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Triggered kV Imaging During Spine SBRT for Intrafraction Motion Management.

Jihye Koo1,2, Louis Nardella2, Michael Degnan3

  • 17831University of South Florida, 33620, USA.

Technology in Cancer Research & Treatment
|December 2, 2021
PubMed
Summary

Triggered kV imaging effectively monitors intrafraction motion during spine stereotactic body radiotherapy (SBRT). This readily available technology uses on-board imager (OBI) technology for efficient, non-invasive patient position verification during treatment.

Keywords:
image-guided radiotherapylinear accelerator-based stereotactic radiosurgerynon-invasivepatient monitoring

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Image-Guided Therapy

Background:

  • Intrafraction motion during spine stereotactic body radiotherapy (SBRT) can compromise treatment accuracy.
  • Monitoring this motion requires efficient and readily available technology.

Purpose of the Study:

  • To implement and evaluate triggered kV imaging for intrafraction motion monitoring during spine SBRT.
  • To assess the feasibility and clinical utility of this technique using on-board imager (OBI) technology.

Main Methods:

  • Triggered kV imaging was tested using an anthropomorphic phantom and simulated spine SBRT treatments.
  • Image-guided radiotherapy (IGRT) structures (vertebral bodies, spinous processes) were contoured.
  • 2D projections of IGRT structures were automatically calculated and displayed on kV images.
  • Gantry-angle-based (45°) and time-based (15s) triggering were employed, alongside a survey of physicists/physicians.

Main Results:

  • Image-guided radiotherapy (IGRT) structure accuracy improved with smaller CT slice thickness.
  • Detectability of shifts was proportional to shift size and inversely related to CT slice thickness.
  • Appreciable intrafraction motion was detected in 11.7% of clinically treated fractions.

Conclusions:

  • Triggered kV imaging is a feasible technique for spine SBRT intrafraction motion management.
  • This method provides efficient, non-invasive patient position monitoring using OBI and patient anatomy.
  • The technique enhances the robustness of patient immobilization assessment during treatment.