Accuracy of optical surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization
Li Tantan1,2, Liu Qingfeng1, Zhang Tao1,2, Zhang Ye1, Zhang Wei1, Chen Huan1, Li Zhaohui1, Huan Fukui1, Yi Junlin1,2
1Department of Radiation Oncology, National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2Department of Radiation Oncology, National Cancer Center / National Clinical Research Center for Cancer / Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang 065001, China
Abstract：Objective To investigate the feasibility of surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization. Methods Nineteen patients treated with hypo‐ fractionated radiotherapy for intracranial metastasis in our hospital were included. Before the start of treatment, each patient underwent simulation with open face mask immobilization. During the treatment, cone‐beam CT(CBCT)images were collected for verification each time. Laser‐guided positioning was used for the first time in the treatment, and surface images were captured after six‐dimensional position correction as the reference images for subsequent treatment. Subsequent treatment was randomly divided into laser‐guided positioning group(LG, 85/F)and optical surface‐guided positioning group(SG, 101/F). The six‐dimensional error data of patients with two positioning methods were compared and expressed as mean ± standard deviation. Meanwhile, the correlation and consistency between the optical surface error data and the gold standard CBCT error data were compared in the laser‐guided fraction. GraphPad Prism 6.0 software was used for data processing and mapping, and SPSS 21.software was used for mean analysis and normality test. Pearson correlation analysis was used to analyze the correlation, and Bland‐Altman plot analysis was used to test the coincidence between two methods. Results Compared with the laser‐guided positioning, the 3D error of optical surface‐guided positioning was reduced from(0.35±0.16)cm to(0.14±0.07)cm. The Pearson coefficient of correlation along all three directions was less than 0.01,R2 was 0.91,0.70 and 0.78 on Lat, Lng and Vrt, and R2 was 0.75,0.85 and 0.77 on Pitch, Roll and Rtn(all P<0.01), respectively. The measurement results of two methods were positively correlated. The Bland‐Altman plot analysis showed that the 95% limits of agreement were within preset 3 mm tolerance([-0.29 cm, 0.19 cm], [-0.25 cm, 0.25 cm], [-0.27 cm, 0.19 cm]), and the 95% limits of agreement were within preset 3° tolerance(Pitch[-1.76°,1.76°], Roll[-1.54°,1.60°], ROT[-2.18°,1.69°]), indicating agreement between two methods. Conclusions The optical surface‐guided positioning can reduce the setup errors in the hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization. The optical surface error and CBCT error have good correlation and agreement.
Li Tantan,Liu Qingfeng,Zhang Tao et al. Accuracy of optical surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization[J]. Chinese Journal of Radiation Oncology, 2022, 31(8): 722-726.
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