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This study evaluated two radiotherapy patient positioning software programs, iView and PIPSpro. Both showed high intrinsic accuracy, with overall accuracy around 2 mm and 1° when using high-resolution digital reconstructed radiographs (DRRs).

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Area of Science:

  • Medical Physics
  • Radiotherapy
  • Image-guided therapy

Background:

  • Accurate patient positioning is crucial in radiotherapy for effective treatment delivery.
  • Treatment portal images and digitally reconstructed radiographs (DRRs) are used for patient setup verification.
  • Registration software accuracy directly impacts patient positioning precision.

Purpose of the Study:

  • To assess the intrinsic and global accuracy of iView and PIPSpro, two common radiotherapy registration software programs.
  • To compare manual (iView) and semiautomatic (PIPSpro) registration approaches.
  • To evaluate the impact of different digital reconstructed radiograph (DRR) generation parameters on registration accuracy.

Main Methods:

  • Intrinsic accuracy was tested using a computer-generated phantom.
  • Global accuracy was evaluated by registering portal images with DRRs from an Alderson RANDO phantom.
  • DRRs were generated using four treatment planning systems (TPS) and CT studies with varying slice thicknesses (e.g., 2 mm).

Main Results:

  • Both iView and PIPSpro demonstrated intrinsic accuracy within 1 pixel and 1°.
  • Overall accuracy was approximately 2 mm and 1° when using DRRs from 2 mm CT studies.
  • Accuracy degraded with thicker CT slices, showing significant rotational parameter differences (>1.5°) between software.

Conclusions:

  • iView and PIPSpro exhibit comparable and high accuracy for radiotherapy patient setup verification.
  • DRR quality, particularly CT slice thickness, significantly influences the global registration accuracy.
  • Both software packages are reliable, but careful consideration of DRR generation parameters is recommended for optimal results.