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Quality Improvement Investigation for Head and Neck Stabilization in Radiotherapy Using Setup Tattoos
Brenda Cronin1, Alicia McCarthy1, Kathleen Claire2
1Radiation Therapy Services, Radiation Oncology Mater Centre, Princess Alexandra Hospital Health Service District, South Brisbane, Queensland, Australia.
Summary
Adding chest tattoos to the CIVCO Vac-Lok stabilization system significantly improves patient setup accuracy for head and neck cancer treatment. This technique reduces setup errors, enhancing radiation therapy precision.
Area of Science:
- Radiation oncology
- Medical physics
- Cancer treatment accuracy
Background:
- Head and neck cancer treatment requires high precision for complex planning and delivery.
- The CIVCO Vac-Lok stabilization system is used to ensure patient positioning accuracy.
Purpose of the Study:
- To evaluate if adding tattoos to the chest improves patient setup accuracy and reproducibility.
- To assess the impact of tattoos on reducing translational and rotational setup errors.
Main Methods:
- Eighteen head and neck cancer patients were divided into two groups: routine CIVCO stabilization and CIVCO with chest tattoos.
- Daily orthogonal kilovoltage setup images were analyzed to quantify setup errors.
- Left/right (Lt/Rt), superior/inferior (Sup/Inf), anterior/posterior (Ant/Post) displacements, and pitch/yaw rotations were measured.
Main Results:
- Tattooed patients showed clinically significant improvements in yaw error, Lt/Rt, and Sup/Inf displacements.
- Median absolute yaw error was lower in tattooed patients (0.8°) compared to non-tattooed patients (1.4°).
- The percentage of Sup/Inf and Lt/Rt errors exceeding 3 mm was reduced in the tattooed group.
Conclusions:
- Chest tattoos enhance the accuracy and reproducibility of patient setup in head and neck cancer radiotherapy.
- This simple addition to the CIVCO Vac-Lok system leads to clinically relevant improvements in patient positioning.
- Tattoo-guided patient positioning is recommended for head and neck cancer treatment to minimize setup variations.
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