Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Residual positioning errors and uncertainties for pediatric craniospinal irradiation and the impact of image guidance

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. TEDDI: radiotherapy delivery in deep inspiration for pediatric patients - a NOPHO feasibility study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Dose painting based on tumor uptake of Cu-ATSM and FDG: a comparative study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. A criterion for the reliable use of MRI-only radiotherapy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Early Postoperative 18F-FET PET/MRI for Pediatric Brain and Spinal Cord Tumors

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Hearing Status in Survivors of Childhood Acute Myeloid Leukemia Treated With Chemotherapy Only: A NOPHO-AML Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. 18F-FET PET/MRI for CNS-tumors in children and adolescents

    Publikation: KonferencebidragKonferenceabstrakt til konferenceForskningpeer review

Vis graf over relationer

BACKGROUND: Optimal alignment is of utmost importance when treating pediatric patients with craniospinal irradiation (CSI), especially with regards to field junctions and multiple isocenters and techniques applying high dose gradients. Here, we investigated the setup errors and uncertainties for pediatric CSI using different setup verification protocols.

METHODS: A total of 38 pediatric patients treated with CSI were identified for whom treatment records and setup images were available. The setup images were registered retrospectively to the reference image using an automated tool and matching on bony anatomy, subsequently, the impact of different correction protocols was simulated.

RESULTS: For an action-level (AL)-protocol and a non-action level (NAL)-protocol, the translational residual setup error can be as large as 24 mm for an individual patient during a single fraction, and the rotational error as large as 6.1°. With daily IGRT, the maximum setup errors were reduced to 1 mm translational and 5.4° rotational versus 1 mm translational and 2.4° rotational for 3- and 6- degrees of freedom (DoF) couch shifts, respectively. With a daily 6-DoF IGRT protocol for a wide field junction irradiation technique, the residual positioning uncertainty was below 1 mm and 1° for translational and rotational directions, respectively. The largest rotational uncertainty was found for the patients' roll even though this was the least common type of rotational error, while the largest translational uncertainty was found in the patients' anterior-posterior-axis.

CONCLUSIONS: These results allow for informed margin calculation and robust optimization of treatments. Daily IGRT is the superior choice for setup of pediatric patients treated with CSI, although centers that do not have this option could use the results presented here to improve their margins and uncertainty estimates for a more accurate treatment alignment.

OriginalsprogEngelsk
TidsskriftRadiation Oncology
Vol/bind15
Udgave nummer1
Sider (fra-til)149
ISSN1748-717X
DOI
StatusUdgivet - 10 jun. 2020

ID: 61991955