Verification of respiratory-gated radiotherapy with new real-time tumour-tracking radiotherapy system using cine EPID images and a log file

Phys Med Biol. 2017 Feb 21;62(4):1585-1599. doi: 10.1088/1361-6560/aa587d. Epub 2017 Jan 10.

Abstract

A combined system comprising the TrueBeam linear accelerator and a new real-time tumour-tracking radiotherapy system, SyncTraX, was installed at our institution. The objectives of this study are to develop a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine electronic portal image device (EPID) images and a log file and to verify this treatment in clinical cases. Respiratory-gated radiotherapy was performed using TrueBeam and the SyncTraX system. Cine EPID images and a log file were acquired for a phantom and three patients during the course of the treatment. Digitally reconstructed radiographs (DRRs) were created for each treatment beam using a planning CT set. The cine EPID images, log file, and DRRs were analysed using a developed software. For the phantom case, the accuracy of the proposed method was evaluated to verify the respiratory-gated radiotherapy. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker used as an internal surrogate were calculated to evaluate the gating accuracy and set-up uncertainty in the superior-inferior (SI), anterior-posterior (AP), and left-right (LR) directions. The proposed method achieved high accuracy for the phantom verification. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker were ⩽3 mm and ±3 mm in the SI, AP, and LR directions. We proposed a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine EPID images and a log file and showed that this treatment is performed with high accuracy in clinical cases.

MeSH terms

  • Computer Systems*
  • Fiducial Markers
  • Humans
  • Neoplasms / diagnostic imaging
  • Neoplasms / radiotherapy
  • Phantoms, Imaging
  • Radiotherapy Planning, Computer-Assisted / instrumentation
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy Planning, Computer-Assisted / standards
  • Respiratory-Gated Imaging Techniques / instrumentation
  • Respiratory-Gated Imaging Techniques / methods*
  • Respiratory-Gated Imaging Techniques / standards
  • Software
  • Tomography, X-Ray Computed / instrumentation
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / standards