Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T16:03:57.622Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of set-up errors and determination of set-up margin in pelvic radiotherapy by electronic portal imaging device (EPID)

Published online by Cambridge University Press:  10 September 2019

Vajiheh Vejdani Noghreiyan ,
Shahrookh Nasseri ,
Kazem Anvari ,
Maryam Naji  and
Mehdi Momennezhad Open the ORCID record for Mehdi Momennezhad [Opens in a new window]
Vajiheh Vejdani Noghreiyan
Affiliation:
Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
Shahrookh Nasseri
Affiliation:
Medical Physics Department, Faculty of Medicine, Imam Reza Center of Medical Education and Treatment, Mashhad, Iran
Kazem Anvari
Affiliation:
Faculty of Medicine, Solid Tumour Treatment Research Center, Omid Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Maryam Naji
Affiliation:
Radiotherapy Department, Imam Reza Hospital, Mashhad, Iran
Mehdi Momennezhad*
Affiliation:
Medical Physics Department, Faculty of Medicine, Imam Reza Center of Medical Education and Treatment, Mashhad, Iran
*
Author for correspondence: Mehdi Momennezhad, Medical Physics Department, Faculty of Medicine, Mashhad University of Medical Sciences Imam Reza Center of Medical Education and Treatment, Mashhad, Iran. Tel: +98 51 38002316. Fax: +98 51 38002320. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction and purpose:

The error in set-up of patients is an inherent part of treatment processes. The positioning errors can be used to determine the margins of the planning target volume (PTV) to cover the target volume, while minimising the radiation dose delivered to normal tissues. This study aimed to evaluate random and systematic errors occurring in inter-fraction set-ups of pelvic radiotherapy measured by electronic portal imaging device (EPID) and then to propose the optimum clinical target volume (CTV) to PTV margin in pelvic cancer patients.

Materials and methods:

This study examined 22 patients treated with pelvic radiotherapy. A total of 182 portal images were evaluated. Population random (σ) and systematic (Σ) errors were determined based on the portal images in three directions (X, Y and Z). The set-up margin for CTV to PTV was calculated by published margin formulae of International Commission on Radiation Units and measurements (ICRU) report No. 62 recommendation and formulas presented by Stroom and Heijmen and Van Herk et al.

Results:

Systematic set-up errors for radiotherapy to patients ranged between 2·36 and 4·99 mm, and random errors ranged between 1·51 and 2·74 mm. The margin required to cover the target volume retrospectively was calculated based on ICRU 62 and formulas presented by Stroom and Heijmen and Van Herk et al. were used to calculate the range 2·8–5·7 mm, 5·7–11·9 mm and 6·9–14·4 mm, respectively.

Conclusion:

According to our findings, it can be concluded that by extending the CTV margin by 6·9–14·4 mm, we can ensure that 90% of the pelvic cancer patients will receive ≥ 95% of the prescribed dose in the CTV area.

Keywords

3DCRTCTV to PTV marginEPIDpelvic cancerset-up errors
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 2 , June 2020 , pp. 150 - 156
Copyright
© Cambridge University Press 2019

