Comparison of setup accuracy of optical surface image versus orthogonal x-ray images for VMAT of the left breast using deep-inspiration breath-hold Journal Article
| Authors: | Lu, W.; Hong, L. X.; Yamada, N.; Berry, S. L.; Song, Y.; Choi, W.; Cerviño, L. I.; Tang, X.; Mechalakos, J. G.; Romesser, P. B.; Powell, S.; Li, G. |
| Article Title: | Comparison of setup accuracy of optical surface image versus orthogonal x-ray images for VMAT of the left breast using deep-inspiration breath-hold |
| Abstract: | To compare the setup accuracy of optical surface image (OSI) versus orthogonal x-ray images (2DkV) using cone beam computed tomography (CBCT) as ground truth for radiotherapy of left breast cancer in deep-inspiration breath-hold (DIBH). Ten left breast DIBH patients treated with volumetric modulated arc therapy (VMAT) were studied retrospectively. OSI, 2DkV, and CBCT were acquired weekly at treatment setup. OSI, 2DkV, and CBCT were registered to planning CT or planning DRR based on a breast surface region of interest (ROI), bony anatomy (chestwall and sternum), and both bony anatomy and breast surface, respectively. These registrations provided couch shifts for each imaging system. The setup errors, or the difference in couch shifts between OSI and CBCT were compared to those between 2DkV and CBCT. A second OSI was acquired during last beam delivery to evaluate intrafraction motion. The median absolute setup errors were (0.21, 0.27, 0.23 cm, 0.6°, 1.3°, 1.0°) for OSI, and (0.26, 0.24, 0.18 cm, 0.9°, 1.0°, 0.6°) for 2DkV in vertical, longitudinal and lateral translations, and in rotation, roll and pitch, respectively. None of the setup errors was significantly different between OSI and 2DkV. For both systems, the systematic and random setup errors were ≤0.6 cm and ≤1.5° in all directions. Nevertheless, larger setup errors were observed in some sessions in both systems. There was no correlation between OSI and CBCT whereas there was modest correlation between 2DkV and CBCT. The intrafraction motion in DIBH detected by OSI was small with median absolute translations <0.2 cm, and rotations ≤0.4°. Though OSI showed comparable and small setup errors as 2DkV, it showed no correlation with CBCT. We concluded that to achieve accurate setup for both bony anatomy and breast surface, daily 2DkV can't be omitted following OSI for left breast patients treated with DIBH VMAT. © 2023 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine. |
| Keywords: | retrospective studies; intensity modulated radiation therapy; radiotherapy; diagnostic imaging; breast neoplasms; retrospective study; radiotherapy, intensity-modulated; breast tumor; radiotherapy planning, computer-assisted; breath holding; cone beam computed tomography; x ray; cone-beam computed tomography; x-rays; cbct; dibh; procedures; humans; human; female; 2dkv; left breast cancer; optical surface image; orthogonal x-ray image; osi; setup accuracy |
| Journal Title: | Journal of Applied Clinical Medical Physics |
| Volume: | 24 |
| Issue: | 12 |
| ISSN: | 1526-9914 |
| Publisher: | American College of Medical Physics |
| Date Published: | 2023-12-01 |
| Start Page: | e14117 |
| Language: | English |
| DOI: | 10.1002/acm2.14117 |
| PUBMED: | 37535396 |
| PROVIDER: | scopus |
| PMCID: | PMC10691624 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Wei Lu -- Source: Scopus |
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