 50923 Cologne, Germany.
Jazyk: angličtina
Zdroj: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) [Phys Med] 2024 Jun; Vol. 122, pp. 103372. Date of Electronic Publication: 2024 May 16.
DOI: 10.1016/j.ejmp.2024.103372
Abstrakt: Purpose: Although emerging clinical evidence supports robotic radiosurgery as a highly effective treatment option for renal cell carcinoma (RCC) less than 4 cm in diameter, delivery uncertainties and associated target volume margins have not been studied in detail. We assess intrafraction tumor motion patterns and accuracy of robotic radiosurgery in renal tumors with real-time respiratory tracking to optimize treatment margins.
Methods: Delivery log files from 165 consecutive treatments of RCC were retrospectively analyzed. Five components were considered for planning target volume (PTV) margin estimation: (a) The model error from the correlation model between patient breath and tumor motion, (b) the prediction error from an algorithm predicting the patient breathing pattern, (c) the targeting error from the treatment robot, (d) the inherent total accuracy of the system for respiratory motion tracking, and (e) the margin required to cover potential target rotation, simulated with PTV rotations up to 10°.
Results: The median tumor motion was 10.5 mm, 2.4 mm and 4.4 mm in the superior-inferior, left-right, and anterior-posterior directions, respectively. The root of the sum of squares of all contributions to the system's inaccuracy results in a minimum PTV margin of 4.3 mm, 2.6 mm and 3.0 mm in the superior-inferior, left-right and anterior-posterior directions, respectively, assuming optimal fiducial position and neglecting target deformation.
Conclusions: We have assessed kidney motion and derived PTV margins for the treatment of RCC with robotic radiosurgery, which helps to deliver renal treatments in a more consistent manner and potentially further improve outcomes.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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