ArticleJournal of applied clinical medical physics2024
Setup errors analysis in iterative kV CBCT: A clinical study of cervical cancer treated with Volumetric Modulated Arc Therapy.
Article in Journal of applied clinical medical physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Refining imaging parameters for dual-energy cone-beam computed tomography in image-guided radiation therapy.Journal of applied clinical medical physics · 2026Article
- Potential of margin reduction for cervical cancer radiotherapy in an online adaptive image-guided workflow.Physics and imaging in radiation oncology · 2026Article
- Setup errors analysis in iterative kV CBCT: A clinical study of cervical cancer treated with Volumetric Modulated Arc Therapy.Journal of applied clinical medical physics · 2024Article
- Dosimetric and Radiobiological Impact of Patient Setup Errors in Intensity-modulated Radiotherapy for Esophageal Cancer.Technology in cancer research & treatmentArticle
- Surface-Guided Radiation Therapy (SGRT) for Pediatric Oncology: An Analysis of Inter- and Intra-fraction Motion Variability and PTV Margins.Technology in cancer research & treatmentArticle
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Authors and funding
10 authors.
Funding
Abstract
objectiveThis study aims to analyze setup errors in pelvic Volumetric Modulated Arc Therapy (VMAT) for patients with non-surgical primary cervical cancer, utilizing the onboard iterative kV cone beam CT (iCBCT) imaging system on the Varian Halcyon 2.0 ring gantry structure accelerator to enhance radiotherapy precision.
methodWe selected 132 cervical cancer patients who underwent VMAT with daily iCBCT imaging guidance. Before each treatment session, a registration method based on the bony structure was employed to acquire iCBCT images with the corresponding planning CT images. Following verification and adjustment of image registration results along the three axes (but not rotational), setup errors in the lateral (X-axis), longitudinal (Y-axis), and vertical (Z-axis) directions were recorded for each patient. Subsequently, we analyzed 3642 iCBCT image setup errors.
resultsThe mean setup errors for the X, Y, and Z axes were 4.50 ± 3.79 mm, 6.08 ± 6.30 mm, and 1.48 ± 2.23 mm, respectively. Before correction with iCBCT, setup margins based on the Van Herk formula for the X, Y, and Z axes were 6.28, 12.52, and 3.26 mm, respectively. In individuals aged 60 years and older, setup errors in the X and Y axes were significantly larger than those in the younger group (p < 0.05). Additionally, there is no significant linear correlation between setup errors and treatment fraction numbers.
conclusionData analysis underscores the importance of precise Y-axis setup for cervical cancer patients undergoing VMAT. Radiotherapy centers without daily iCBCT should appropriately extend the planning target volume (PTV) along the Y-axis for cervical cancer patients receiving pelvic VMAT. Elderly patients exhibit significantly larger setup errors compared to younger counterparts. In conclusion, iCBCT-guided radiotherapy is recommended for cervical cancer patients undergoing VMAT to improve setup precision.
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