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SU-E-J-59: Dual Imaging Guided Localization System for Spine Radiosurgery.

N Wen1, J Kim1, S Kim1

  • 1Henry Ford Health System, Detroit, MI.

Medical Physics
|May 19, 2017
PubMed
Summary
This summary is machine-generated.

This study compared ExacTrac and cone beam computed tomography (CBCT) for spine radiosurgery localization. Both systems showed systematic differences, leading to established tolerance levels for accurate patient positioning.

Keywords:
Cone beam computed tomographyLinear acceleratorsMedical imagingRadiosurgery

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiosurgery Imaging

Background:

  • Accurate patient localization is critical for effective spine radiosurgery.
  • ExacTrac and cone beam computed tomography (CBCT) are commonly used imaging systems for treatment verification.

Purpose of the Study:

  • To compare the localization accuracy of ExacTrac and CBCT systems in single fraction spine radiosurgery.
  • To evaluate the inherent systematic deviations of both ExacTrac and CBCT for spine radiosurgery.

Main Methods:

  • ExacTrac and CBCT systems were evaluated using the linac isocenter as a reference.
  • A phantom study and a patient study (51 patients) were conducted to quantify displacement discrepancies.
  • Discrepancies were measured in four dimensions (3 translations, 1 rotation) and analyzed using a Student's t-test.

Main Results:

  • Phantom and patient studies showed systematic differences of approximately 1 mm in the anterior/posterior and superior/inferior directions between ExacTrac and CBCT.
  • Statistical significance was found for discrepancies in the A/P and S/I directions (p < 0.000).
  • Angular differences were minimal, and a procedure was developed to mitigate systematic discrepancies.

Conclusions:

  • The observed systematic differences between ExacTrac and CBCT justify established patient localization tolerance levels.
  • A 2 mm translation and 1-degree rotation tolerance is appropriate for single fraction spine stereotactic radiosurgery (SRS) treatment.