Daily targeting of liver tumors: screening patients with a mock treatment and using a combination of internal and external fiducials for image-guided respiratory-gated radiotherapy.

The feasibility and accuracy of using a mock treatment to screen suitable patients for respiratory-gated image-guided radiotherapy was investigated. Radio-opaque fiducials implanted adjacent to the liver tumor were used for online positioning to minimize the systematic error in patient positioning. The consistency in the degree of correlation between the external and internal fiducials was analyzed during a mock treatment. This technique could screen patients for gated therapy, reduce setup inaccuracy, and possibly individualize treatment margins.