Clinical experience of the importance of daily portal imaging for head and neck IMRT treatments.

Journal of Applied Clinical Medical Physics
Laurence E CourtRoy B Tishler

Abstract

The purpose of this study was to evaluate patient setup in head and neck IMRT using daily portal imaging. At our institution, orthogonal digital portal images are taken daily to check patient positioning prior to head and neck IMRT treatment. Isocenter misalignments are corrected using a couch shift (3mm action level). Therapists also compare the DRRs and portal images looking at points more distant from the isocenter, particular in the supraclavicular region, and re-position the patient's shoulders in the mask if considered necessary. The daily isocenter shifts (C2 region) and frequency of patient repositioning were investigated by review of record-and-verify records for 15 patients. The magnitude of the shoulder repositioning was evaluated for 10 of these patients by comparing portal images and plan DRRs for a point 8 cm inferior of isocenter (T2-T4). For all patients, pretreatment isocenter discrepancies 3mm or smaller were recorded for a median of 92.5% of fractions (range: 71.4 -100%). Patients were repositioned in the immobilization mask before treatment for a median of 14% of fractions (3-34%). Thirty percent of these were for shoulder shifts of 1cm or larger. Twenty percent of patients needed shoulder shifts of 1cm or m...Continue Reading

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Citations

Jan 8, 2013·Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)·Bojan Strbac, Vesna Spasic Jokic
Jan 20, 2010·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Suzanne van BeekJan-Jakob Sonke
Nov 22, 2011·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Markus StockDietmar Georg
Feb 1, 2011·American Journal of Clinical Oncology·Roger OveSuzanne M Russo

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