Fractionated stereotactic radiotherapy for skull base tumors: Analysis of treatment accuracy using a stereotactic mask fixation system

Giuseppe Minniti, Maurizio Valeriani, Enrico Clarke, Marco D'Arienzo, Michelangelo Ciotti, Roberto Montagnoli, Francesca Saporetti, Riccardo M. Enrici

Research output: Contribution to journalArticlepeer-review


Background: To assess the accuracy of fractionated stereotactic radiotherapy (FSRT) using a stereotactic mask fixation system.Patients and Methods: Sixteen patients treated with FSRT were involved in the study. A commercial stereotactic mask fixation system (BrainLAB AG) was used for patient immobilization. Serial CT scans obtained before and during FSRT were used to assess the accuracy of patient immobilization by comparing the isocenter position. Daily portal imaging were acquired to establish day to day patient position variation. Displacement errors along the different directions were calculated as combination of systematic and random errors.Results: The mean isocenter displacements based on localization and verification CT imaging were 0.1 mm (SD 0.3 mm) in the lateral direction, 0.1 mm (SD 0.4 mm) in the anteroposterior, and 0.3 mm (SD 0.4 mm) in craniocaudal direction. The mean 3D displacement was 0.5 mm (SD 0.4 mm), being maximum 1.4 mm. No significant differences were found during the treatment (P = 0.4). The overall isocenter displacement as calculated by 456 anterior and lateral portal images were 0.3 mm (SD 0.9 mm) in the mediolateral direction, -0.2 mm (SD 1 mm) in the anteroposterior direction, and 0.2 mm (SD 1.1 mm) in the craniocaudal direction. The largest displacement of 2.7 mm was seen in the cranio-caudal direction, with 95% of displacements <2 mm in any direction.Conclusions: The results indicate that the setup error of the presented mask system evaluated by CT verification scans and portal imaging are minimal. Reproducibility of the isocenter position is in the best range of positioning reproducibility reported for other stereotactic systems.

Original languageEnglish
Article number1
JournalRadiation Oncology
Issue number1
Publication statusPublished - Jan 13 2010

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)


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