Evidence map›Paper›PMID 40263748›Full record

ArticleJapanese journal of clinical oncology2025

Enhancing patient positioning accuracy: evaluating daily cone beam computed tomography in the halcyon system.

Duong Thanh Tai, Luong Tien Phat, Tran Trung Kien, Nguyen Ngoc Anh, Nguyen Xuan Hai, Peter Sandwall, David Bradley, James C L Chow

Abstract read
In one paragraph

Article in Japanese journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Duong Thanh TaiDepartment of Medical Physics, Faculty of Medicine, Nguyen Tat Thanh University, 298-300A Nguyen Tat Thanh Street, Ward 13, District 4, Ho Chi Minh City 700000, Vietnam.ORCID 0000-0001-7276-8105
Luong Tien PhatDepartment of Radiation Oncology, University Medical Shing Mark Hospital, 1054 QL51, Long Binh Tan Ward, Bien Hoa City, Dong Nai 810000, Vietnam.ORCID 0009-0004-0963-1922
Tran Trung KienPhenikaa Institute for Advanced Study (PIAS), Phenikaa University, 01 Nguyen Trac, Ha Dong District, Hanoi 12116, Vietnam.
Nguyen Ngoc AnhPhenikaa Institute for Advanced Study (PIAS), Phenikaa University, 01 Nguyen Trac, Ha Dong District, Hanoi 12116, Vietnam.ORCID 0000-0002-7482-2600
Nguyen Xuan HaiCenter for Analytical Techniques, Dalat Nuclear Research Institute, 01 Nguyen Tu Luc Street, Ward 8, Da Lat City, Lam Dong Province 670000, Vietnam.ORCID 0000-0002-2768-6503
Peter SandwallDepartment of Radiation Oncology, OhioHealth Mansfield Hospital, 330 Glessner Avenue, Mansfield, OH 44903, United States.ORCID 0000-0001-9962-7281
David BradleyApplied Radiation Physics and Technologies Group, Department of Engineering, Sunway University, No. 5 Jalan Universiti, Bandar Sunway, Subang Jaya, 46150 Petaling Jaya, Selangor, Malaysia.ORCID 0000-0001-9485-5242
James C L ChowDepartment of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada.ORCID 0000-0003-4202-4855

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrecise patient positioning is crucial for successful radiotherapy, ensuring accurate delivery of radiation to tumors while minimizing exposure to healthy tissues. Positional errors can significantly impact treatment efficacy and increase side effects. This study evaluates the effectiveness of daily cone beam computed tomography (CBCT) imaging in the Halcyon system for detecting and correcting patient misalignments across various cancer types and treatment sites.

methodsA retrospective analysis was conducted on 411 patients treated with the Varian Halcyon linear accelerator from August 2022 to August 2024. Patients were grouped based on tumor location: Head and Neck (118 patients), Chest (188 patients), and Pelvis (105 patients). Daily pre-treatment CBCT scans were performed to verify positioning, with shifts in the x, y, and z axes quantified and adjusted using automated couch corrections.

resultsThe study revealed average positional shifts along the x-axis of ~0.112 cm, while both the Chest and Pelvic groups recorded 0.194 cm. The y-axis deviations were 0.135 cm for Head and Neck, 0.206 cm for Chest, and 0.195 cm for the Pelvis. On the z-axis, a mean deviation of 0.07 cm was found for the Head and Neck group, while 0.11 cm for the Chest group, and 0.085 cm for the Pelvic group. The Head and Neck group exhibited the smallest standard deviations across all axes, indicating greater positional consistency. Normalized density distributions showed distinct emergent patterns, the Head and Neck group showing tighter distributions compared to the broader distributions observed in the Chest and Pelvic groups.

conclusionsDaily CBCT imaging in the Halcyon system significantly enhances patient positioning accuracy in radiotherapy. The findings demonstrate that this approach minimizes positional shifts, particularly in the Head and Neck region, essential for optimizing treatment outcomes and reducing the risk of adverse effects. Future studies should further explore the integration of advanced imaging techniques to improve precision in patient positioning.

Indexed as

Cone-Beam Computed TomographyHead and Neck NeoplasmsNeoplasmsPatient PositioningRadiotherapy Planning, Computer-AssistedFemaleHumansMaleMiddle AgedParticle AcceleratorsRetrospective Studiescone beam computed tomographyhalcyonIMRTpatient positioningpatient setup errorradiation therapyVMAT

Identifiers

PMID40263748
PMCPMC12319221

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.