Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T09:20:18.574Z Has data issue: false hasContentIssue false
  • English
  • Français

A comparison of imaging schedules for prostate radiotherapy including online tracking techniques

Published online by Cambridge University Press:  27 May 2011

A Baker ,
JD Fenwick ,
WP Mayles ,
I Syndikus  and
H Wong
A Baker*
Affiliation:
Radiotherapy Department, Clatterbridge Centre for Oncology, Wirral CH63 4JY, UK
JD Fenwick
Affiliation:
Department of Surgery and Oncology, School of Cancer Studies, University of Liverpool, Liverpool L69 3GA, UK
WP Mayles
Affiliation:
Physics Department, Clatterbridge Centre for Oncology, Wirral CH63 4JY, UK
I Syndikus
Affiliation:
Radiotherapy Department, Clatterbridge Centre for Oncology, Wirral CH63 4JY, UK
H Wong
Affiliation:
Clinical Governance Department, Clatterbridge Centre for Oncology, Wirral CH63 4JY, UK
*
Correspondence to: A Baker, Radiotherapy Department, Clatterbridge Centre for Oncology, Wirral CH63 4JY, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background and purpose: Repeat imaging protocols, specifying imaging frequency and action levels for movement correction, can be used to achieve more accurate targeting of the prostate gland during radiotherapy. We have carried out a study comparing the accuracies of online versus off-line correction strategies which use implanted marker seeds to localize the prostate.

Material and methods: Data have been analysed for 60 prostate patients, verified using an online imaging technique. Systematic and random errors have been calculated for a daily imaging protocol and for other common imaging schedules. Resource requirements have been assessed for the daily imaging technique by analysing the in-room timings performed on 10 patients.

Results: Daily imaging is beneficial for the majority of patients, an online imaging schedule with a 2 mm action level significantly reducing systematic and random errors. The online imaging can be performed with a 2-minute increase in the standard treatment slot.

Conclusions: Online imaging tracking techniques can facilitate margin reduction, which may help to reduce rectal toxicities. The impact on departmental time and resource requirements is modest for the online daily tracking technique with marker seeds and kilovoltage planar imaging.

