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Assessment of unintended shifts during frame-based stereotactic radiosurgery using cone beam computed tomography image guidance.
Seneviratne, Danushka S; Hadley, Austin R; Peterson, Jennifer L; Malouff, Timothy D; Reimer, Ronald; Herchko, Steve M; May, Byron; Ko, Stephen; Trifiletti, Daniel M; Vallow, Laura A.
Afiliação
  • Seneviratne DS; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
  • Hadley AR; Alaska Cancer Treatment Center, Anchorage, AK, USA.
  • Peterson JL; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
  • Malouff TD; Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA.
  • Reimer R; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
  • Herchko SM; Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA.
  • May B; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
  • Ko S; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
  • Trifiletti DM; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
  • Vallow LA; Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA. trifiletti.daniel@mayo.edu.
J Neurooncol ; 148(2): 273-279, 2020 Jun.
Article em En | MEDLINE | ID: mdl-32474748
PURPOSE: To investigate the frequency, magnitude and possible causes of frame-shifts that may occur between treatment planning and treatment delivery when performing Gamma Knife radiosurgery with rigid frame-based immobilization. METHODS: Differences between computed tomography (CT) framed fiducial stereotactic coordinate reference and cone beam computed tomography stereotactic coordinates after image registration were recorded for 49 frame-based GK radiosurgery cases performed using the Gamma Knife Icon. Parameters recorded include rotational shifts, translational shifts, and the GK-computed Maximum Shot Displacement (MSD) between the two stereotactic coordinate spaces. Other patient-specific parameters were collected and linear regression analysis was performed to evaluate predictors of increased displacement. RESULTS: The median values of rotational shifts were: pitch 0.14°, yaw 0.17°, and roll 0.13°. The median absolute values of translational shifts were: left-right 0.39 mm, anteroposterior 0.14 mm, and superior-inferior 0. 22 mm. The median value of MSD was 0.71 mm. Twelve cases (24.5%) had a MSD of greater than 1.0 mm. Male gender was associated with increased MSD (p = 0.013) and translational shifts (root-mean-squared value, p = 0.017). Cases with large differences between right and left sided pin lengths were also associated with increased MSD (p = 0.011). CONCLUSIONS: The use of CBCT image guidance in frame-based GK radiosurgery allows unintended frame shifts to be identified and corrected. A significant fraction (24.5%) of patients had large enough shifts to result in a MSD of greater than 1.0 mm. Male gender and eccentrically placed frames were associated with increased MSD, and particular care should be taken in these cases.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Planejamento da Radioterapia Assistida por Computador / Neoplasias Encefálicas / Radiocirurgia / Tomografia Computadorizada de Feixe Cônico Tipo de estudo: Guideline Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Planejamento da Radioterapia Assistida por Computador / Neoplasias Encefálicas / Radiocirurgia / Tomografia Computadorizada de Feixe Cônico Tipo de estudo: Guideline Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos