Dataset Information

The influence of a six degrees of freedom couch and an individual head support in patient positioning in radiotherapy of head and neck cancer.

ABSTRACT: Reproducible patient positioning is important in radiotherapy (RT) of head-and-neck cancer. We therefore compared set-up errors in head-and-neck RT resulting from three different patient positioning systems. Patients were either treated with a standard head support (SHS) and conventional treatment couch (SHS-3, n = 10), a SHS and rotational couch (SHS-6, n = 10), or an individual head support (IHS) and rotational couch (IHS-6, n = 10). Interfraction mean translation vector lenghts were significantly lower for IHS-6 compared to SHS-3 (0.8 ± 0.3 mm vs. 1.4 ± 0.7 mm, P = 0.001). Intrafraction displacement was comparable among cohorts. This study showed that the use of a six degrees of freedom couch combined with an IHS in head-and-neck RT resulted in better interfraction reproducibility.

SUBMITTER: Rodrigues MF

PROVIDER: S-EPMC7807734 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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The influence of a six degrees of freedom couch and an individual head support in patient positioning in radiotherapy of head and neck cancer.

Rodrigues Myra F MF Veen Sten S van Egmond Jaap J van Hameren Mark M van Oorschot Theodorus T de Vet Steven S van Santvoort Jan P C JPC Wiggenraad Ruud G J RGJ Mast Mirjam E ME

Physics and imaging in radiation oncology 20190726

Reproducible patient positioning is important in radiotherapy (RT) of head-and-neck cancer. We therefore compared set-up errors in head-and-neck RT resulting from three different patient positioning systems. Patients were either treated with a standard head support (SHS) and conventional treatment couch (SHS-3, n = 10), a SHS and rotational couch (SHS-6, n = 10), or an individual head support (IHS) and rotational couch (IHS-6, n = 10). Interfraction mean translation vector lenghts were significa ...[more]

PMID: 33458274

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Project description:BackgroundTo introduce a novel method of patient positioning for high precision intracranial radiotherapy.MethodsAn infrared(IR)-array, reproducibly attached to the patient via a vacuum-mouthpiece(vMP) and connected to the table via a 6 degree-of-freedom(DoF) mechanical arm serves as positioning and fixation system. After IR-based manual prepositioning to rough treatment position and fixation of the mechanical arm, a cone-beam CT(CBCT) is performed. A robotic 6 DoF treatment couch (HexaPOD) then automatically corrects all remaining translations and rotations. This absolute position of infrared markers at the first fraction acts as reference for the following fractions where patients are manually prepositioned to within +/- 2 mm and +/- 2 degrees of this IR reference position prior to final HexaPOD-based correction; consequently CBCT imaging is only required once at the first treatment fraction.The preclinical feasibility and attainable repositioning accuracy of this method was evaluated on a phantom and human volunteers as was the clinical efficacy on 7 pilot study patients.ResultsPhantom and volunteer manual IR-based prepositioning to within +/- 2 mm and +/- 2 degrees in 6 DoF was possible within a mean(+/- SD) of 90 +/- 31 and 56 +/- 22 seconds respectively. Mean phantom translational and rotational precision after 6 DoF corrections by the HexaPOD was 0.2 +/- 0.2 mm and 0.7 +/- 0.8 degrees respectively. For the actual patient collective, the mean 3D vector for inter-treatment repositioning accuracy (n = 102) was 1.6 +/- 0.8 mm while intra-fraction movement (n = 110) was 0.6 +/- 0.4 mm.ConclusionsThis novel semi-automatic 6DoF IR-based system has been shown to compare favourably with existing non-invasive intracranial repeat fixation systems with respect to handling, reproducibility and, more importantly, intra-fraction rigidity. Some advantages are full cranial positioning flexibility for single and fractionated IGRT treatments and possibly increased patient comfort.

Dataset Information

The influence of a six degrees of freedom couch and an individual head support in patient positioning in radiotherapy of head and neck cancer.

Publications

The influence of a six degrees of freedom couch and an individual head support in patient positioning in radiotherapy of head and neck cancer.

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