intracranial high precision radiotherapy; first phantom and clinical results

Background: To introduce a novel method of patient positioning for high precision intracranial radiotherapy. Methods: An infrared(IR)-array, reproducibly attached to the patient via a vacuum-mouthpiece(vMP) and connected to the table via a 6 degree-of-freedom(DoF) mechanical arm serves as positioning and fixation system. After IR-based manual prepositioning to rough treatment position and fixation of the mechanical arm, a cone-beam CT(CBCT) is performed. A robotic 6 DoF treatment couch (HexaPOD™) then automatically corrects all remaining translations and rotations. This absolute position of infrared markers at the first fraction acts as reference for the following fractions where patients are manually prepositioned to within ± 2 mm and ± 2° of this IR reference position prior to final HexaPOD-based correction; consequently CBCT imaging is only required once at the first treatment fraction.

[1]  R. Maciunas,et al.  The application accuracy of stereotactic frames. , 1994, Neurosurgery.

[2]  M Bellerive,et al.  Adaptation and verification of the relocatable Gill-Thomas-Cosman frame in stereotactic radiotherapy. , 1994, International journal of radiation oncology, biology, physics.

[3]  D E Mellenberg,et al.  Dose behind various immobilization and beam-modifying devices. , 1995, International journal of radiation oncology, biology, physics.

[4]  M van Herk,et al.  Interactive three dimensional inspection of patient setup in radiation therapy using digital portal images and computed tomography data. , 1996, International journal of radiation oncology, biology, physics.

[5]  K. Bratengeier,et al.  CT simulation in stereotactic brain radiotherapy--analysis of isocenter reproducibility with mask fixation. , 1997, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[6]  M. Vogele,et al.  Vogele-Bale-Hohner mouthpiece: registration device for frameless stereotactic surgery. , 1998, Radiology.

[7]  S L Meeks,et al.  IRLED-based patient localization for linac radiosurgery. , 1998, International journal of radiation oncology, biology, physics.

[8]  R Bale,et al.  Repositioning accuracy: comparison of a noninvasive head holder with thermoplastic mask for fractionated radiotherapy and a case report. , 1998, International journal of radiation oncology, biology, physics.

[9]  O Jäkel,et al.  Selection of beam angles for radiotherapy of skull base tumours using charged particles. , 2000, Physics in medicine and biology.

[10]  J. Carl,et al.  Skin damage probabilities using fixation materials in high-energy photon beams. , 2000, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[11]  Michael Vogele,et al.  A Simple and Non-Invasive Vacuum Mouthpiece-Based Head Fixation System for High Precision Radiotherapy , 2001, Strahlentherapie und Onkologie.

[12]  B. Salter,et al.  The TALON removable head frame system for stereotactic radiosurgery/radiotherapy: measurement of the repositioning accuracy. , 2001, International journal of radiation oncology, biology, physics.

[13]  J H Siewerdsen,et al.  A performance comparison of flat-panel imager-based MV and kV cone-beam CT. , 2002, Medical physics.

[14]  A. Olch,et al.  Reproducibility and treatment planning advantages of a carbon fiber relocatable head fixation system. , 2002, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[15]  Hui Yan,et al.  A phantom study on the positioning accuracy of the Novalis Body system. , 2003, Medical physics.

[16]  W. Eisner,et al.  Neuroendoscopy based on computer assisted adjustment of the endoscope holder in the laboratory. , 2003, Minimally invasive neurosurgery : MIN.

[17]  Quynh-Thu Le,et al.  Patterns of patient movement during frameless image-guided radiosurgery. , 2003, International journal of radiation oncology, biology, physics.

[18]  M. Herk.  Errors and margins in radiotherapy. , 2004 .

[19]  Bill J Salter,et al.  Repositioning accuracy of a commercially available thermoplastic mask system. , 2004, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[20]  J. Debus,et al.  Correction of patient positioning errors based on in-line cone beam CTs: clinical implementation and first experiences , 2005, Radiation oncology.

[21]  Frederik Wenz,et al.  Repositioning accuracy of two different mask systems-3D revisited: comparison using true 3D/3D matching with cone-beam CT. , 2006, International journal of radiation oncology, biology, physics.

[22]  D. Verellen,et al.  Six dimensional analysis with daily stereoscopic x-ray imaging of intrafraction patient motion in head and neck treatments using five points fixation masks. , 2006, Medical physics.

[23]  Warren D D'Souza,et al.  An analysis of the treatment couch and control system dynamics for respiration-induced motion compensation. , 2006, Medical physics.

[24]  Matthias Guckenberger,et al.  Positioning accuracy of cone-beam computed tomography in combination with a HexaPOD robot treatment table. , 2007, International journal of radiation oncology, biology, physics.

[25]  Matthias Guckenberger,et al.  Precision of Image-Guided Radiotherapy (IGRT) in Six Degrees of Freedom and Limitations in Clinical Practice , 2007, Strahlentherapie und Onkologie.

[26]  T. Marchant,et al.  Imaging doses from the Elekta Synergy X-ray cone beam CT system. , 2007, The British journal of radiology.

[27]  Matthias Guckenberger,et al.  Nonrigid Patient Setup Errors in the Head-and-Neck Region , 2007, Strahlentherapie und Onkologie.

[28]  O. Ganslandt,et al.  Hypofractionated Stereotactic Radiotherapy for Brain Metastases , 2007, Strahlentherapie und Onkologie.

[29]  J. V. van Santvoort,et al.  Positioning accuracy in stereotactic radiotherapy using a mask system with added vacuum mouth piece and stereoscopic X-ray positioning. , 2008, International journal of radiation oncology, biology, physics.

[30]  Klaus Schilling,et al.  Tumor tracking and motion compensation with an adaptive tumor tracking system (ATTS): System description and prototype testing. , 2008, Medical physics.

[31]  Carlo Cavedon,et al.  Cone beam CT image guidance for intracranial stereotactic treatments: comparison with a frame guided set-up. , 2007, International journal of radiation oncology, biology, physics.

[32]  R. Sweeney,et al.  Intra-fractional uncertainties in image-guided intensity-modulated radiotherapy (IMRT) of prostate cancer , 2008, Strahlentherapie und Onkologie.

[33]  Frameless stereotactic radiosurgery with a bite-plate: our experience with brain metastases. , 2008, Minimally invasive neurosurgery : MIN.

[34]  Peter C Levendag,et al.  Time dependence of intrafraction patient motion assessed by repeat stereoscopic imaging. , 2008, International journal of radiation oncology, biology, physics.

[35]  K. Herfarth,et al.  Reirradiation of multiple brain metastases with helical tomotherapy , 2009, Strahlentherapie und Onkologie.

[36]  R. Warnick,et al.  Evaluation of image-guided positioning for frameless intracranial radiosurgery. , 2009, International journal of radiation oncology, biology, physics.

[37]  R. Warnick,et al.  Frameless image-guided intracranial stereotactic radiosurgery: clinical outcomes for brain metastases. , 2009, International journal of radiation oncology, biology, physics.

[38]  Zhifei Wen,et al.  Development of a frameless stereotactic radiosurgery system based on real-time 6D position monitoring and adaptive head motion compensation , 2010, Physics in medicine and biology.