A clinical comparison of patient setup and intra-fraction motion using frame-based radiosurgery versus a frameless image-guided radiosurgery system for intracranial lesions


Ramakrishna N., Rosca F., Friesen S., Tezcanli E. K., Zygmanszki P., Hacker F.

Radiotherapy and Oncology, cilt.95, sa.1, ss.109-115, 2010 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 95 Sayı: 1
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1016/j.radonc.2009.12.030
  • Dergi Adı: Radiotherapy and Oncology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.109-115
  • Anahtar Kelimeler: Frameless, Image-guided, Radiosurgery, Stereotactic
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

Background and purpose: A comparison of patient positioning and intra-fraction motion using invasive frame-based radiosurgery with a frameless X-ray image-guided system utilizing a thermoplastic mask for immobilization. Materials and methods: Overall system accuracy was determined using 57 hidden-target tests. Positioning agreement between invasive frame-based setup and image-guided (IG) setup, and intra-fraction displacement, was evaluated for 102 frame-based SRS treatments. Pre and post-treatment imaging was also acquired for 7 patients (110 treatments) immobilized with an aquaplast mask receiving fractionated IG treatment. Results: The hidden-target tests demonstrated a mean error magnitude of 0.7 mm (SD = 0.3 mm). For SRS treatments, mean deviation between frame-based and image-guided initial positioning was 1.0 mm (SD = 0.5 mm). Fusion failures were observed among 3 patients resulting in aberrant predicted shifts. The image-guidance system detected frame slippage in one case. The mean intra-fraction shift magnitude observed for the BRW frame was 0.4 mm (SD = 0.3 mm) compared to 0.7 mm (SD = 0.5 mm) for the fractionated patients with the mask system. Conclusions: The overall system accuracy is similar to that reported for invasive frame-based SRS. The intra-fraction motion was larger with mask-immobilization, but remains within a range appropriate for stereotactic treatment. These results support clinical implementation of frameless radiosurgery using the Novalis Body Exac-Trac system. © 2010 Elsevier Ireland Ltd. All rights reserved.