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• W1963571548 abstract "A vacuum bite block relocatable head frame (RHF) is currently available for fractionated radiotherapy on the gamma knife radiosurgery unit (Perfexion). The purpose of this study is to evaluate the setup reproducibility between the CT and treatment unit couch, as well as the interfraction uncertainty for patients receiving fractionated radiotherapy using the RHF. Four patients were accrued on a prospective hypofractionated dose escalation study, treating large oligometastases to the brain over three fractions on the gamma knife machine. Two patients were treated using a prototype device, and two with the commercial RHF (eXtend). A dedicated radiation oncology CT scanner with a flat-top carbon-fiber couch was used for simulation, whereas the treatment unit employs a sloped, height adjustable couch with a mattress top. To determine setup reproducibility, a repositioning check tool (RCT) was used to measure anatomic displacements relative to the frame, using the patient's external contour as a surrogate for internal anatomic displacement. To assess the daily reproducibility of setup from couch to couch, the mean difference in RCT readings between initial CT and the treatment couch was measured. The mean difference between setups performed on the same couch was also measured to assess the reproducibility of setup. Finally, the variation in the difference (i.e. systematic and random uncertainties) between initial CT RCT readings and treatment couch RCT readings were assessed to quantify interfraction motion. Twelve treatment fractions were analyzed. The mean difference (± 1 standard deviation) between RCT readings at the CT and treatment couch for each direction was 0.5 ± 0.3 mm anterior, 0.5 ± 0.3 mm superior, 0.1 ± 0.3 mm right, and 0.1 ± 0.2 mm left. For two patients who received daily CT imaging, the mean difference between RCT readings acquired on the CT couch was less than 0.2 mm along any direction. Similarly, the mean difference between RCT readings acquired on the treatment couch was less than 0.2 mm in any direction. The interfraction variability (i.e. random uncertainty) was less than 0.4 mm along any axis, with the largest interfraction difference observed in the superior/inferior direction (range 1.7 mm to -0.6 mm). Our finding that the mean difference between RCT readings was larger between two different couches than setups on any one couch suggests that the use of different couch designs may impact setup reproducibility. The largest baseline shift detected with the RHF frame between couch tops was in the cranial/caudal direction." @default.
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• W1963571548 date "2011-10-01" @default.
• W1963571548 modified "2023-09-27" @default.
• W1963571548 title "Evaluating Setup Reproducibility between a CT Planning and Gamma Knife Radiosurgery Couch Using a Relocatable Head Frame" @default.
• W1963571548 doi "https://doi.org/10.1016/j.ijrobp.2011.06.1552" @default.
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