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Volume 16, Number 3, 2011

Detection of setup uncertainties with 3D surface registration system for conformal radiotherapy of breast cancer

Letizia Deantonio, Laura Masini, Gianfranco Loi, Giuseppina Gambaro, Cesare Bolchini, Marco Krengli

Summary:

Aim: To investigate the clinical application of a technique for patient set-up verification in
breast cancer radiotherapy based on a 3D surface image registration system.
Background: Accurate and reproducible patient set-up is a prerequisite to correctly deliver
fractionated radiotherapy. Various approaches are available to verify and correct patient
setup for 3D image acquisition in a radiation treatment room.
Materials and methods: The study analyzed the setup reproducibility of 15 patients affected
by breast cancer and candidates for conformal radiotherapy by using the AlignRT system
(VisionRT, London, UK). At the initial setup, electronic portal imaging device (EPID) images
were compared with Digitally Reconstructed Radiographs (DRRs) and a reference threedimensional
(3D) surface imagewas obtained by AlignRT. Surface imageswere acquired prior
to every subsequent setup procedure. The systematic and random errors along longitudinal
and vertical directions were measured and compared for the two systems.
Results: The procedure for surface registration, image acquisition and comparison with the
reference image took less than 1 min on average. The T test for systematic error showed no
significant difference between the 2 verification systems along the longitudinal (p = 0.69) and
vertical (p = 0.67) axes. The T-test for random error showed a significant difference between
the 2 systems along the vertical axis (p = 0.05).
Conclusion: AlignRT is fast, simple, non-invasive and seems to be reliable in detecting patient
setup errors. Our results suggest that it could be used to assess the setup reproducibility for
breast cancer patients.

Signature: Rep Pract Oncol Radiother, 2011; 16(3) : 77-81


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Indexed in: EMBASE®, the Excerpta Medica database, the Elsevier BIOBASE (Current Awareness in Biological Sciences) and in the Index Copernicus.

http://www.sciencedirect.com/science/journal/15071367/19/2