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- W2122352332 abstract "Beside the translational motion of the prostate, prostate rotation is also reported by the Calypso 4D localization system (Calypso Medical, Seattle, WA) during the external beam radiation treatment. Although large rotation angles have been observed for some patients no guidelines have been reported on how to deal with this information since it is often not possible to correct rotational changes using standard couches and sometimes large rotations are misrepresentations due to transponder migration. A practical procedure is described in this work based on our clinical experience and observations. In our procedure portal images are taken at the first treatment if a >10 degree rotation angle is reported. Transponder alignments are checked between the portal images and the DRRs generated from the simulation CT. If all three transponders on the portal images are aligned with their contours on the DRR within an acceptable range, the treatment will continue. Otherwise, a simulation CT or Cone beam CT is suggested. By fusing the new CT with the old simulation CT based on the prostate geometry, location changes of the three individual transponders can be determined and the cause of the reported prostate rotation can be determined. If a significant transponder migration is found, patient setup for the subsequent treatments will be based on the new CT. If the organ has indeed rotated significantly it has to be analyzed and corrected in the treatment margin. More than a centimeter transponder migration has been observed in some patients. The transponder coordinates from the new CT have been used for subsequent treatment setup. A relationship between the rotation-related translational geometrical uncertainty and the rotation angle has been derived using prostate contours and isocenter locations from 20 patients, which can be fitted to a power function: Δx = -0.0024θ2+0.3226θ-0.0082 where Δx is the rotation-related translational geometrical uncertainty in mm and θ is the prostate rotation angle in degree. The rotation-related translational geometrical uncertainty is significant if the rotation angle is greater than 5 degrees. Prostate rotation effects on the treatment margin can be significant if the rotation angle is greater than 5 degrees. The cause of the reported rotation has to be identified to exclude transponder migration, which should be corrected with a new CT for subsequent treatments." @default.
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- W2122352332 date "2010-11-01" @default.
- W2122352332 modified "2023-09-27" @default.
- W2122352332 title "A Practical Strategy to Correct Prostate Rotation Reported by a 4D Localization System" @default.
- W2122352332 doi "https://doi.org/10.1016/j.ijrobp.2010.07.1628" @default.
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