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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
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Performance of Makerless Tracking for Gimbaled Dynamic Tumor Tracking.

Marc Ziegler1, Sebastian Lettmaier1, Rainer Fietkau1

  • 1Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.

Zeitschrift Fur Medizinische Physik
|November 30, 2019
PubMed
Summary

The new markerless dynamic tumor tracking (MLDTT) method on the Vero 4DRT system demonstrates accuracy comparable to marker-based approaches. This advanced MLDTT technology enables successful patient treatments with efficient workflow.

Keywords:
NSCLCReal-time monitoringStereotactic body radiation therapyTumor Tracking

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Image-Guided Therapy

Background:

  • The Vero 4DRT system has introduced a new markerless dynamic tumor tracking (MLDTT) method.
  • Accurate tumor tracking is crucial for effective radiation therapy, especially for moving targets.

Purpose of the Study:

  • To report the workflow and assess the accuracy of the novel markerless dynamic tumor tracking (MLDTT) method.
  • Evaluate the performance of the MLDTT feature integrated with the ExacTrac 3.6.1 software on the Vero 4DRT system.

Main Methods:

  • Phantom measurements using a QA tool and a patient breathing curve to simulate motion.
  • Comparison of MLDTT-detected target positions against defined positions.
  • Log-file analysis of treatment data from eight patients treated with MLDTT.

Main Results:

  • MLDTT detection accuracy achieved was 0.12mm ± 0.12mm (x-axis), 0.12mm ± 0.11mm (y-axis), and 0.20mm ± 0.21mm (z-axis).
  • Treatment accuracy is comparable to marker-based dynamic tumor tracking (DTT) on the Vero system and reported values for CyberKnife's XSight Lung.
  • Median treatment time was 21 minutes and 34 seconds, with 175kV images used for motion monitoring.

Conclusions:

  • The MLDTT algorithm offers accuracy comparable to marker-based methods and other leading systems.
  • Successful treatment of eight patients using MLDTT confirms its clinical applicability.
  • Treatment durations with MLDTT are similar to standard DTT procedures, indicating workflow efficiency.