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

Strbac, B, Jokic, V S.Evaluation of set-up errors in head and neck radiotherapy using electronic portal imaging. Phys Med 2013; 29 (5): 531–536.CrossRefGoogle ScholarPubMed
Boyer, A L, Antonuk, L, Fenster, Aet al.A review of electronic portal imaging devices (EPIDs). Med Phys 1992; 19 (1): 1–16.CrossRefGoogle Scholar
Castadot, P, Lee, J A, Parraga, A, Geets, X, Macq, B, Grégoire, V.Comparison of 12 deformable registration strategies in adaptive radiation therapy for the treatment of head and neck tumors. Radiother Oncol 2008; 89 (1): 1–12.CrossRefGoogle ScholarPubMed
Goitein, M (ed.). Organ and tumor motion: an overview. In: Seminars in Radiation Oncology. Boston, MA: Harvard Medical School, 2004.Google Scholar
Podgorsak, E B.Review of Radiation Oncology Physics: A Handbook for Teachers and Students. Vienna: International Atomic Energy Agency, Educational Reports Series, 2003.Google Scholar
Asnaashari, K, Gholami, S, Khosravi, H.Lessons learnt from errors in radiotherapy centers. Int J Radiat Res 2014; 12 (4): 361–367.Google Scholar
Herman, M G, Kruse, J J, Hagness, C R.Guide to clinical use of electronic portal imaging. J Appl Clin Med Phys 2000; 1 (2): 38–57.CrossRefGoogle ScholarPubMed
Burnet, N G, Thomas, S J, Burton, K E, Jefferies, S J.Defining the tumour and target volumes for radiotherapy. Cancer Imag 2004; 4 (2): 153–161.CrossRefGoogle ScholarPubMed
Kang, H, Lovelock, D M, Yorke, E D, Kriminiski, S, Lee, N, Amols, H I.Accurate positioning for head and neck cancer patients using 2D and 3D image guidance. J Appl Clin Med Phys 2011; 12 (1): 3270.CrossRefGoogle Scholar
Wambersie, A, Landgerg, T.ICRU Report 62: Prescribing, Recording and Reporting Photon Beam Therapy. Bethesda MD: ICRU Publ, 1999.Google Scholar
Stroom, J C, Heijmen, B J.Geometrical uncertainties, radiotherapy planning margins, and the ICRU-62 report. Radiother Oncol 2002; 64 (1): 75–83.CrossRefGoogle ScholarPubMed
van Herk, M, Remeijer, P, Rasch, C, Lebesque, J V.The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. Int J Radiat Oncol Biol Phys 2000; 47 (4): 1121–1135.CrossRefGoogle ScholarPubMed
Gupta, T, Chopra, S, Kadam, Aet al.Assessment of three-dimensional set-up errors in conventional head and neck radiotherapy using electronic portal imaging device. Radiat Oncol 2007; 2 (44): 1–8.CrossRefGoogle ScholarPubMed
Van Herk, M (ed.) Errors and margins in radiotherapy. In: Seminars in Radiation Oncology. Amsterdam: Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, 2004.Google Scholar
Yan, D, Ziaja, E, Jaffray, Det al.The use of adaptive radiation therapy to reduce setup error: a prospective clinical study. Int J Radiat Oncol Biol Phys 1998; 41 (3): 715–720.CrossRefGoogle ScholarPubMed
Hess, C F, Kortmann, R-D, Jany, R, Hamberger, A, Bamberg, M.Accuracy of field alignment in radiotherapy of head and neck cancer utilizing individualized face mask immobilization: a retrospective analysis of clinical practice. Radiother Oncol 1995; 34 (1): 69–72.CrossRefGoogle ScholarPubMed
Bentel, G C, Marks, L B, Hendren, K, Brizel, D M.Comparison of two head and neck immobilization systems. Int J Radiat Oncol Biol Phys 1997; 38 (4): 867–873.CrossRefGoogle ScholarPubMed
Gilbeau, L, Octave-Prignot, M, Loncol, T, Renard, L, Scalliet, P, Grégoire, V.Comparison of setup accuracy of three different thermoplastic masks for the treatment of brain and head and neck tumors. Radiother Oncol 2001; 58 (2): 155–162.CrossRefGoogle ScholarPubMed
De Boer, H C, de Koste, J R vS, Creutzberg, C L, Visser, A G, Levendag, P C, Heijmen, B J.Electronic portal image assisted reduction of systematic set-up errors in head and neck irradiation. Radiother Oncol 2001; 61 (3): 299–308.CrossRefGoogle ScholarPubMed
Humphreys, M, Urbano, M T G, Mubata, Cet al.Assessment of a customised immobilisation system for head and neck IMRT using electronic portal imaging. Radiother Oncol 2005; 77 (1): 39–44.CrossRefGoogle ScholarPubMed
Zhang, L, Garden, AS, Lo, Jet al.Multiple regions-of-interest analysis of setup uncertainties for head-and-neck cancer radiotherapy. Int J Radiat Oncol Biol Phys 2006; 64 (5): 1559–1569.CrossRefGoogle ScholarPubMed
Suzuki, M, Nishimura, Y, Nakamatsu, Ket al.Analysis of interfractional set-up errors and intrafractional organ motions during IMRT for head and neck tumors to define an appropriate planning target volume (PTV)-and planning organs at risk volume (PRV)-margins. Radiother Oncol 2006; 78 (3): 283–290.CrossRefGoogle ScholarPubMed
Ippolito, E, Mertens, I, Haustermans, K, Gambacorta, M A, Pasini, D, Valentini, V.IGRT in rectal cancer. Acta Oncol 2008; 47 (7): 1317–1324.CrossRefGoogle ScholarPubMed
Khosa, R, Nangia, S, Chufal, K S, Ghosh, D, Kaul, R, Sharma, L.Daily online localization using implanted fiducial markers and its impact on planning target volume for carcinoma prostate. J Cancer Res Ther 2010; 6 (2): 172–178CrossRefGoogle ScholarPubMed
Osei, E, Jiang, R, Barnett, R, Fleming, K, Panjwani, D.Evaluation of daily online set-up errors and organ displacement uncertainty during conformal radiation treatment of the prostate. Br J Radiol 2009; 82 (973): 49–61.CrossRefGoogle Scholar