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Accuracy of the Dose Delivery in Prostate Cancer Patients-Using an Electronic Portal Imaging Device (Epid) Publisher



Mahdavi SR1 ; Jazayeri Gharehbagh E2 ; Mofid B3 ; Jafari AH4 ; Nikoofar AR5
Authors

Source: International Journal of Radiation Research Published:2017


Abstract

Background: To correct paent posioning errors (setup errors) during prostate cancer treatment using EPID and fiducial gold markers, to improve the accuracy of the dose delivery in these paents. Materials and Methods: Fieen paents with localized prostate carcinoma aer implantaon of fiducial gold markers in their prostate gland underwent the five-field IMRT planning technique. The plan was prepared in accordance with ICRU 50 guidance (PTV to receive 95-107% dose). The soware program reconstructed the three-dimensional posion of the markers from the different Beams Eye Views (BEV). The discrepancies of the seeds' posions (prostate surrogate) between plan and daily images were calculated three dimensionally. Then, necessary correcons were applied to match the prostate fiducial markers in the portal image with the BEV image in the planned one by moving the couch in the X, Y and Z direcons. Results: Data from 15 paents and 469 fracons of radiotherapy were analyzed in this study. Two sets of data were available from EPID soware before and aer 3D set-up correcons. The mean of the populaon displacement in Le /Right (L/R), Anterior/Posterior (A/P) and Crania/Caudal (C/C) direcons were 0.5, -1.0 and 2.4mm before, and -0.1, -0.5 and 0.9mm aer correcons, respecvely. The systemac and random errors for the measured populaons in the three menoned direcons were 2.4, 2.7 and 2mm and 6.4, 5.9 and 6.1mm before correcons, and 1.1, 2.4 and 1.4mm and 3.8, 3.9 and 3.6mm aer correcons, correspondingly. Conclusion: This study provides further evidence that using gold markers in the prostate improves dose delivery to the prostate. Also, it has been demonstrated that the EPID can be a powerful tool in the reducon of treatment setup errors and the quality assurance and verificaon of complex treatments.
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