Journal article
A high-precision system for conformal intracranial radiotherapy
International journal of radiation oncology, biology, physics, Vol.47(4), pp.1137-1143
2000
DOI: 10.1016/S0360-3016(00)00502-2
PMID: 10863087
Abstract
Purpose: Currently, optimally precise delivery of intracranial radiotherapy is possible with stereotactic radiosurgery and fractionated stereotactic radiotherapy. We report on an optimally precise optically guided system for three-dimensional (3D) conformal radiotherapy using multiple noncoplanar fixed fields.
Methods and Materials: The optically guided system detects infrared light emitting diodes (IRLEDs) attached to a custom bite plate linked to the patient’s maxillary dentition. The IRLEDs are monitored by a commercially available stereo camera system, which is interfaced to a personal computer. An IRLED reference is established with the patient at the selected stereotactic isocenter, and the computer reports the patient’s current position based on the location of the IRLEDs relative to this reference position. Using this readout from the computer, the patient may be dialed directly to the desired position in stereotactic space. The patient is localized on the first day and a reference file is established for 5 different couch positions. The patient’s image data are then imported into a commercial convolution-based 3D radiotherapy planning system. The previously established isocenter and couch positions are then used as a template upon which to design a conformal 3D plan with maximum beam separation.
Results: The use of the optically guided system in conjunction with noncoplanar radiotherapy treatment planning using fixed fields allows the generation of highly conformal treatment plans that exhibit a high degree of dose homogeneity and a steep dose gradient. To date, this approach has been used to treat 28 patients.
Conclusion: Because IRLED technology improves the accuracy of patient localization relative to the linac isocenter and allows real-time monitoring of patient position, one can choose treatment-field margins that only account for beam penumbra and image resolution without adding margin to account for larger and poorly defined setup uncertainty. This approach enhances the normal tissue sparing, high degree of conformality, and homogeneity characteristics possible with 3D conformal radiotherapy.
Details
- Title: Subtitle
- A high-precision system for conformal intracranial radiotherapy
- Creators
- Wolfgang A Tomé - Department of Human Oncology, University of Wisconsin Medical School, Madison, WI, USASanford L Meeks - Division of Radiation Oncology, University of Iowa College of Medicine, Iowa City, IA, USAJohn M Buatti - Division of Radiation Oncology, University of Iowa College of Medicine, Iowa City, IA, USAFrancis J Bova - Department of Neurological Surgery, University of Florida College of Medicine, Gainesville, FL, USAWilliam A Friedman - Department of Neurological Surgery, University of Florida College of Medicine, Gainesville, FL, USAZuofeng Li - Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
- Resource Type
- Journal article
- Publication Details
- International journal of radiation oncology, biology, physics, Vol.47(4), pp.1137-1143
- DOI
- 10.1016/S0360-3016(00)00502-2
- PMID
- 10863087
- NLM abbreviation
- Int J Radiat Oncol Biol Phys
- ISSN
- 0360-3016
- eISSN
- 1879-355X
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 2000
- Academic Unit
- Radiation Oncology; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040574902771
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