Real-time prostate motion assessment

Image-guidance and the temporal dependence of intra-fraction motion

Avilash K. Cramer, Amanu G. Haile, Sanja Ognjenovic, Tulsee S. Doshi, William M. Reilly, Katherine E. Rubinstein, Nima Nabavizadeh, Thuan Nguyen, Lu Z. Meng, Martin Fuss, James Tanyi, Arthur Hung

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The rapid adoption of image-guidance in prostate intensity-modulated radiotherapy (IMRT) results in longer treatment times, which may result in larger intrafraction motion, thereby negating the advantage of image-guidance. This study aims to qualify and quantify the contribution of image-guidance to the temporal dependence of intrafraction motion during prostate IMRT.Methods: One-hundred and forty-three patients who underwent conventional IMRT (n=67) or intensity-modulated arc therapy (IMAT/RapidArc, n=76) for localized prostate cancer were evaluated. Intrafraction motion assessment was based on continuous RL (lateral), SI (longitudinal), and AP (vertical) positional detection of electromagnetic transponders at 10 Hz. Daily motion amplitudes were reported as session mean, median, and root-mean-square (RMS) displacements. Temporal effect was evaluated by categorizing treatment sessions into 4 different classes: IMRTc (transponder only localization), IMRTcc (transponder + CBCT localization), IMATc (transponder only localization), or IMATcc (transponder + CBCT localization).Results: Mean/median session times were 4.15/3.99 min (IMATc), 12.74/12.19 min (IMATcc), 5.99/5.77 min (IMRTc), and 12.98/12.39 min (IMRTcc), with significant pair-wise difference (pcc vs. IMATcc (p>0.05). Median intrafraction motion difference between CBCT and non-CBCT categories strongly correlated with time for RMS (t-value=17.29; p4-6 minutes, and without any intrafraction motion mitigation protocol in place, patient repositioning is recommended, with at least the acquisition of the lateral component of an orthogonal image pair in the absence of volumetric imaging.

Original languageEnglish (US)
Article number4
JournalBMC Medical Physics
Volume13
Issue number1
DOIs
StatePublished - Sep 23 2013

Fingerprint

Prostate
Intensity-Modulated Radiotherapy
Moving and Lifting Patients
Electromagnetic Phenomena
Prostatic Neoplasms
Therapeutics

Keywords

  • Intrafraction variation
  • Prostate cancer
  • Real-time motion tracking
  • Treatment margin
  • Treatment time

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Real-time prostate motion assessment : Image-guidance and the temporal dependence of intra-fraction motion. / Cramer, Avilash K.; Haile, Amanu G.; Ognjenovic, Sanja; Doshi, Tulsee S.; Reilly, William M.; Rubinstein, Katherine E.; Nabavizadeh, Nima; Nguyen, Thuan; Meng, Lu Z.; Fuss, Martin; Tanyi, James; Hung, Arthur.

In: BMC Medical Physics, Vol. 13, No. 1, 4, 23.09.2013.

Research output: Contribution to journalArticle

Cramer, AK, Haile, AG, Ognjenovic, S, Doshi, TS, Reilly, WM, Rubinstein, KE, Nabavizadeh, N, Nguyen, T, Meng, LZ, Fuss, M, Tanyi, J & Hung, A 2013, 'Real-time prostate motion assessment: Image-guidance and the temporal dependence of intra-fraction motion', BMC Medical Physics, vol. 13, no. 1, 4. https://doi.org/10.1186/1756-6649-13-4
Cramer, Avilash K. ; Haile, Amanu G. ; Ognjenovic, Sanja ; Doshi, Tulsee S. ; Reilly, William M. ; Rubinstein, Katherine E. ; Nabavizadeh, Nima ; Nguyen, Thuan ; Meng, Lu Z. ; Fuss, Martin ; Tanyi, James ; Hung, Arthur. / Real-time prostate motion assessment : Image-guidance and the temporal dependence of intra-fraction motion. In: BMC Medical Physics. 2013 ; Vol. 13, No. 1.
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AU - Doshi, Tulsee S.

AU - Reilly, William M.

AU - Rubinstein, Katherine E.

AU - Nabavizadeh, Nima

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