Set-up Errors and Determination of Planning Target Volume Margins Protocol for Different Anatomical Sites in a Newly Established Tertiary Radiotherapy Centre in India

Abstract Objective Our study aimed to assess the set-up errors for image-guided radiotherapy at a newly established tertiary radiation center in India and to establish the departmental protocol of clinical target volume–planning target volume (CTV–PTV) margins for different anatomical sites. Materials and Methods This study enrolled the first 200 patients who were treated with curative intent at All India Institute of Medical Sciences, Patna, from February 2019 to September 2019. Number of patients were 53, 26, 53, 11, 6, 47, and 4 for head and neck, brain, breast, thorax, abdomen, pelvis, and craniospinal irradiation (CSI), respectively. The translational vectors for total 1,463 kV cone-beam computed tomography (CBCT) images were collected from the treatment record. Results For the systematic error, the largest value is found for the thoracic subset on the X and Y directions, and for breast patients on Z axis, whereas the smallest values were found for CSI. For random error, the largest value was found for pelvic in the X, Y direction, and for breast subset on Z axis, whereas the smallest values on X and Z axes were found in the brain and for head and neck on the Y axis. Largest value for systemic error is smaller than 5 mm in all directions and for all anatomical subsets. The highest random error value is 5.07 mm in Y axis for pelvic subset. The largest values for CTV–PTV margin are found for thoracic subset and the smallest for CSI followed by the brain. Significant reduction of set-up error observed for the last hundred patients as compared to the first half of the patient population. Conclusion Use of thermoplastic cast along with breast board and respiratory motion management should be recommended to reduce set-up error for breast and thoracic subset. Six degrees of freedom robotic couch system can also further rectify the set-up error in image-guided radiotherapy.

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Feasibility of Margin Reduction for Level II and III Planning Target Volume in Head-and-Neck Image-Guided Radiotherapy – Dosimetric Assessment via A Deformable Image Registration Framework

Current Cancer Therapy Reviews ◽

10.2174/157339471004150407130229 ◽

2015 ◽

Vol 10 (4) ◽

pp. 323-333 ◽

Cited By ~ 1

Author(s):

X. Qi ◽

John Neylon ◽

Sumeyra Can ◽

Robert Staton ◽

Jason Pukala ◽

...

Keyword(s):

Image Registration ◽

Head And Neck ◽

Planning Target Volume ◽

Deformable Image Registration ◽

Target Volume ◽

Image Guided Radiotherapy ◽

Image Guided ◽

Level Ii ◽

Dosimetric Assessment

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SU-E-J-88: Margin Reduction of Level II/III Planning Target Volume for Image-Guided Simultaneous Integrated Boost Head-And-Neck Treatment

Medical Physics ◽

10.1118/1.4888140 ◽

2014 ◽

Vol 41 (6Part7) ◽

pp. 175-176

Author(s):

S Can ◽

J Neylon ◽

S Qi ◽

A Santhanam ◽

D Low

Keyword(s):

Head And Neck ◽

Planning Target Volume ◽

Target Volume ◽

Simultaneous Integrated Boost ◽

Image Guided ◽

Level Ii ◽

Integrated Boost

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Feasibility of Margin Reduction for Level II and III Planning Target Volume in Head-and-Neck Image Guided Radiation Therapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2013.06.1245 ◽

2013 ◽

Vol 87 (2) ◽

pp. S470-S471

Author(s):

X. Qi ◽

A. Santhanam ◽

J. Neylon ◽

P. Kupelian ◽

M. Steinberg ◽

...

Keyword(s):

Radiation Therapy ◽

Head And Neck ◽

Planning Target Volume ◽

Target Volume ◽

Image Guided Radiation Therapy ◽

Image Guided ◽

Level Ii

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Setup Uncertainty as Determined by Daily Image Guided Radiation Therapy (IGRT) for Head-and-Neck Cancer (HNC): Evaluation of Safety and Implications on Defining Planning Target Volume (PTV) Margins

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2013.06.1229 ◽

2013 ◽

Vol 87 (2) ◽

pp. S464-S465

Author(s):

A. Orisamolu ◽

N. Anderson ◽

A. Lin

Keyword(s):

Radiation Therapy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Planning Target Volume ◽

Target Volume ◽

Image Guided Radiation Therapy ◽

Image Guided

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Impact of planning target volume margins and rectal distention on biochemical failure in image-guided radiotherapy of prostate cancer

Radiotherapy and Oncology ◽

10.1016/j.radonc.2014.02.009 ◽

2014 ◽

Vol 111 (1) ◽

pp. 106-109 ◽

Cited By ~ 23

Author(s):

Benedikt Engels ◽

Guy Soete ◽

Thierry Gevaert ◽

Guy Storme ◽

Dirk Michielsen ◽

...

