Abstract
Purpose: To assess setup and organ motion error by means of analysis of daily megavoltage computed tomography (MVCT) of patients treated with hypofractionated helical tomotherapy (71.4-74.2 Gy in 28 fractions). Methods and Materials: Data from 21 patients were analyzed. Patients were instructed to empty the rectum carefully before planning CT and every morning before therapy by means of a self-applied rectal enema. The position of the prostate was assessed by means of automatic bone matching (BM) with the planning kilovoltage CT (BM, setup error) followed by a direct visualization (DV) match on the prostate. Deviations between planning and therapy positions referred to BM and BM + DV were registered for the three main axes. In case of a full rectum at MVCT with evident shift of the prostate, treatment was postponed until after additional rectal emptying procedures; in this case, additional MVCT was performed before delivering the treatment. Data for 522 fractions were available; the impact of post-MVCT procedure was investigated for 17 of 21 patients (410 fractions). Results: Prostate motion relative to bony anatomy was limited. Concerning posterior-anterior shifts, only 4.9% and 2.7% of fractions showed deviation of 3 mm or greater of the prostate relative to BM without and with consideration of post-MVCT procedures, respectively. Interobserver variability for BM + DV match was within 0.8 mm (1 SD). Conclusions: Daily MVCT-based correction is feasible. The BM + DV matching was found to be consistent between operators. Rectal emptying using a daily enema is an efficient tool to minimize prostate motion, even for centers that have not yet implemented image-guided radiotherapy.
| Original language | English |
|---|---|
| Pages (from-to) | 611-617 |
| Number of pages | 7 |
| Journal | International Journal of Radiation Oncology Biology Physics |
| Volume | 71 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jun 1 2008 |
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Keywords
- Image-guided radiotherapy
- Intensity-modulated radiotherapy
- Organ motion
- Prostate
- Tomotherapy
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Radiation
Cite this
Evidence of Limited Motion of the Prostate by Carefully Emptying the Rectum as Assessed by Daily MVCT Image Guidance with Helical Tomotherapy. / Fiorino, Claudio; Di Muzio, Nadia; Broggi, Sara; Cozzarini, Cesare; Maggiulli, Eleonora; Alongi, Filippo; Valdagni, Riccardo; Fazio, Ferruccio; Calandrino, Riccardo.
In: International Journal of Radiation Oncology Biology Physics, Vol. 71, No. 2, 01.06.2008, p. 611-617.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Evidence of Limited Motion of the Prostate by Carefully Emptying the Rectum as Assessed by Daily MVCT Image Guidance with Helical Tomotherapy
AU - Fiorino, Claudio
AU - Di Muzio, Nadia
AU - Broggi, Sara
AU - Cozzarini, Cesare
AU - Maggiulli, Eleonora
AU - Alongi, Filippo
AU - Valdagni, Riccardo
AU - Fazio, Ferruccio
AU - Calandrino, Riccardo
PY - 2008/6/1
Y1 - 2008/6/1
N2 - Purpose: To assess setup and organ motion error by means of analysis of daily megavoltage computed tomography (MVCT) of patients treated with hypofractionated helical tomotherapy (71.4-74.2 Gy in 28 fractions). Methods and Materials: Data from 21 patients were analyzed. Patients were instructed to empty the rectum carefully before planning CT and every morning before therapy by means of a self-applied rectal enema. The position of the prostate was assessed by means of automatic bone matching (BM) with the planning kilovoltage CT (BM, setup error) followed by a direct visualization (DV) match on the prostate. Deviations between planning and therapy positions referred to BM and BM + DV were registered for the three main axes. In case of a full rectum at MVCT with evident shift of the prostate, treatment was postponed until after additional rectal emptying procedures; in this case, additional MVCT was performed before delivering the treatment. Data for 522 fractions were available; the impact of post-MVCT procedure was investigated for 17 of 21 patients (410 fractions). Results: Prostate motion relative to bony anatomy was limited. Concerning posterior-anterior shifts, only 4.9% and 2.7% of fractions showed deviation of 3 mm or greater of the prostate relative to BM without and with consideration of post-MVCT procedures, respectively. Interobserver variability for BM + DV match was within 0.8 mm (1 SD). Conclusions: Daily MVCT-based correction is feasible. The BM + DV matching was found to be consistent between operators. Rectal emptying using a daily enema is an efficient tool to minimize prostate motion, even for centers that have not yet implemented image-guided radiotherapy.
AB - Purpose: To assess setup and organ motion error by means of analysis of daily megavoltage computed tomography (MVCT) of patients treated with hypofractionated helical tomotherapy (71.4-74.2 Gy in 28 fractions). Methods and Materials: Data from 21 patients were analyzed. Patients were instructed to empty the rectum carefully before planning CT and every morning before therapy by means of a self-applied rectal enema. The position of the prostate was assessed by means of automatic bone matching (BM) with the planning kilovoltage CT (BM, setup error) followed by a direct visualization (DV) match on the prostate. Deviations between planning and therapy positions referred to BM and BM + DV were registered for the three main axes. In case of a full rectum at MVCT with evident shift of the prostate, treatment was postponed until after additional rectal emptying procedures; in this case, additional MVCT was performed before delivering the treatment. Data for 522 fractions were available; the impact of post-MVCT procedure was investigated for 17 of 21 patients (410 fractions). Results: Prostate motion relative to bony anatomy was limited. Concerning posterior-anterior shifts, only 4.9% and 2.7% of fractions showed deviation of 3 mm or greater of the prostate relative to BM without and with consideration of post-MVCT procedures, respectively. Interobserver variability for BM + DV match was within 0.8 mm (1 SD). Conclusions: Daily MVCT-based correction is feasible. The BM + DV matching was found to be consistent between operators. Rectal emptying using a daily enema is an efficient tool to minimize prostate motion, even for centers that have not yet implemented image-guided radiotherapy.
KW - Image-guided radiotherapy
KW - Intensity-modulated radiotherapy
KW - Organ motion
KW - Prostate
KW - Tomotherapy
UR - http://www.scopus.com/inward/record.url?scp=43049172149&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=43049172149&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2008.01.048
DO - 10.1016/j.ijrobp.2008.01.048
M3 - Article
C2 - 18374511
AN - SCOPUS:43049172149
VL - 71
SP - 611
EP - 617
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
SN - 0360-3016
IS - 2
ER -