Comparison of setup uncertainties of two immobilization devices for pelvic external beam radiotherapy
Keywords:
PTV margin, Setup uncertainty, Immobilization deviceAbstract
Background: In pelvic external beam radiotherapy, patient immobilization has an important role in maintaining patient’s position during the course of treatment. This study compares positioning method of two immobilization devices between Vacuum Bag Cushion (VBC) and Feet Fix (FF) at Ramathibodi Hospital. The choice of an appropriate immobilization would lead to reduce setup uncertainties.
Objectives: The aim of this study was to quantify the setup uncertainties and to determine PTV margin in the pelvic radiation therapy of the two different immobilization devices: VBC and FF.
Materials and methods: Fifty-three patients were included and divided into two groups based on using immobilization devices (VBC vs FF). The setup uncertainties were determined using the kV-kV imaging by matching between acquired image and reference DRRs image. The displacement in each direction: Vertical (VRT), Longitudinal (LONG), and Lateral (LAT) were recorded. The Total Vector Error (TVE), Systematic error, Random error and Planning Target Volume (PTV) margin were calculated and statistically analyzed for both devices.
Results: The TVE of the VBC group was 0.51 cm, and the FF was 0.57 cm. The differences were not statistically significant between the two devices. The PTV margins in VRT, LONG, and LAT were 0.53, 0.75, and 0.97 cm, respectively, for VBC device while those of FF device were 0.51, 0.69 and 1.12 cm, respectively.
Conclusion: The setup uncertainties evaluated from displacement in each direction for VBC and FF were in the same magnitude in pelvic external beam radiotherapy. The setup variation was found to be largest in the lateral direction. The PTV margin should be applied according to each immobilization system.
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