Keyword(s):

Prostate Cancer ◽

Planning Target Volume ◽

Target Volume ◽

Biochemical Failure ◽

Image Guided Radiotherapy ◽

Image Guided ◽

Rectal Distention

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Analysis of interfractional set-up errors and intrafractional organ motions during IMRT for head and neck tumors to define an appropriate planning target volume (PTV)- and planning organs at risk volume (PRV)-margins

Radiotherapy and Oncology ◽

10.1016/j.radonc.2006.03.006 ◽

2006 ◽

Vol 78 (3) ◽

pp. 283-290 ◽

Cited By ~ 68

Author(s):

Minoru Suzuki ◽

Yasumasa Nishimura ◽

Kiyoshi Nakamatsu ◽

Masahiko Okumura ◽

Hisayuki Hashiba ◽

...

Keyword(s):

At Risk ◽

Head And Neck ◽

Planning Target Volume ◽

Organs At Risk ◽

Target Volume ◽

Head And Neck Tumors ◽

Neck Tumors ◽

Set Up

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Evaluation of interfraction patient setup errors for image-guided prostate and head-and-neck radiotherapy using kilovoltage cone beam and megavoltage fan beam computed tomography

Journal of Radiotherapy in Practice ◽

10.1017/s1460396912000337 ◽

2013 ◽

Vol 12 (4) ◽

pp. 334-343 ◽

Cited By ~ 6

Author(s):

X. Sharon Qi ◽

Sutan Wu ◽

Francis Newman ◽

X. Allen Li ◽

Angie Y. Hu

Keyword(s):

Computed Tomography ◽

Head And Neck ◽

Target Volume ◽

Cone Beam ◽

Setup Errors ◽

Image Guided Radiotherapy ◽

Image Guided ◽

Significant Difference ◽

Late Stages ◽

Head And Neck Radiotherapy

AbstractPurposeTo analyse interfraction setup using two different image guidance modalities for prostate and head-and-neck (H&N) cancer treatment.Materials and methodsSeventy-two prostate and 60 H&N cancer patients, imaged with kilovoltage cone beam computed tomography (KVCBCT) or megavoltage fan beam computed tomography (MVFBCT), were studied retrospectively. The daily displacements in mediolateral (ML), craniocaudal (CC) and anteroposterior (AP) dimensions were investigated. The setup errors were calculated to determine the clinical target volume to planning target volume (CTV-to-PTV) margins.ResultsBased on 1,606 KVCBCT and 2,054 MVFBCT scans, average interfraction shifts in ML, CC and AP direction for H&N cases were 0·5 ± 1·5, −0·3 ± 2·0, 0·3 ± 1·7 mm using KVCBCT, 0·2 ± 1·9, −0·2 ± 2·4 and 0·0 ± 1·7 mm using MVFBCT. For prostate cases, average interfraction displacements were −0·3 ± 3·9, 0·2 ± 2·4, 0·4 ± 3·8 mm for MVFBCT and −0·2 ± 2·7, −0·6 ± 2·9, −0·5 ± 3·4 mm for KVCBCT. The calculated CTV-to-PTV margins, if determined by image-guided radiotherapy (IGRT) data, were 5·6 mm (H&N) and 7·8 mm (prostate) for MVFBCT, compared with 4·8 mm and 7·2 mm for KVCBCT. We observed no statistically significant difference in daily repositioning using KVCBCT and MVFBCT in early, middle and late stages of the treatment course.ConclusionIn the absence of IGRT, the CTV-to-PTV margin determined using IGRT data, may be varied for different imaging modalities for prostate and H&N irradiation.

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