International Journal of Radiation Oncology * Biology * Physics
Volume 74, Issue 3 , Pages 868-875 , 1 July 2009

Integration of Real-Time Internal Electromagnetic Position Monitoring Coupled With Dynamic Multileaf Collimator Tracking: An Intensity-Modulated Radiation Therapy Feasibility Study

  • Ryan L. Smith

      Affiliations

    • Washington University Saint Louis, Saint Louis, MO
  • ,
  • Amit Sawant, PhD.

      Affiliations

    • Stanford University, Palo Alto, CA
  • ,
  • Lakshmi Santanam, PhD.

      Affiliations

    • Washington University Saint Louis, Saint Louis, MO
  • ,
  • Raghu B. Venkat, MS.

      Affiliations

    • Stanford University, Palo Alto, CA
  • ,
  • Laurence J. Newell, MS.

      Affiliations

    • Calypso® Medical Technologies, Inc., Seattle, WA
  • ,
  • Byung-chul Cho, PhD.

      Affiliations

    • Stanford University, Palo Alto, CA
  • ,
  • Per Poulsen, PhD.

      Affiliations

    • Stanford University, Palo Alto, CA
  • ,
  • Herbert Catell

      Affiliations

    • Varian Medical Systems, Palo Alto, CA
  • ,
  • Paul J. Keall, PhD.

      Affiliations

    • Stanford University, Palo Alto, CA
  • ,
  • Parag J. Parikh, MD.

      Affiliations

    • Washington University Saint Louis, Saint Louis, MO
    • Corresponding Author InformationReprint request to: Parag J. Parikh, M.D., Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Saint Louis, MO 63110. Tel: (314) 747-9614; Fax: (314) 362-8521

Received 11 August 2008 ,Revised 22 January 2009 ,Accepted 25 January 2009.