Keywords

Prostate cancerradiotherapyonline trackingmotionimage-guidedmarkers
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 10 , Issue 4 , December 2011 , pp. 239 - 249
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kupelian, PA, Elshaikh, M, Reddy, CA, Zippe, C, Klein, EA. Comparison of the efficacy of local therapies for localized prostate cancer in the prostate-specific antigen era: a large single-institution experience with radical prostatectomy and external-beam radiotherapy. J Clin Oncol 2002; 20:3376–3385.Google Scholar
Dearnaley, DP, Hall, E, Lawrence, D, Huddart, RA, Eeles, R, Nutting, CM, Gadd, J, Warrington, A, Bidmead, M, Horwich, A. Phase III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects. Br J Cancer 2005; 92:488–498.Google Scholar
Cheung, P, Sixel, K, Morton, G, Loblaw, DA, Tirona, R, Pang, G, Choo, R, Szumacher, E, Deboer, G, Pignol, JP. Individualized planning target volumes for intrafraction motion during hypofractionated intensity-modulated radiotherapy boost for prostate cancer. Int J Radiat Oncol Biol Phys 2005; 62:418–425.CrossRefGoogle ScholarPubMed
Nederveen, AJ, Dehnad, H, van der Heide, UA, van Moorselaar, RJ, Hofman, P, Lagendijk, JJ. Comparison of megavoltage position verification for prostate irradiation based on bony anatomy and implanted fiducials. Radiother Oncol 2003; 68:81–88.Google Scholar
Van den Heuvel, F, Fugazzi, J, Seppi, E, Forman, JD. Clinical application of a repositioning scheme, using gold markers and electronic portal imaging. Radiother Oncol 2006; 79:94–100.Google Scholar
Chen, J, Lee, RJ, Handrahan, D, Sause, WT. Intensity-modulated radiotherapy using implanted fiducial markers with daily portal imaging: assessment of prostate organ motion. Int J Radiat Oncol Biol Phys 2007; 68:912–919.CrossRefGoogle ScholarPubMed
Ghilezan, MJ, Jaffray, DA, Siewerdsen, JH, Van Herk, M, Shetty, A, Sharpe, MB, Zafar Jafri, S, Vicini, FA, Matter, RC, Brabbins, DS, Martinez, AA. Prostate gland motion assessed with cine-magnetic resonance imaging (cine-MRI). Int J Radiat Oncol Biol Phys 2005; 62:406–417.CrossRefGoogle ScholarPubMed
Pouliot, J, Aubin, M, Langen, KM, Liu, YM, Pickett, B, Shinohara, K, Roach, M 3rd. (Non)-migration of radiopaque markers used for on-line localization of the prostate with an electronic portal imaging device. Int J Radiat Oncol Biol Phys 2003; 56:862–866.Google Scholar
Kupelian, PA, Willoughby, TR, Meeks, SL, Forbes, A, Wagner, T, Maach, M, Langen, KM. Intraprostatic fiducials for localization of the prostate gland: monitoring intermarker distances during radiation therapy to test for marker stability. Int J Radiat Oncol Biol Phys 2005; 62:1291–1296.CrossRefGoogle ScholarPubMed
van Herk, M, Remeijer, P, Rasch, C, Lebesque, JV. The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. Int J Radiat Oncol Biol Phys 2000; 47:1121–1135.CrossRefGoogle ScholarPubMed
Remeijer, P, Geerlof, E, Ploeger, L, Gilhuijs, K, van Herk, M, Lebesque, JV. 3-D portal image analysis in clinical practice: an evaluation of 2-D and 3-D analysis techniques as applied to 30 prostate cancer patients. Int J Radiat Oncol Biol Phys 2000; 46:1281–1290.CrossRefGoogle ScholarPubMed
de Boer, JC, Heijmen, BJ. A new approach to off-line setup corrections: combining safety with minimum workload. Med Phys 2002; 29:1998–2012.Google Scholar
Chung, PW, Haycocks, T, Brown, T, Cambridge, Z, Kelly, V, Alasti, H, Jaffray, DA, Catton, CN. On-line aSi portal imaging of implanted fiducial markers for the reduction of interfraction error during conformal radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys 2004; 60:329–334.CrossRefGoogle ScholarPubMed
McNair, HA, Hansen, VN, Parker, CC, Evans, PM, Norman, A, Miles, E, Harris, EJ, Del-Acroix, L, Smith, E, Keane, R, Khoo, VS, Thompson, AC, Dearnaley, DP. A comparison of the use of bony anatomy and internal markers for offline verification and an evaluation of the potential benefit of online and offline verification protocols for prostate radiotherapy. Int J Radiat Oncol Biol Phys 2008; 71:41–50.CrossRefGoogle Scholar
van der Vight, LP, van Lin, EMJT, Spiiters-Post, I, Visser, AG, Louwe, RJW. Off-line setup corrections only marginally reduce the number of on-line corrections for prostate radiotherapy using implanted gold markers. Radiother Oncol 2009; 90:359–366.CrossRefGoogle ScholarPubMed
van der Heide, UA, Kotte, NTJ, Dehnad, H, Hofman, P, Lagenijk, JJW, van Vulpen, M. Analysis of fiducial marker-based position verification in the external beam radiotherpay of patients with prostate cancer. Radiother Oncol 2007; 82:38–45.CrossRefGoogle Scholar
de Neve, W, Van den Heuvel, F, de Beukeleer, M, Coghe, M, Thon, L, de Roover, P, van Lancker, M, Storme, G. Routine clinical on-line portal imaging followed by immediate field adjustment using a tele-controlled patient couch. Radiother Oncol 1992; 24:45–54.CrossRefGoogle ScholarPubMed
Stroom, J, Quint, S, Seven, Met al. The need for on-line set-up corrections of patients with gynaecological tumors (Abstr.). Med Phys 1996; 23:1083.Google Scholar
Huang, E, Dong, L, Chandra, A, Kuban, DA, Rosen, II, Evans, A, Pollack, A. Intrafraction prostate motion during IMRT for prostate cancer. Int J Radiat Oncol Biol Phys 2002; 53:261–268.Google Scholar
Madsen, BL, Hsi, RA, Pham, HT, Presser, J, Esagui, L, Corman, J, Myers, L, Jones, D. Intrafractional stability of the prostate using a stereotactic radiotherapy technique. Int J Radiat Oncol Biol Phys 2003; 57:1285–1291.CrossRefGoogle ScholarPubMed
Kitamura, K, Shirato, H, Seppenwoolde, Y, Onimaru, R, Oda, M, Fujita, K, Shimizu, S, Shinohara, N, Harabayashi, T, Miyasaka, K. Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions. Int J Radiat Oncol Biol Phys 2002; 53:1117–1123.Google Scholar
Rasch, C, Barillot, I, Remeijer, P, Touw, A, van Herk, M, Lebesque, JV. Definition of the prostate in CT and MRI: a multi-observer study. Int J Radiat Oncol Biol Phys 1999; 43:57–66.Google Scholar
Nichol, AM, Brock, KK, Lockwood, GA, Moseley, DJ, Rosewall, T, Warde, PR, Catton, CN, Jaffray, DA. A magnetic resonance imaging study of prostate deformation relative to implanted gold fiducial markers. Int J Radiat Oncol Biol Phys 2007; 67:48–56.Google Scholar
Dehnad, H, Nederveen, AJ, van der Heide, UA, van Moorselaar, RJ, Hofman, P, Lagendijk, JJ. Clinical feasibility study for the use of implanted gold seeds in the prostate as reliable positioning markers during megavoltage irradiation. Radiother Oncol 2003; 67:295–302.Google Scholar
Stroom, JC, de Boer, HC, Huizenga, H, Visser, AG. Inclusion of geometrical uncertainties in radiotherapy treatment planning by means of coverage probability. Int J Radiat Oncol Biol Phys 1999; 43:905–919.CrossRefGoogle ScholarPubMed
van Herk, M, Bruce, A, Kroes, AP, Shouman, T, Touw, A, Lebesque, JV. Quantification of organ motion during conformal radiotherapy of the prostate by three dimensional image registration. Int J Radiat Oncol Biol Phys 1995; 33:1311–1320.CrossRefGoogle ScholarPubMed
de Crevoisier, R, Tucker, SL, Dong, L, Mohan, R, Cheung, R, Cox, JD, Kuban, DA. Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys 2005; 62:965–973.CrossRefGoogle ScholarPubMed
Ghilezan, M, Yan, D, Liang, J, Jaffray, D, Wong, J, Martinez, A. Online image-guided intensity-modulated radiotherapy for prostate cancer: How much improvement can we expect? A theoretical assessment of clinical benefits and potential dose escalation by improving precision and accuracy of radiation delivery. Int J Radiat Oncol Biol Phys 2004; 60:1602–1610.Google Scholar
National Radiotherapy Advisory Group Report. Radiotherapy: developing a world class service for England. Department of Health Report. http://www.dh.gov.uk. 2007.Google Scholar