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Authors Wang G, Wang WL, Liu YQ, Dong HM, Hu YX
Received 29 September 2017
Accepted for publication 18 December 2017
Published 6 April 2018 Volume 2018:11 Pages 1981—1988
DOI https://doi.org/10.2147/OTT.S152915
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Ru Chen
Peer reviewer comments 3
Editor who approved publication: Dr Ingrid Espinoza
Objective: In this study, prostate cancer patients were treated with image-guided
radiotherapy (IGRT). The translational positioning errors were discussed to
provide the basis for determining margins of the planning target volume (PTV).
Methods: Thirty prostate cancer patients were treated with radical radiotherapy
using the IGRT system. Patients were placed in the supine position and
underwent kilovoltage cone beam computed tomography (KVCBCT) scans before
radiotherapy. A total of 447 images were acquired. The translational
positioning errors were obtained in three linear directions which were X
(left-to-right), Y (superior-to-inferior) and Z (anterior-to-posterior) axes
(denoted as Lx, Ly and Lz) through the contrast between images adjusted with
gray and manual registrations and the planning CT images. Rotational errors
were denoted as Rx, Ry and Rz.
Results: Uncorrected translational errors Lx, Ly and Lz in the 251
positioning images were all higher than those after correction, and the
differences were all statistically significant (P =0.000,
0.037 and 0.004, respectively). For rotational errors Rx, Ry and Rz, only Rx
had a significant difference before and after correction (P =0.044). Before correction, PTV
margins in the X, Y and Z directions were 0.61, 0.78 and 0.41 cm,
respectively; after correction, these were 0.17, 0.12 and 0.17 cm,
respectively.
Conclusion: KVCBCT can be applied to measure positioning errors in prostate
cancer radiotherapy and correct these errors in real time through the 6°
robotic patient positioning system, in order to improve patient positioning
accuracy. The application of IGRT with KVCBCT may reduce PTV margins.
Keywords: prostate cancer, image-guided radiotherapy, kilovoltage cone beam
CT, positioning error, planning target volume