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Original Knee Fixation Device as a Useful Fixation Method during Prostate Intensity-Modulated Radiation Therapy.

Noriyuki Kuga1,2, Katsutoshi Shirieda2,3, Yuta Sato2

  • 1Department of Radiological Science, Faculty of Health Sciences, Junshin Gakuen University, Fukuoka, Japan.

Journal of Medical Physics
|May 13, 2022
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Summary

A novel knee fixation device (KFD) significantly reduced setup errors in intensity-modulated radiation therapy (IMRT). This improved clinical target volume (CTV) coverage, particularly for prostate cancer patients.

Keywords:
Clinical target volume coveragefixation methodintensity-modulated radiation therapylogistic regression curveoriginal knee fixation device

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Biomedical Engineering

Background:

  • Intensity-modulated radiation therapy (IMRT) requires precise patient positioning to ensure accurate radiation delivery.
  • Setup errors, including rotational and translational inaccuracies, can compromise treatment efficacy and increase toxicity.
  • Existing immobilization techniques may not sufficiently address all sources of setup variability.

Purpose of the Study:

  • To evaluate the effectiveness of an original knee fixation device (KFD) in reducing setup errors during IMRT.
  • To assess the impact of the KFD on clinical target volume (CTV) coverage.
  • To quantify improvements in rotational and translational accuracy with the KFD.

Main Methods:

  • A comparative study was conducted with two groups: knee flexion (KF) using KFD (n=16) and knee extension (KE) without KFD (n=15).
  • Residual rotational errors (yaw, pitch, roll) and inter-fractional setup errors (A-P, S-I) were measured.
  • Inter-fractional margins were calculated, and CTV coverage was evaluated using logistic regression analysis.

Main Results:

  • The KF group showed significant improvements in residual rotational errors (yaw, roll) and inter-fractional error in the A-P direction (P < 0.02).
  • Inter-fractional margins were reduced by 20.8% in the A-P and 12.6% in the S-I directions in the KF group.
  • The odds ratios for CTV coverage were significantly higher in the KF group (2.76 for A-P, 1.74 for S-I).

Conclusions:

  • The KFD effectively reduces rotational and translational setup errors in IMRT.
  • The use of KFD leads to improved CTV coverage and reduced margins, enhancing treatment precision.
  • This original KFD is a potentially valuable tool for improving prostate IMRT immobilization.