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Related Experiment Videos

[Positioning accuracy in conformational prostatic irradiation using portal imaging].

Annemarie Bakai1, Frank Paulsen, Ludwig Plasswilm

  • 1Abteilung Medizinische Physik, Universitätsklinik für Radioonkologie, Tübingen. aebakai@med.uni-tuebingen.de

Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft ... [Et Al]
|April 11, 2002
PubMed
Summary

Accurate patient positioning is crucial for conformal radiotherapy. This study used electronic portal imaging to assess positioning uncertainties in prostate cancer patients, finding comparable errors across devices but highlighting the need for improved positioning aids, especially for intensity-modulated radiation therapy.

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Area of Science:

  • Radiation Oncology
  • Medical Imaging
  • Prostate Cancer Treatment

Background:

  • Conformal radiotherapy requires precise patient positioning to spare healthy tissues.
  • Electronic portal imaging devices (EPID) are used to verify patient alignment in radiotherapy.
  • Understanding positioning uncertainties is key to optimizing treatment delivery.

Purpose of the Study:

  • To investigate patient positioning uncertainties in the pelvic region during prostate cancer radiotherapy.
  • To evaluate the impact of different patient positioning devices on these uncertainties.
  • To determine the effectiveness of EPID in assessing positioning errors.

Main Methods:

  • 15 prostate cancer patients were enrolled, treated with or without rectal balloon/pelvic mask.

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  • Multiple portal images were acquired using an EPID and compared to digitally reconstructed radiographs (DRRs).
  • Positioning uncertainties were analyzed for systematic and random components.

    • Main Results:

    • Total positioning uncertainties were comparable across different devices: 4.0 mm (lateral), 4.5 mm (cranio-caudal), and 1.7 mm (dorso-ventral).
    • A pelvic mask reduced lateral error but increased cranio-caudal error.
    • Six to eight portal images provided a good estimate of systematic and random positioning errors.

    Conclusions:

    • A small number of portal images can accurately determine patient-specific systematic and random positioning errors.
    • Knowledge of random errors allows for clinical adjustment of treatment margins.
    • While EPID is convenient, improvements are needed for positioning devices, particularly for intensity-modulated radiation therapy (IMRT).