PMID- 23008828
OWN - NLM
STAT- MEDLINE
DCOM- 20130227
LR  - 20220317
IS  - 0025-0244 (Print)
IS  - 0025-0244 (Linking)
VI  - 56
IP  - 3
DP  - 2012 Sep
TI  - [Patient positioning using in-room kV CT for image-guided radiotherapy (IGRT) of 
      prostate cancer].
PG  - 193-8
AB  - The purpose of the study was to evaluate accuracy of patients' set up verified by 
      kV CT-on-rails system and compare automatic and manual image registration of 
      planning and verification kVCT-s. Between January 2001 and March 2011, at ten 
      patients with prostate cancer the clinical target volumes (CTVs) for prostate 
      (CTV-PROS), and prostate plus caudal 1 cm of seminal vesicles (CTV-PVS) with or 
      without pelvic lymph node region were contoured on the treatment planning CT, 
      according to risk category of the patient. Planning target volumes (PTVs) were 
      created with 1 cm margin extended around the CTVs in each direction. The 
      isocentre was marked on the skin with three radiopaque markers. After the set up, 
      treatment couch with the patient was turned by 180 degree and images were 
      acquired of the region of the isocentre with a kV helical CT-on-rails system 
      (treatment CT). An image registration software was used to co-register planning 
      and treatment CT images. Automatic CT image co-registration was followed by 
      manual co-registration taking into account the CTV-PROS contour and soft tissue 
      informations. Deviations of the isocentres in lateral (LAT), longitudinal (LONG) 
      and vertical (VERT) directions were recorded after each image co-registration. 
      Corresponding data were compared using the t-probe. Systematic (S) and random (s) 
      errors of the set up were calculated. Adequate PTV to CTV margins were calculated 
      by van Herk's formula (2.5xS + 0,7xs). Overall 252 deviations were analysed on 
      fourty-two CT series of 10 patients. The mean errors of the set up with automatic 
      and manual image co-registrations were 0.19 cm and 0.07 cm (p=0.001) in LAT, 0.05 
      cm and 0.03 cm (p=0.07) in LONG and 0.16 cm and 0.22 cm (p=0.16) in VERT 
      directions, respectively. The systematic errors of the set up for automatic and 
      manual image registrations were 0.22 cm and 0.26 cm in LAT, 0.17 cm and 0.18 cm 
      in LONG, 0.25 cm and 0.26 cm in VERT directions, respectively. The random errors 
      of the set up for automatic and manual image registrations were 0.31 cm and 0.26 
      cm in LAT, 0.27 cm and 0.27 cm in LONG and 0.24 cm and 0.33 cm in VERT 
      directions, respectively. In case of manual image co-registration, the required 
      PTV to CTV margins to cover at least 95% of the CTVs with at least 95% percent of 
      the prescribed dose were calculated to 0.93 cm in LAT, 0.65 cm in LONG, and 0.89 
      cm in VERT directions. Patients set up can be verified with manual image 
      co-registration based on soft tissues around the prostate using a kV CT-on-rails 
      system installed in the treatment room. The difference between automatic and 
      manual image co-registration was significant in LAT direction. A PTV to CTV 
      margin <1 cm seems to be appropriate to cover the CTVs in image-guided prostate 
      radiotherapy. These findings support our recent clinical protocol.
FAU - Kliton, Jorgo
AU  - Kliton J
AD  - Sugarterapias Kozpont, Orszagos Onkologiai Intezet, Budapest, Hungary. 
      jorgokliton@gmail.com
FAU - Agoston, Peter
AU  - Agoston P
FAU - Major, Tibor
AU  - Major T
FAU - Polgar, Csaba
AU  - Polgar C
LA  - hun
PT  - Clinical Trial
PT  - Journal Article
TT  - Kilovoltos CT-vel vegzett betegbeallitas vizsgalata prosztatarakos betegek 
      kepvezerelt kulso besugarzasakor.
DEP - 20120125
PL  - Hungary
TA  - Magy Onkol
JT  - Magyar onkologia
JID - 9313833
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Humans
MH  - Male
MH  - Patient Positioning/*methods
MH  - Prostatic Neoplasms/*diagnostic imaging/*radiotherapy
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - *Radiotherapy, Image-Guided
MH  - *Tomography, X-Ray Computed
EDAT- 2012/09/26 06:00
MHDA- 2013/02/28 06:00
CRDT- 2012/09/26 06:00
PHST- 2011/10/15 00:00 [received]
PHST- 2012/01/25 00:00 [accepted]
PHST- 2012/09/26 06:00 [entrez]
PHST- 2012/09/26 06:00 [pubmed]
PHST- 2013/02/28 06:00 [medline]
PST - ppublish
SO  - Magy Onkol. 2012 Sep;56(3):193-8. Epub 2012 Jan 25.