PMID- 29333353
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220311
IS  - 2168-5436 (Print)
IS  - 2168-5444 (Electronic)
IS  - 2168-5436 (Linking)
VI  - 3
IP  - 1
DP  - 2014 Feb
TI  - Spine Stereotactic Body Radiation Therapy Residual Setup Errors and 
      Intra-Fraction Motion Using the Stereotactic X-Ray Image Guidance Verification 
      System.
PG  - 1-8
LID - 10.4236/ijmpcero.2014.31001 [doi]
AB  - PURPOSE: To determine the precision of our institution's current immobilization 
      devices for spine SBRT, ultimately leading to recommendations for appropriate 
      planning margins. METHODS: We identified 12 patients (25 treatments) with spinal 
      metastasis treated with spine Stereotactic Body Radiation Therapy (SBRT). The 
      Body-FIX system was used as immobilization device for thoracic (T) and lumbar (L) 
      spine lesions. The head and shoulder mask system was used as immobilization 
      device for cervical (C) spine lesions. Initial patient setup used the infrared 
      positioning system with body markers. Stereotactic X-ray imaging was then 
      performed and correction was made if the initial setup error exceeded 
      predetermined institutional tolerances, 1.5 mm for translation and 2 degrees  for 
      rotation. Three additional sets of verification X-rays were obtained pre-, mid-, 
      and post-treatment for all treatments. RESULTS: Intrafraction motion regardless 
      of immobilization technique was found to be 1.28 +/- 0.57 mm. The mean and standard 
      deviation of the variances along each direction were as follows: 
      Superior-inferior, 0.56 +/- 0.39 mm and 0.77 +/- 0.52 mm, (p = 0.25); 
      Anterior-posterior, 0.57 +/- 0.43 mm and 1.14 +/- 0.61 mm, (p = 0.01); Left-right, 
      0.48 +/- 0.34 mm and 0.74 +/- 0.40 mm, (p = 0.09) respectively. There was a 
      significantly greater difference in the average 3D variance of the BodyFIX as 
      compared to the head and shoulder mask immobilization system, 1.04 +/- 0.46 mm and 
      1.71 +/- 0.52 mm; (p = 0.003) respectively. CONCLUSIONS: Overall, our institution's 
      image guidance system using stereotactic X-ray imaging verification provides 
      acceptable localization accuracy as previously defined in the literature. We 
      observed a greater intrafraction motion for the head and shoulder mask as 
      compared with the BodyFIX immobilization system, which may be a result of greater 
      C-spine mobility and/or the suboptimal mask immobilization. Thus, better 
      immobilization techniques for C-spine SBRT are needed to reduce setup error and 
      intrafraction motion. We are currently exploring alternative C-spine 
      immobilization techniques to improve set up accuracy and decrease intrafraction 
      motion during treatment.
FAU - Yamoah, Kosj
AU  - Yamoah K
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
FAU - Zaorsky, Nicholas G
AU  - Zaorsky NG
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
AD  - Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA.
FAU - Siglin, Joshua
AU  - Siglin J
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
FAU - Shi, Wenyin
AU  - Shi W
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
FAU - Werner-Wasik, Maria
AU  - Werner-Wasik M
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
FAU - Andrews, David W
AU  - Andrews DW
AD  - Department of Neurological Surgery, Jefferson Medical College, Philadelphia, USA.
FAU - Dicker, Adam P
AU  - Dicker AP
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
FAU - Bar-Ad, Voichita
AU  - Bar-Ad V
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
FAU - Liu, Haisong
AU  - Liu H
AD  - Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer 
      Center of Thomas Jefferson University, Philadelphia, USA.
LA  - eng
GR  - L60 MD008180/MD/NIMHD NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - Int J Med Phys Clin Eng Radiat Oncol
JT  - International journal of medical physics, clinical engineering and radiation 
      oncology
JID - 101689675
PMC - PMC5766040
MID - NIHMS907356
OTO - NOTNLM
OT  - Immobilization
OT  - Intrafraction Motion
OT  - Spine Stereotactic Body Radiotherapy
COIS- Conflicts of Interest Notification We have no conflicts of interests.
EDAT- 2014/02/01 00:00
MHDA- 2014/02/01 00:01
PMCR- 2018/01/12
CRDT- 2018/01/16 06:00
PHST- 2018/01/16 06:00 [entrez]
PHST- 2014/02/01 00:00 [pubmed]
PHST- 2014/02/01 00:01 [medline]
PHST- 2018/01/12 00:00 [pmc-release]
AID - 10.4236/ijmpcero.2014.31001 [doi]
PST - ppublish
SO  - Int J Med Phys Clin Eng Radiat Oncol. 2014 Feb;3(1):1-8. doi: 
      10.4236/ijmpcero.2014.31001.