Clinical results of a pilot study on stereovision-guided stereotactic radiotherapy and intensity modulated radiotherapy

Shidong Li, Lawrence R. Kleinberg, Daniele Rigamonti, Moody D. Wharam, Abdul Rashid, Juan Jackson, David Djajaputra, Shenjen He, Tunisia Creasey, Theodore L. DeWeese

Research output: Contribution to journalArticle

Abstract

Real-time stereovision-guidance has been introduced for efficient and convenient fractionated stereotactic radiotherapy (FSR) and image-guided intensity-modulated radiation therapy (IMRT). This first pilot study is to clinically evaluate its accuracy and precision as well as impact on treatment doses. Sixty-one FSR patients wearing stereotactic masks (SMs) and nine IMRT patients wearing flexible masks (FMs), were accrued. Daily target reposition was initially based-on biplane-radiographs and then adjusted in six degrees of freedom under real-time stereovision guidance. Mean and standard deviation of the head displacements measured the accuracy and precision. Head positions during beam-on times were measured with real-time stereovisions and used for determination of delivered doses. Accuracy ± precision in direction with the largest errors shows improvement from 0.4 ± 2.3 mm to 0.0 ± 1.0 mm in the inferior-to-superior direction for patients wearing SM or from 0.8 ± 4.3 mm to 0.4 ± 1.7 mm in the posterior-to-anterior direction for patients wearing FM. The image-guidance increases target volume coverage by <30% for small lesions. Over half of head position errors could be removed from the stereovision-guidance. Importantly, the technique allows us to check head position during beam-on time and makes it possible for having frameless head refixation without tight masks.

Original languageEnglish (US)
Pages (from-to)603-617
Number of pages15
JournalTechnology in Cancer Research and Treatment
Volume9
Issue number6
DOIs
StatePublished - Dec 2010

Keywords

  • Fractionated stereotactic radiotherapy (FSR)
  • Image-guided radiation therapy (IGRT)
  • Intensity modulated radiotherapy (IMRT)
  • Stereovision (3D video imaging)

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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