Application of combined cone-beam CT and ExacTrac X-ray image-guided system in high-grade glioma radiotherapy
10.19745/j.1003-8868.2024154
- VernacularTitle:CBCT和EXT图像引导系统在高级别脑胶质瘤放疗中的应用分析
- Author:
Jun ZHOU
1
;
Han-Xu LI
;
Zhi-Bing HUANG
;
Jiu-Qing WAN
;
Dong-Chun LI
;
Liang-Zhi ZHONG
Author Information
1. 陆军军医大学第二附属医院肿瘤科放疗中心,重庆 400037
- Keywords:
ExacTrac X-ray image-guided system;
cone-beam CT image-guided system;
intensity-modulated radiotherapy;
setup error;
glioma
- From:
Chinese Medical Equipment Journal
2024;45(8):57-62
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the optimal image-guided verification mode by using combined cone-beam CT(CBCT)and ExacTrac X-ray(ETX)image-guided system for the position verification during the first and remaining fractionated radiotherapy of high-grade glioma patients.Methods Twenty high-grade glioma patients undergoing intensity-modulated radiotherapy at some hospital from January 2018 to June 2020 were analyzed retrospectively.CBCT image-guided system was used for the patients treated for the first time to determine the corresponding position of the treatment center on the body surface and to reset and mark the treatment center,then on-line auto registration of the CBCT images with CT positioning images was carried out,and the residual setup errors were verified with ETX image-guided system;position verification of the setup errors was performed with ETX image-guided sysem during the remaining fractionated treatment.The setup errors and their interval distributionswere calculated for the patients in six directions including left-right direction(Lat),head-foot direction(Lng),anterior-posterior direction(Vrt),rotation around left-right(Pitch),rotation around head-foot(Roll)and rotation around anterior-posterior(Yaw).SPSS 22.0 statistical software was used for data analysis.Results There were 75％patients treated for the first time and 78.62％ones undergoing the remaining fractionated radiotherapy only needed one time of setup error corre-ction.Combined CBCT and ETX image-guided resetting during the first radiotherapy met clinical requirements;during the remaining fractionated radiotherapy there were significant differences between the setup errors in the six directions before and after calibration(P＜0.05).The interval distribution of setup errors showed the error values in the six directions were all restricted within 0 to 1 mm and within 0° to l °during the first and remaining fractionated radiotherapy.Conclusion Involve-ment of combined CBCT and ETX image-guided system in the first and remaining fractionated radiotherapy of high-grade glioma patients after operation contributes to determining and resetting the treatment center rapidly and accurately,decreasing setup errors and enhancing the accuracy and repeatability of radiotherapy.[Chinese Medical Equipment Journal,2024,45(8):57-62].
