open access

Vol 16, No 3 (2011)
Published online: 2011-05-01
Submitted: 2010-12-03
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Detection of setup uncertainties with 3D surface registration system for conformal radiotherapy of breast cancer

Letizia Deantonio, Laura Masini, Gianfranco Loi, Giuseppina Gambaro, Cesare Bolchini, Marco Krengli
DOI: 10.1016/j.rpor.2011.02.003
·
Rep Pract Oncol Radiother 2011;16(3):77-81.

open access

Vol 16, No 3 (2011)
Published online: 2011-05-01
Submitted: 2010-12-03

Abstract

Aim

To investigate the clinical application of a technique for patient set-up verification in breast cancer radiotherapy based on a 3D surface image registration system.

Background

Accurate and reproducible patient set-up is a prerequisite to correctly deliver fractionated radiotherapy. Various approaches are available to verify and correct patient setup for 3D image acquisition in a radiation treatment room.

Materials and methods

The study analyzed the setup reproducibility of 15 patients affected by breast cancer and candidates for conformal radiotherapy by using the AlignRT system (VisionRT, London, UK). At the initial setup, electronic portal imaging device (EPID) images were compared with Digitally Reconstructed Radiographs (DRRs) and a reference three-dimensional (3D) surface image was obtained by AlignRT. Surface images were acquired prior to every subsequent setup procedure. The systematic and random errors along longitudinal and vertical directions were measured and compared for the two systems.

Results

The procedure for surface registration, image acquisition and comparison with the reference image took less than 1[[ce:hsp sp="0.25"/]]min on average. The T test for systematic error showed no significant difference between the 2 verification systems along the longitudinal (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.69) and vertical (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.67) axes. The T-test for random error showed a significant difference between the 2 systems along the vertical axis (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.05).

Conclusion

AlignRT is fast, simple, non-invasive and seems to be reliable in detecting patient setup errors. Our results suggest that it could be used to assess the setup reproducibility for breast cancer patients.

Abstract

Aim

To investigate the clinical application of a technique for patient set-up verification in breast cancer radiotherapy based on a 3D surface image registration system.

Background

Accurate and reproducible patient set-up is a prerequisite to correctly deliver fractionated radiotherapy. Various approaches are available to verify and correct patient setup for 3D image acquisition in a radiation treatment room.

Materials and methods

The study analyzed the setup reproducibility of 15 patients affected by breast cancer and candidates for conformal radiotherapy by using the AlignRT system (VisionRT, London, UK). At the initial setup, electronic portal imaging device (EPID) images were compared with Digitally Reconstructed Radiographs (DRRs) and a reference three-dimensional (3D) surface image was obtained by AlignRT. Surface images were acquired prior to every subsequent setup procedure. The systematic and random errors along longitudinal and vertical directions were measured and compared for the two systems.

Results

The procedure for surface registration, image acquisition and comparison with the reference image took less than 1[[ce:hsp sp="0.25"/]]min on average. The T test for systematic error showed no significant difference between the 2 verification systems along the longitudinal (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.69) and vertical (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.67) axes. The T-test for random error showed a significant difference between the 2 systems along the vertical axis (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.05).

Conclusion

AlignRT is fast, simple, non-invasive and seems to be reliable in detecting patient setup errors. Our results suggest that it could be used to assess the setup reproducibility for breast cancer patients.

Get Citation

Keywords

Surface imaging; Patient setup; Radiotherapy; Breast cancer

About this article
Title

Detection of setup uncertainties with 3D surface registration system for conformal radiotherapy of breast cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 16, No 3 (2011)

Pages

77-81

Published online

2011-05-01

DOI

10.1016/j.rpor.2011.02.003

Bibliographic record

Rep Pract Oncol Radiother 2011;16(3):77-81.

Keywords

Surface imaging
Patient setup
Radiotherapy
Breast cancer

Authors

Letizia Deantonio
Laura Masini
Gianfranco Loi
Giuseppina Gambaro
Cesare Bolchini
Marco Krengli

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