Rosalinda Ricotti1, Delia Ciardo2, Giovanni Fattori3, Maria Cristina Leonardi2, Anna Morra2, Samantha Dicuonzo4, Damaris Patricia Rojas4, Floriana Pansini5, Raffaella Cambria5, Federica Cattani5, Chiara Gianoli3, Chiara Spinelli6, Marco Riboldi3, Guido Baroni7, Roberto Orecchia8, Barbara Alicja Jereczek-Fossa4. 1. Department of Radiation Oncology, European Institute of Oncology, Milan, Italy. Electronic address: rosalinda.ricotti@ieo.it. 2. Department of Radiation Oncology, European Institute of Oncology, Milan, Italy. 3. Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano, Milan,Italy. 4. Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy. 5. Unit of Medical Physics, European Institute of Oncology, Milan, Italy. 6. Tecniche di radiologia medica, per immagini e radioterapia, University of Milan, Milan, Italy. 7. Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano, Milan,Italy; Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy. 8. Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy; Scientific Directorate, European Institute of Oncology, Milan, Italy.
Abstract
BACKGROUND AND PURPOSE: To investigate the intra-fraction breast motion during long-lasting treatments of breast cancer with Helical Tomotherapy by means of an optical tracking system. MATERIALS AND METHODS: A set of seven radio-transparent passive markers was placed on the thoraco-abdominal surface of twenty breast cancer patients and tracked by an infrared tracking system. A continuous non-invasive monitoring of intra-fraction motion from patient setup verification and correction to the end of radiation delivery was thus obtained. The measured displacements were analysed in terms of cyclic respiratory motion and slow baseline drift. RESULTS: The average monitoring time per patient was 15.57min. The breathing amplitude of the chest was less than 2mm, on average, along all anatomical directions. The baseline drift of the body led to more significant setup uncertainties than the respiratory motion. The main intra-fraction baseline drifts were in posterior and inferior directions and occurred within the first eight minutes of monitoring. Considering the intra-fraction motion only, the resultant clinical-to-planning target volume safety margins are highly patient-specific and largely anisotropic. CONCLUSION: The non-respiratory motion occurring during prolonged treatments induces notable uncertainties. Non-invasive continuous monitoring of patient setup variations including baseline drifts is recommended in order to minimize dosimetric deviations, which might jeopardize the therapeutic ratio between target coverage and the sparing of organs at risk.
BACKGROUND AND PURPOSE: To investigate the intra-fraction breast motion during long-lasting treatments of breast cancer with Helical Tomotherapy by means of an optical tracking system. MATERIALS AND METHODS: A set of seven radio-transparent passive markers was placed on the thoraco-abdominal surface of twenty breast cancerpatients and tracked by an infrared tracking system. A continuous non-invasive monitoring of intra-fraction motion from patient setup verification and correction to the end of radiation delivery was thus obtained. The measured displacements were analysed in terms of cyclic respiratory motion and slow baseline drift. RESULTS: The average monitoring time per patient was 15.57min. The breathing amplitude of the chest was less than 2mm, on average, along all anatomical directions. The baseline drift of the body led to more significant setup uncertainties than the respiratory motion. The main intra-fraction baseline drifts were in posterior and inferior directions and occurred within the first eight minutes of monitoring. Considering the intra-fraction motion only, the resultant clinical-to-planning target volume safety margins are highly patient-specific and largely anisotropic. CONCLUSION: The non-respiratory motion occurring during prolonged treatments induces notable uncertainties. Non-invasive continuous monitoring of patient setup variations including baseline drifts is recommended in order to minimize dosimetric deviations, which might jeopardize the therapeutic ratio between target coverage and the sparing of organs at risk.
Authors: Roberta Castriconi; Pier Giorgio Esposito; Alessia Tudda; Paola Mangili; Sara Broggi; Andrei Fodor; Chiara L Deantoni; Barbara Longobardi; Marcella Pasetti; Lucia Perna; Antonella Del Vecchio; Nadia Gisella Di Muzio; Claudio Fiorino Journal: Front Oncol Date: 2021-08-24 Impact factor: 6.244
Authors: Maureen L Groot Koerkamp; H J G Desirée van den Bongard; Marielle E P Philippens; Femke van der Leij; Stefano Mandija; Antonetta C Houweling Journal: Phys Imaging Radiat Oncol Date: 2022-07-05
Authors: D Reitz; G Carl; S Schönecker; M Pazos; P Freislederer; M Niyazi; U Ganswindt; F Alongi; M Reiner; C Belka; S Corradini Journal: Radiat Oncol Date: 2018-07-16 Impact factor: 3.481