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Research paper
Published online: 2021-03-30
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Comparison of three differently shaped ROIs in free breathing breast radiotherapy setup using surface guidance with AlignRT®

Marko Laaksomaa, Torsten Moser, Julia Kritz, Kiira Pynnönen, Maija Rossi
DOI: 10.5603/RPOR.a2021.0062

open access

Ahead of print
Original research articles
Published online: 2021-03-30

Abstract

BACKGROUND: Setup accuracy within adjuvant radiotherapy of breast cancer treated in free breathing is well studied, but a comparison of the typical regions of interest (ROI) used in surface guided radiation therapy (SGRT) does not exist.

The aim of this study was to estimate the setup accuracy obtained with differently shaped ROIs in SGRT.

MATERIALS AND METHODS: A total of 573 orthogonal image pairs were analyzed from free breathing breast patients in two groups: positioning using AlignRT® surface guidance system (Group A, n = 20), and setup using conventional laser and tattoo setup (Group L, n = 20). For SGRT, three different setup ROIs were used: a Breast-shaped, O-shaped and T-shaped (B-O and T-ROI). We evaluated the isocenter-, rotation-, pitch and arm position accuracy and residual errors for the chest wall and shoulder joint in kV orthogonal and tangential setup images with laser- or SGRT-based setup.

RESULTS: Less isocenter variance was found in Group A than in Group L. Rotations and posture errors were larger in group L than in Group A (p ≤ 0.05). Rotation error was smaller with T-shaped ROI than with O- or B-shape (p = 0.01–0.05).

CONCLUSION: Setup with AlignRT® improves reproducibility compared to laser setup. Between the different ROI shapes only small differences were found in the patient posture or the isocenter position in the images. The T-ROI is recommended to set up the chest wall bony structure and an additional B-ROI may be used to fine-tune the soft tissue accuracy. 

Abstract

BACKGROUND: Setup accuracy within adjuvant radiotherapy of breast cancer treated in free breathing is well studied, but a comparison of the typical regions of interest (ROI) used in surface guided radiation therapy (SGRT) does not exist.

The aim of this study was to estimate the setup accuracy obtained with differently shaped ROIs in SGRT.

MATERIALS AND METHODS: A total of 573 orthogonal image pairs were analyzed from free breathing breast patients in two groups: positioning using AlignRT® surface guidance system (Group A, n = 20), and setup using conventional laser and tattoo setup (Group L, n = 20). For SGRT, three different setup ROIs were used: a Breast-shaped, O-shaped and T-shaped (B-O and T-ROI). We evaluated the isocenter-, rotation-, pitch and arm position accuracy and residual errors for the chest wall and shoulder joint in kV orthogonal and tangential setup images with laser- or SGRT-based setup.

RESULTS: Less isocenter variance was found in Group A than in Group L. Rotations and posture errors were larger in group L than in Group A (p ≤ 0.05). Rotation error was smaller with T-shaped ROI than with O- or B-shape (p = 0.01–0.05).

CONCLUSION: Setup with AlignRT® improves reproducibility compared to laser setup. Between the different ROI shapes only small differences were found in the patient posture or the isocenter position in the images. The T-ROI is recommended to set up the chest wall bony structure and an additional B-ROI may be used to fine-tune the soft tissue accuracy. 

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Keywords

breast; surface-guided radiotherapy; region of interest; patient positioning

About this article
Title

Comparison of three differently shaped ROIs in free breathing breast radiotherapy setup using surface guidance with AlignRT®

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Ahead of print

Article type

Research paper

Published online

2021-03-30

DOI

10.5603/RPOR.a2021.0062

Keywords

breast
surface-guided radiotherapy
region of interest
patient positioning

Authors

Marko Laaksomaa
Torsten Moser
Julia Kritz
Kiira Pynnönen
Maija Rossi

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