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Accurate setup of paraspinal patients using a noninvasive patient immobilization cradle and portal imaging

Because of the proximity of the spinal cord, effective radiotherapy of paraspinal tumors to high doses requires highly conformal dose distributions, accurate patient setup, setup verification, and patient immobilization. An immobilization cradle has been designed to facilitate the rapid setup and ra...

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Published in:Medical physics (Lancaster) 2005-08, Vol.32 (8), p.2606-2614
Main Authors: Lovelock, D. Michael, Hua, Chiaho, Wang, Ping, Hunt, Margie, Fournier-Bidoz, Nathalie, Yenice, Kamil, Toner, Sean, Lutz, Wendell, Amols, Howard, Bilsky, Mark, Fuks, Zvi, Yamada, Yoshiya
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cited_by cdi_FETCH-LOGICAL-c4742-e35830506c51d529720b64c6b8a656821f876739ee9cadcd21fe3702cb936bf93
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container_title Medical physics (Lancaster)
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creator Lovelock, D. Michael
Hua, Chiaho
Wang, Ping
Hunt, Margie
Fournier-Bidoz, Nathalie
Yenice, Kamil
Toner, Sean
Lutz, Wendell
Amols, Howard
Bilsky, Mark
Fuks, Zvi
Yamada, Yoshiya
description Because of the proximity of the spinal cord, effective radiotherapy of paraspinal tumors to high doses requires highly conformal dose distributions, accurate patient setup, setup verification, and patient immobilization. An immobilization cradle has been designed to facilitate the rapid setup and radiation treatment of patients with paraspinal disease. For all treatments, patients were set up to within 2.5 mm of the design using an amorphous silicon portal imager. Setup reproducibility of the target using the cradle and associated clinical procedures was assessed by measuring the setup error prior to any correction. From 350 anterior/posterior images, and 303 lateral images, the standard deviations, as determined by the imaging procedure, were 1.3 m, 1.6 m, and 2.1 in the ant/post, right/left, and superior/inferior directions. Immobilization was assessed by measuring patient shifts between localization images taken before and after treatment. From 67 ant/post image pairs and 49 lateral image pairs, the standard deviations were found to be less than 1 mm in all directions. Careful patient positioning and immobilization has enabled us to develop a successful clinical program of high dose, conformal radiotherapy of paraspinal disease using a conventional Linac equipped with dynamic multileaf collimation and an amorphous silicon portal imager.
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Michael ; Hua, Chiaho ; Wang, Ping ; Hunt, Margie ; Fournier-Bidoz, Nathalie ; Yenice, Kamil ; Toner, Sean ; Lutz, Wendell ; Amols, Howard ; Bilsky, Mark ; Fuks, Zvi ; Yamada, Yoshiya</creator><creatorcontrib>Lovelock, D. Michael ; Hua, Chiaho ; Wang, Ping ; Hunt, Margie ; Fournier-Bidoz, Nathalie ; Yenice, Kamil ; Toner, Sean ; Lutz, Wendell ; Amols, Howard ; Bilsky, Mark ; Fuks, Zvi ; Yamada, Yoshiya</creatorcontrib><description>Because of the proximity of the spinal cord, effective radiotherapy of paraspinal tumors to high doses requires highly conformal dose distributions, accurate patient setup, setup verification, and patient immobilization. An immobilization cradle has been designed to facilitate the rapid setup and radiation treatment of patients with paraspinal disease. For all treatments, patients were set up to within 2.5 mm of the design using an amorphous silicon portal imager. 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Michael</creatorcontrib><creatorcontrib>Hua, Chiaho</creatorcontrib><creatorcontrib>Wang, Ping</creatorcontrib><creatorcontrib>Hunt, Margie</creatorcontrib><creatorcontrib>Fournier-Bidoz, Nathalie</creatorcontrib><creatorcontrib>Yenice, Kamil</creatorcontrib><creatorcontrib>Toner, Sean</creatorcontrib><creatorcontrib>Lutz, Wendell</creatorcontrib><creatorcontrib>Amols, Howard</creatorcontrib><creatorcontrib>Bilsky, Mark</creatorcontrib><creatorcontrib>Fuks, Zvi</creatorcontrib><creatorcontrib>Yamada, Yoshiya</creatorcontrib><title>Accurate setup of paraspinal patients using a noninvasive patient immobilization cradle and portal imaging</title><title>Medical physics (Lancaster)</title><addtitle>Med Phys</addtitle><description>Because of the proximity of the spinal cord, effective radiotherapy of paraspinal tumors to high doses requires highly conformal dose distributions, accurate patient setup, setup verification, and patient immobilization. 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source Wiley-Blackwell Read & Publish Collection
subjects amorphous semiconductors
CALIBRATION STANDARDS
cancer
CARCINOMAS
Collimation
COLLIMATORS
Computed tomography
Conformal radiation treatment
CORRECTIONS
Dosimetry
Equipment Design
Equipment Failure Analysis
ERRORS
Humans
Image registration
immobilization
Immobilization - instrumentation
Immobilization - methods
Intensity modulated radiation therapy
LINEAR ACCELERATORS
Medical imaging
neurophysiology
Neuroscience
paraspinal
PATIENTS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
radiation therapy
RADIOLOGY AND NUCLEAR MEDICINE
Radiometry - methods
RADIOTHERAPY
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - instrumentation
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Conformal - methods
Reproducibility of Results
SEMICONDUCTOR MATERIALS
Sensitivity and Specificity
setup uncertainty
SILICON
SPINAL CORD
Spinal Neoplasms - radiotherapy
Therapeutics
Titanium
Tomography, X-Ray Computed - instrumentation
Tomography, X-Ray Computed - methods
tumours
VERIFICATION
title Accurate setup of paraspinal patients using a noninvasive patient immobilization cradle and portal imaging
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