TY - JOUR
T1 - Target position uncertainty during visually guided deep-inspiration breath-hold radiotherapy in locally advanced lung cancer
AU - Rydhog, Jonas Scherman
AU - de Blanck, Steen Riisgaard
AU - Josipovic, Mirjana
AU - Jølck, Rasmus Irming
AU - Larsen, Klaus Richter
AU - Clementsen, Paul
AU - Andersen, Thomas Lars
AU - Poulsen, Per Rugaard
AU - Persson, Gitte Fredberg
AU - af Rosenschold, Per Munck
PY - 2017
Y1 - 2017
N2 - Purpose: The purpose of this study was to estimate the uncertainty in voluntary deep-inspiration breath hold (DISH) radiotherapy for locally advanced non-small cell lung cancer (NSCLC) patients.Methods: Perpendicular fluoroscopic movies were acquired in free breathing (FB) and DIBH during a course of visually guided DIBH radiotherapy of nine patients with NSCLC. Patients had liquid markers injected in mediastinal lymph nodes and primary tumours. Excursion, systematic- and random errors, and inter-breath-hold position uncertainty were investigated using an image based tracking algorithm.Results: A mean reduction of 2-6 mm in marker excursion in DIBH versus FB was seen in the anterior posterior (AP), left-right (LR) and cranio-caudal (CC) directions. Lymph node motion during DIBH originated from cardiac motion. The systematic-(standard deviation (SD) of all the mean marker positions) and random errors (root-mean-square of the intra-BH SD) during DIBH were 0.5 and 0.3 mm (AP), 0.5 and 0.3 mm (LR), 0.8 and 0.4 mm (CC), respectively. The mean inter-breath-hold shifts were -0.3 mm (AP), -0.2 mm (LR), and -0.2 mm (CC).Conclusion: Intra- and inter-breath-hold uncertainty of tumours and lymph nodes were small in visually guided breath-hold radiotherapy of NSCLC. Target motion could be substantially reduced, but not eliminated, using visually guided DIBH. (C) 2017 Elsevier B.V. All rights reserved.
AB - Purpose: The purpose of this study was to estimate the uncertainty in voluntary deep-inspiration breath hold (DISH) radiotherapy for locally advanced non-small cell lung cancer (NSCLC) patients.Methods: Perpendicular fluoroscopic movies were acquired in free breathing (FB) and DIBH during a course of visually guided DIBH radiotherapy of nine patients with NSCLC. Patients had liquid markers injected in mediastinal lymph nodes and primary tumours. Excursion, systematic- and random errors, and inter-breath-hold position uncertainty were investigated using an image based tracking algorithm.Results: A mean reduction of 2-6 mm in marker excursion in DIBH versus FB was seen in the anterior posterior (AP), left-right (LR) and cranio-caudal (CC) directions. Lymph node motion during DIBH originated from cardiac motion. The systematic-(standard deviation (SD) of all the mean marker positions) and random errors (root-mean-square of the intra-BH SD) during DIBH were 0.5 and 0.3 mm (AP), 0.5 and 0.3 mm (LR), 0.8 and 0.4 mm (CC), respectively. The mean inter-breath-hold shifts were -0.3 mm (AP), -0.2 mm (LR), and -0.2 mm (CC).Conclusion: Intra- and inter-breath-hold uncertainty of tumours and lymph nodes were small in visually guided breath-hold radiotherapy of NSCLC. Target motion could be substantially reduced, but not eliminated, using visually guided DIBH. (C) 2017 Elsevier B.V. All rights reserved.
KW - Image based tracking
KW - Image-guided radiotherapy
KW - Liquid fiducial marker
U2 - 10.1016/j.radonc.2017.02.003
DO - 10.1016/j.radonc.2017.02.003
M3 - Journal article
C2 - 28245908
VL - 123
SP - 78
EP - 84
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
SN - 0167-8140
IS - 1
ER -