References 

  1. Zelefsky MJ, Fuks Z, Happersett L, et al. Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer. Radiother Oncol. 2000;55:241–249
  2. Ozyigit G, Yang T, Chao KSC, et al. Intensity-modulated radiation therapy in head and neck cancers: The Mallinckrodt experience. Curr Treat Options in Oncol. 2004;5:3–9
  3. Münter MW, Thilmann C, Hof H, et al. Stereotactic intensity modulated radiation therapy and inverse treatment planning for tumors of the head and neck region: Clinical implementation of the step and shoot approach and first clinical results. Radiother Oncol. 2003;66:313–321
  4. Grills IS, Yan D, Martinez AA, et al. Potential for reduced toxicity and dose escalation in the treatment of inoperable non–small-cell lung cancer: A comparison of intensity-modulated radiation therapy (IMRT), 3D conformal radiation, and elective nodal irradiation. Int J Radiat Oncol Biol Phys. 2003;57:875–890
  5. Kupelian P, Willoughby T, Mahadevan A, et al. Multi-institutional clinical experience with the Calypso System in localization and continuous, real-time monitoring of the prostate gland during external radiotherapy. Int J Radiat Oncol Biol Phys. 2007;67:1088–1098
  6. George R, Keall PJ, Kini VR, et al. Quantifying the effect of intrafraction motion during breast IMRT planning and dose delivery. Med Phys. 2003;30:552–562
  7. Langen KM, Jones DT. Organ motion and its management. Int J Radiat Oncol Biol Phys. 2001;50:265–278
  8. Bortfeld T, Jokivarsi K, Goitein M, et al. Effects of intra-fraction motion on IMRT dose delivery: Statistical analysis and simulation. Phys Med Biol. 2002;47:2203–2220
  9. Jiang SB, Pope C, Jarrah KMA, et al. An experimental investigation on intra-fractional organ motion effects in lung IMRT treatments. Phys Med Biol. 2003;48:1773–1784
  10. Gierga DP, Chen GTY, Kung JH, et al. Quantification of respiration-induced abdominal tumor motion and its impact on IMRT dose distributions. Int J Radiat Oncol Biol Phys. 2004;58:1584–1595
  11. Marnitz S, Stuschke M, Bohsung J, et al. Intraindividual comparison of conventional three-dimensional radiotherapy and intensity modulated radiotherapy in the therapy of locally advanced non-small cell lung cancer. Strahlenther Onkol. 2002;178:651–658
  12. Hanley J, Debois MM, Mah D, et al. Deep inspiration breath-hold technique for lung tumors: The potential value of target immobilization and reduced lung density in dose escalation. Int J Radiat Oncol Biol Phys. 1999;45:603–611
  13. Rosenzweig KE, Hanley J, Mah D, et al. The deep inspiration breath-hold technique in the treatment of inoperable non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2000;48:81–87
  14. Barnes EA, Murray BR, Robinson DM, et al. Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration. Int J Radiat Oncol Biol Phys. 2001;50:1091–1098
  15. Balter JM, Lam KL, McGinn CJ, et al. Improvement of CT-based treatment-planning models of abdominal targets using static exhale imaging. Int J Radiat Oncol Biol Phys. 1998;41:939–943
  16. Wong JW, Sharpe MB, Jaffray DA, et al. The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol Biol Phys. 1999;44:911–919
  17. Shirato H, Shimizu S, Kunieda T, et al. Physical aspects of a real-time tumor-tracking system for gated radiotherapy. Int J Radiat Oncol Biol Phys. 2000;48:1187–1195
  18. Kini VR, Vedam SS, Keall PJ, et al. Patient training in respiratory-gated radiotherapy. Med Dosim. 2003;28:7–11
  19. Kubo HD, Len PM, Minohara S, et al. Breathing-synchronized radiotherapy program at the University of California Davis Cancer Center. Med Phys. 2000;27:346–353
  20. Berson AM, Emery R, Rodriguez L, et al. Clinical experience using respiratory gated radiation therapy: Comparison of free-breathing and breath-hold techniques. Int J Radiat Oncol Biol Phys. 2004;60:419–426
  21. Kubo HD, Hill BC. Respiration gated radiotherapy treatment: A technical study. Phys Med Biol. 1996;41:83–91
  22. Ramsey CR, Scaperoth D, Arwood D, et al. Clinical efficacy of respiratory gated conformal radiation therapy. Med Dosim. 1999;24:115–119
  23. Keall P. 4-Dimensional computed tomography imaging and treatment planning. Semin Radiat Oncol. 2004;14:81–90
  24. Rietzel E, Chen GTY, Choi NC, et al. Four-dimensional image-based treatment planning: Target volume segmentation and dose calculation in the presence of respiratory motion. Int J Radiat Oncol Biol Phys. 2005;61:1535–1550
  25. Keall PJ, Joshi S, Vedam SS, et al. Four-dimensional radiotherapy planning for DMLC-based respiratory motion tracking. Med Phys. 2005;32:942–951
  26. Shirato H, Shimizu S, Kitamura K, et al. Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor. Int J Radiat Oncol Biol Phys. 2000;48:435–442
  27. Adler JR, Chang SD, Murphy MJ, et al. The Cyberknife: A frameless robotic system for radiosurgery. Stereotact Funct Neurosurg. 1997;69:124–128
  28. Seppenwoolde Y, Berbeco RI, Nishioka S, et al. Accuracy of tumor motion compensation algorithm from a robotic respiratory tracking system: A simulation study. Med Phys. 2007;34:2774–2784
  29. von Siebenthal M, Székely G, Lomax AJ, et al. Systematic errors in respiratory gating due to intrafraction deformations of the liver. Med Phys. 2007;34:3620–3629
  30. Berbeco RI, Nishioka S, Shirato H, et al. Residual motion of lung tumours in gated radiotherapy with external respiratory surrogates. Phys Med Biol. 2005;50:3655–3667
  31. Gierga DP, Brewer J, Sharp GC, et al. The correlation between internal and external markers for abdominal tumors: Implications for respiratory gating. Int J Radiat Oncol Biol Phys. 2005;61:1551–1558
  32. Sawant A, Smith RL, Venkat RB. Geometric accuracy and latency of an integrated 4D IMRT delivery system using real-time internal position monitoring and dynamic MLC tracking. Int J Radiat Oncol Biol Phys. 2008;72:S27–S28
  33. Verellen D, Tournel K, Van de Steene J, et al. Breathing-synchronized irradiation using stereoscopic kV-imaging to limit influence of interplay between leaf motion and organ motion in 3D-CRT and IMRT: Dosimetric verification and first clinical experience. Int J Radiat Oncol Biol Phys. 2006;66:108–119
  34. Berbeco RI, Pope CJ, Jiang SB. Measurement of the interplay effect in lung IMRT treatment using EDR2 films. J Appl Clin Med Phys. 2006;7:33–42
  35. Verellen D, Tournel K, Linthout N, et al. Importing measured field fluences into the treatment planning system to validate a breathing synchronized DMLC-IMRT irradiation technique. Radiother Oncol. 2006;78:332–338
  36. Parikh P, Lechleiter K, Malinowski K, et al. Dosimetric effects of a 4D magnetic localization system for LINAC beam gating on prostate and lung radiation therapy. Medical Physics. 2007;34:2625
  37. Sawant A, Venkat R, Srivastava V, et al. Management of three-dimensional intrafraction motion through real-time DMLC tracking. Med Phys. 2008;35:2050–2061
  38. Srivastava V, Keall P, Sawant A, et al. Accurate prediction of intra-fraction motion using a modified linear adaptive filter. Med Phys. 2007;34:2546
  39. Malinowski K, Lechleiter K, Hubenschmidt J. Use of the 4D phantom to test real-time targeted radiation. Med Phys. 2007;34:2611
  40. Suh Y, Dieterich S, Cho B, et al. An analysis of thoracic and abdominal tumour motion for stereotactic body radiotherapy patients. Phys Med Biol. 2008;53:3623–3640
  41. Low DA, Dempsey JF. Evaluation of the gamma dose distribution comparison method. Med Phys. 2003;30:2455–2464

 Conflict of interest: Drs. Parag J. Parikh and Paul J Keall receive funding from Varian Medical Systems and Calypso Medical Technologies.

PII: S0360-3016(09)00127-8

doi: 10.1016/j.ijrobp.2009.01.031

International Journal of Radiation Oncology * Biology * Physics
Volume 74, Issue 3 , Pages 868-875 , 1 July 2009