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Prostate intrafraction motion evaluation using kV fluoroscopy during treatment delivery: a feasibility and accuracy
1Department of Radiation Oncology, Wayne State University, Detroit, Michigan 48201, USA.
Medical Physics
|June 20, 2008
Summary
This study demonstrates that measuring prostate intrafraction motion during radiotherapy using kV fluoroscopy is feasible and accurate. This technique allows for precise tracking of prostate movement, improving treatment localization and potentially reducing margins.
Area of Science:
- Medical Physics
- Radiation Oncology
- Image-Guided Therapy
Background:
- Prostate radiotherapy margin reduction is limited by uncertainties in prostate localization during treatment.
- Accurate intrafraction motion measurement is crucial for improving treatment precision.
Purpose of the Study:
- To investigate the feasibility and accuracy of measuring prostate intrafraction motion using kV fluoroscopy during radiotherapy.
- To develop and validate an algorithm for real-time motion tracking and synchronization with treatment delivery.
Main Methods:
- Implanted three gold coils in the prostate for target localization.
- Performed simultaneous kV fluoroscopy and intensity-modulated radiation therapy (IMRT).
- Developed an algorithm to register fluoroscopy images to a reference CBCT, estimating 3D coil motion and synchronizing with MV beam delivery.
Main Results:
- Submillimeter 2D localization accuracy achieved for phantoms and patients.
- 3D patient localization error was within +/- 0.68 mm across axes.
- Linearly drifting (nonstationary) prostate motion was accurately detected, while oscillating motion was not effectively represented.
Conclusions:
- Measuring prostate intrafraction motion using kV fluoroscopy during radiotherapy is feasible.
- The developed method provides acceptable accuracy for intrafraction motion assessment.
- This technique can potentially enhance prostate radiotherapy precision by accounting for real-time motion.
