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Open Access 01-12-2011 | Research

Intra-fraction setup variability: IR optical localization vs. X-ray imaging in a hypofractionated patient population

Authors: Maria Francesca Spadea, Barbara Tagaste, Marco Riboldi, Eleonora Preve, Daniela Alterio, Gaia Piperno, Cristina Garibaldi, Roberto Orecchia, Antonio Pedotti, Guido Baroni

Published in: Radiation Oncology | Issue 1/2011

Abstract

Background

The purpose of this study is to investigate intra-fraction setup variability in hypo-fractionated cranial and body radiotherapy; this is achieved by means of integrated infrared optical localization and stereoscopic kV X-ray imaging.

Method and Materials

We analyzed data coming from 87 patients treated with hypo-fractionated radiotherapy at cranial and extra-cranial sites. Patient setup was realized through the ExacTrac X-ray 6D system (BrainLAB, Germany), consisting of 2 infrared TV cameras for external fiducial localization and X-ray imaging in double projection for image registration. Before irradiation, patients were pre-aligned relying on optical marker localization. Patient position was refined through the automatic matching of X-ray images to digitally reconstructed radiographs, providing 6 corrective parameters that were automatically applied using a robotic couch. Infrared patient localization and X-ray imaging were performed at the end of treatment, thus providing independent measures of intra-fraction motion.

Results

According to optical measurements, the size of intra-fraction motion was (median ± quartile) 0.3 ± 0.3 mm, 0.6 ± 0.6 mm, 0.7 ± 0.6 mm for cranial, abdominal and lung patients, respectively. X-ray image registration estimated larger intra-fraction motion, equal to 0.9 ± 0.8 mm, 1.3 ± 1.2 mm, 1.8 ± 2.2 mm, correspondingly.

Conclusion

Optical tracking highlighted negligible intra-fraction motion at both cranial and extra-cranial sites. The larger motion detected by X-ray image registration showed significant inter-patient variability, in contrast to infrared optical tracking measurement. Infrared localization is put forward as the optimal strategy to monitor intra-fraction motion, featuring robustness, flexibility and less invasivity with respect to X-ray based techniques.

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Title: Intra-fraction setup variability: IR optical localization vs. X-ray imaging in a hypofractionated patient population
Authors: Maria Francesca Spadea
Barbara Tagaste
Marco Riboldi
Eleonora Preve
Daniela Alterio
Gaia Piperno
Cristina Garibaldi
Roberto Orecchia
Antonio Pedotti
Guido Baroni
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-6-38

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intra-fraction setup variability: IR optical localization vs. X-ray imaging in a hypofractionated patient population

Abstract

Background

Method and Materials

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method and Materials

Results

Conclusion

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