Dosimetric consequences of misalignment and realignment in prostate 3DCRT using intramodality ultrasound image guidance
Abstract
It is common practice to correct for interfraction motion by shifting the patient from reference skin marks to better align the internal target at the linear accelerator's isocenter. Shifting the patient away from skin mark alignment causes the radiation beams to pass through a patient geometry different from that planned. Yet, dose calculations on the new geometry are not commonly performed. The intention of this work was to compare the dosimetric consequences of treating the patient with and without setup correction for the common clinical scenario of prostate interfraction motion. In order to account for prostate motion, 32 patients initially aligned to the room lasers via skin marks were realigned under the treatment beams by shifting the treatment couch based on ultrasound image guidance. An intramodality 3D ultrasound image guidance system was used to determine the setup correction, so that errors stemming from different tissue representations on different imaging modalities were eliminated. Two scenarios were compared to the reference static treatment plan: (1) Uncorrected patient alignment and (2) corrected patient alignment. Prostate displacement statistics and the dose to the clinical target volume (CTV), bladder, and...Continue Reading
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