Reproducibiity of setup error for prostate cancer by ultrasound image-guided radiation therapy

전립선암에 대한 초음파 영상유도 방사선치료의 Setup 오차 분석을 통한 재현성 평가

  • 박성용 (순천향대학교 서울병원) ;
  • 임승규 (순천향대학교 서울병원) ;
  • 시명근 (순천향대학교 서울병원) ;
  • 이지해 (순천향대학교 서울병원) ;
  • 김종열 (순천향대학교 서울병원) ;
  • 조은주 (순천향대학교 서울병원)
  • Published : 2017.12.29

Abstract

Purpose: To evaluate the reproducibility of image-guided radiotherapy using ultrasonography which is non-invasive, without radiation exposure for prostate cancer patients. Materials and Methods: We analyzed the setup variation of 1,105 images for 26 prostate cancer patients and the mean, standard deviation and 3D-error in AP, RL and SI directions. Setup variations were classified 0-1 mm, 1-3 mm, 3-5 mm, 5 mm and more. Results: The mean and standard deviation of setup variation in AP, RL and SI directions was $1.87{\pm}1.36mm$, $1.73{\pm}1.22mm$ and $2.01{\pm}1.40mm$. The 3D-error in AP, RL and SI directions was $3.63{\pm}1.63mm$. The frequency of setup variation in AP direction was 29 % in the range from 0 mm to 1 mm, 50.2 % in the range from 1 mm to 3 mm, 19.6 % in the range from 3 mm to 5 mm and 1.3 % in the range of 5 mm or more. In RL direction, the frequency was 31.3 % in the range from 0 mm to 1 mm, 52.5 % in the range from 1 mm to 3 mm, 15.8 % in the range from 3 mm to 5 mm and 0.5 % in the range of 5 mm or more. SI direction, the frequency of errors in the range from 0 mm to 1 mm was 26.3 %, 50.2 % in the range from 1 mm to 3 mm, 22.4 % in the range from 3 mm to 5 mm, and 1.1 % in the range of 5 mm or more. Conclusion: The setup error was highest in the SI direction of $2.01{\pm}1.40mm$. The frequency in each direction was the highest in more than 50 % in the range from 1 mm to 3 mm. $Clarity^{TM}$ Auto scan is possible to monitoring the motion of the prostate during the treatment and to repositioning the patient. In conclusion real-time image-guided radiotherapy using ultrasonography will be increase the reproducibility of radiation therapy.

References

  1. 중앙암등록본부 암등록통계자료(2015).
  2. Western C, Hristov D, Schlosser J: Ultrasound Imaging in Radiation Therapy: -From Interfractional to Intrafractional GuidanceCureus. 7(6): e280. DOI-10.7759/cureus.280. https://doi.org/10.7759/cureus.280
  3. Fabio C. M.D., George S. M.D., Luis S. M.D et al.: Ultrasound-Based Image Guided Radiotherapy for Prostate cancer-comparison Of Cross-Modality and Intramodality Methods for Daily Localization During External Beam Radiotherapy. Radiation Oncology Biol. Phys. 2006;66(5): 1562-1567. https://doi.org/10.1016/j.ijrobp.2006.07.1375
  4. Hendrik B, Ute Ganswindt, Claus B, et al.: Intrafraction motion of the prostate- is not increased by patient couch shifts. Radiation Oncology (2016) 11:49. https://doi.org/10.1186/s13014-016-0620-z
  5. Anurag C. M.D., Lei D, PH.D. Eugene Huang, M.D et al.: Experience Of Ultrasound-Based Daily Prostate Localization. Radiation Oncology Biol. Phys., 2003;56(2), 436-447. https://doi.org/10.1016/S0360-3016(02)04612-6
  6. Katja M. Langen, PH.D. Twyla R.: Observations On Real-Time Prostate Gland motion Using Electromagnetic Tracking. Radiation Oncology Biol. Phys 2008;71(4): 1084-1090. https://doi.org/10.1016/j.ijrobp.2007.11.054
  7. Don R, Derek L, Stephen S, et al.: An evaluation of the Clarity 3D ultrasound- system for prostate localization. Journal of Applied Clinical medical Physics. 2016;13(4):100-112. https://doi.org/10.1120/jacmp.v13i4.3753
  8. A.K. Richardson, P. Jacobs: Intrafraction monitoring of prostate motion during-radiotherapy using the $Clarity^{(R)}$ Autoscan Transperineal Ultrasound(TPUS)-system. Radiography 2017;23(4):310-313. https://doi.org/10.1016/j.radi.2017.07.003
  9. Mariwan B, Claus F. Behrens B.: Determining intrafractional prostate motion-using four dimensional ultrasound system. BMC Cancer 2016; 16:484. https://doi.org/10.1186/s12885-016-2533-5
  10. Martin L, Tony F: Itrafractional Prostate Motion Management With The Clarity Auto Scan System. Medical Physics Iternational Journal 2013;1(1):72-80.