Add like
Add dislike
Add to saved papers

Quantitative evaluation of patient setup uncertainty of stereotactic radiotherapy with the frameless 6D ExacTrac system using statistical modeling.

The purpose of this study is to evaluate patient setup accuracy and quantify individual and cumulative positioning uncertainties associated with different hardware and software components of the stereotactic radiotherapy (SRS/SRT) with the frameless 6D ExacTrac system. A statistical model is used to evaluate positioning uncertainties of the different components of SRS/SRT treatment with the Brainlab 6D ExacTrac system using the positioning shifts of 35 patients having cranial lesions. All these patients are immobilized with rigid head-and-neck masks, simulated with Brainlab localizer and planned with iPlan treatment planning system. Stereoscopic X-ray images (XC) are acquired and registered to corresponding digitally reconstructed radiographs using bony-anatomy matching to calculate 6D translational and rotational shifts. When the shifts are within tolerance (0.7 mm and 1°), treatment is initiated. Otherwise corrections are applied and additional X-rays (XV) are acquired to verify that patient position is within tolerance. The uncertainties from the mask, localizer, IR -frame, X-ray imaging, MV, and kV isocentricity are quantified individually. Mask uncertainty (translational: lateral, longitudinal, vertical; rotational: pitch, roll, yaw) is the largest and varies with patients in the range (-2.07-3.71mm,-5.82-5.62mm,-5.84-3.61mm;-2.10-2.40∘,-2.23-2.60∘,and-2.7-3.00∘) obtained from mean of XC shifts for each patient. Setup uncertainty in IR positioning (0.88, 2.12, 1.40 mm, and 0.64°, 0.83°, 0.96°) is extracted from standard deviation of XC. Systematic uncertainties of the frame (0.18, 0.25, -1.27mm, -0.32∘, 0.18°, and 0.47°) and localizer (-0.03, -0.01, 0.03 mm, and -0.03∘, 0.00°, -0.01∘) are extracted from means of all XV setups and mean of all XC distributions, respectively. Uncertainties in isocentricity of the MV radiotherapy machine are (0.27, 0.24, 0.34 mm) and kV imager (0.15, -0.4, 0.21 mm). A statistical model is developed to evaluate the individual and cumulative systematic and random positioning uncertainties induced by the different hardware and software components of the 6D ExacTrac system. The uncertainties from the mask, localizer, IR frame, X-ray imaging, couch, MV linac, and kV imager isocentricity are quantified using statistical modeling. PACS number(s): 87.56.B-, 87.59.B.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app