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J Korean Soc Ther Radiol Oncol > Volume 21(1); 2003 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2003;21(1): 100-106.
Patients Setup Verification Tool for RT (PSVTs): DRR, Simulation, Portal and Digital images
Suk Lee, Jinsil Seong, Soo Il Kwon, Sung Sil Chu, Chang Geol Lee, Chang Ok Suh
1Brain Korea 21 Project for Medical Science, College of Medicine, Yonsei University, Seoul, Korea.
2Deptartment of Radiation Oncology, College of Medicine, Yonsei University, Seoul, Korea. jsseong@yumc.yonsei.ac.kr
3Deptartment of Medical Physics, Kyonggi University, Seoul, Korea.
ABSTRACT
PURPOSE:
To develop a patients' setup verification tool (PSVT) to verify the alignment of the machine and the target isocenters, and the reproducibility of patients' setup for three dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT). The utilization of this system is evaluated through phantom and patient case studies.
MATERIALS AND METHODS:
We developed and clinically tested a new method for patients' setup verification, using digitally reconstructed radiography (DRR), simulation, portal and digital images. The PSVT system was networked to a Pentium PC for the transmission of the acquired images to the PC for analysis. To verify the alignment of the machine and target isocenters, orthogonal pairs of simulation images were used as verification images. Errors in the isocenter alignment were measured by comparing the verification images with DRR of CT images. Orthogonal films were taken of all the patients once a week. These verification films were compared with the DRR were used for the treatment setup. By performing this procedure every treatment, using humanoid phantom and patient cases, the errors of localization can be analyzed, with adjustments made from the translation. The reproducibility of the patients' setup was verified using portal and digital images.
RESULTS:
The PSVT system was developed to verify the alignment of the machine and the target isocenters, and the reproducibility of the patients' setup for 3DCRT and IMRT. The results show that the localization errors are 0.8+/-0.2 mm (AP) and 1.0+/-0.3 mm (Lateral) in the cases relating to the brain and 1.1+/-0.5 mm (AP) and 1.0+/-0.6 mm (Lateral) in the cases relating to the pelvis. The reproducibility of the patients' setup was verified by visualization, using real-time image acquisition, leading to the practical utilization of our software.
CONCLUSION:
A PSVT system was developed for the verification of the alignment between machine and the target isocenters, and the reproducibility of the patients' setup in 3DCRT and IMRT. With adjustment of the completed GUI-based algorithm, and a good quality DRR image, our software may be used for clinical applications.
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