Kilovoltage Imaging of Implanted Fiducials to Monitor Intrafraction Motion With Abdominal Compression During Stereotactic Body Radiation Therapy for Gastrointestinal Tumors

International Journal of Radiation Oncology, Biology, Physics
Ellen D YorkeKaryn A Goodman

Abstract

To assess intrafraction respiratory motion using a commercial kilovoltage imaging system for abdominal tumor patients with implanted fiducials and breathing constrained by pneumatic compression during stereotactic body radiation therapy (SBRT). A pneumatic compression belt limited respiratory motion in 19 patients with radiopaque fiducials in or near their tumor during SBRT for abdominal tumors. Kilovoltage images were acquired at 5- to 6-second intervals during treatment using a commercial system. Intrafractional fiducial displacements were measured using in-house software. The dosimetric effect of the observed displacements was calculated for 3 sessions for each patient. Intrafraction displacement patterns varied between patients and between individual treatment sessions. Averaged over 19 patients, 73 sessions, 7.6% of craniocaudal displacements exceeded 0.5 cm, and 1.2% exceeded 0.75 cm. The calculated single-session dose to 95% of gross tumor volume differed from planned by an average of -1.2% (range, -11.1% to 4.8%) but only for 4 patients was the total 3-session calculated dose to 95% of gross tumor volume more than 3% different from planned. Our pneumatic compression limited intrafractional abdominal target motion, maint...Continue Reading

References

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Citations

Apr 2, 2019·Journal of Applied Clinical Medical Physics·Chuan ZengTianfang Li

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