Evaluating positional accuracy using megavoltage cone-beam computed tomography for IMRT with head-and-neck cancer
| Autor: | Takaki Ariji, Mitsuhiko Kawashima, Ryosuke Kohno, Takashi Ueda, Tetsuo Akimoto, Toshiyuki Shibuya, Kana Motegi |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Cone beam computed tomography Adolescent Health Toxicology and Mutagenesis medicine.medical_treatment body mass index Sensitivity and Specificity Patient Positioning head and neck Imaging Three-Dimensional Clivus medicine Humans Radiology Nuclear Medicine and imaging Mental protuberance IMRT Head and neck Aged Aged 80 and over Reproducibility Radiation business.industry positional accuracy Head and neck cancer MV-CBCT Reproducibility of Results Radiotherapy Dosage Cone-Beam Computed Tomography Middle Aged medicine.disease Megavoltage Cone Beam Computed Tomography Radiation therapy medicine.anatomical_structure Oncology Head and Neck Neoplasms Female Radiotherapy Intensity-Modulated Anatomic Landmarks Nuclear medicine business Radiotherapy Image-Guided |
| Zdroj: | Journal of Radiation Research |
| ISSN: | 1349-9157 |
| Popis: | Accurate dose delivery is essential for the success of intensity-modulated radiation therapy (IMRT) for patients with head-and-neck (HN) cancer. Reproducibility of IMRT dose delivery to HN regions can be critically influenced by treatment-related changes in body contours. Moreover, some set-up margins may not be adaptable to positional uncertainties of HN structures at every treatment. To obtain evidence for appropriate set-up margins in various head and neck areas, we prospectively evaluated positional deviation (δ values) of four bony landmarks (i.e. the clivus and occipital protuberance for the head region, and the mental protuberance and C5 for the neck region) using megavoltage cone-beam computed tomography during a treatment course. Over 800 δ values were analyzed in each translational direction. Positional uncertainties for HN cancer patients undergoing IMRT were evaluated relative to the body mass index. Low positional accuracy was observed for the neck region compared with the head region. For the head region, most of the δ was distributed within ± 5 mm, and use of the current set-up margin was appropriate. However, the δ values for the neck region were within ± 8 mm. Especially for overweight patients, a few millimeters needed to be added to give an adequate set-up margin. For accurate dose delivery to targets and to avoid excess exposure to normal tissues, we recommend that the positional verification process be performed before every treatment. |
| Databáze: | OpenAIRE |
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