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Evaluation of set-up errors and determination of set-up margin in pelvic radiotherapy by electronic portal imaging device (EPID)

Published online by Cambridge University Press:  10 September 2019

Vajiheh Vejdani Noghreiyan ,
Shahrookh Nasseri ,
Kazem Anvari ,
Maryam Naji  and
Mehdi Momennezhad Open the ORCID record for Mehdi Momennezhad [Opens in a new window]
Vajiheh Vejdani Noghreiyan
Affiliation:
Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
Shahrookh Nasseri
Affiliation:
Medical Physics Department, Faculty of Medicine, Imam Reza Center of Medical Education and Treatment, Mashhad, Iran
Kazem Anvari
Affiliation:
Faculty of Medicine, Solid Tumour Treatment Research Center, Omid Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Maryam Naji
Affiliation:
Radiotherapy Department, Imam Reza Hospital, Mashhad, Iran
Mehdi Momennezhad*
Affiliation:
Medical Physics Department, Faculty of Medicine, Imam Reza Center of Medical Education and Treatment, Mashhad, Iran
*
Author for correspondence: Mehdi Momennezhad, Medical Physics Department, Faculty of Medicine, Mashhad University of Medical Sciences Imam Reza Center of Medical Education and Treatment, Mashhad, Iran. Tel: +98 51 38002316. Fax: +98 51 38002320. E-mail: MomennezhadM@mums.ac.ir
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Abstract

Introduction and purpose:

The error in set-up of patients is an inherent part of treatment processes. The positioning errors can be used to determine the margins of the planning target volume (PTV) to cover the target volume, while minimising the radiation dose delivered to normal tissues. This study aimed to evaluate random and systematic errors occurring in inter-fraction set-ups of pelvic radiotherapy measured by electronic portal imaging device (EPID) and then to propose the optimum clinical target volume (CTV) to PTV margin in pelvic cancer patients.

Materials and methods:

This study examined 22 patients treated with pelvic radiotherapy. A total of 182 portal images were evaluated. Population random (σ) and systematic (Σ) errors were determined based on the portal images in three directions (X, Y and Z). The set-up margin for CTV to PTV was calculated by published margin formulae of International Commission on Radiation Units and measurements (ICRU) report No. 62 recommendation and formulas presented by Stroom and Heijmen and Van Herk et al.

Results:

Systematic set-up errors for radiotherapy to patients ranged between 2·36 and 4·99 mm, and random errors ranged between 1·51 and 2·74 mm. The margin required to cover the target volume retrospectively was calculated based on ICRU 62 and formulas presented by Stroom and Heijmen and Van Herk et al. were used to calculate the range 2·8–5·7 mm, 5·7–11·9 mm and 6·9–14·4 mm, respectively.

Conclusion:

According to our findings, it can be concluded that by extending the CTV margin by 6·9–14·4 mm, we can ensure that 90% of the pelvic cancer patients will receive ≥ 95% of the prescribed dose in the CTV area.

Keywords

3DCRTCTV to PTV marginEPIDpelvic cancerset-up errors
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 2 , June 2020 , pp. 150 - 156
Copyright
© Cambridge University Press 2019

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