Journal
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Volume 53, Issue 1, Pages 206-214Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0360-3016(01)02823-1
Keywords
prostate intrafraction motion; gold markers; on-line position verification; flat-panel imager; margins
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Purpose: Here we study the magnitude of prostate motion during the delivery of a radiotherapy fraction. These motions have clinical consequences for on-line position verification and the choice of margins around the target volume. Methods and Materials: We studied the motion of the prostate for 10 patients during 251 radiotherapy treatment fractions by assessing the position of implanted gold markers. Gold markers of 1 mm diameter and 5 turn length were implanted in the prostate before the start of the radiotherapy. We obtained movies during each fraction using an a-Si flat-panel imager. The markers could be detected in separate frames using a marker extraction kernel. Results: Marker displacements as large as 9.5 mm were detected in one fraction. The motion of the prostate is greatest in the caudal-cranial and the anterior-posterior directions. Within a time window of 2 to 3 min, deviations from the initial marker position, averaged over all patients, are 0.3 +/- 0.5 mm and -0.4 +/- 0.7 mm in the anterior-posterior and caudal-cranial directions, respectively. Conclusions: It appeared that on average, the intrafraction prostate motions did not result in margins larger than I mm, provided that the position verification is performed at time intervals of 2 to 3 min. Only for some patients performing more frequent position verification or adding extra margins of 2 to 3 mm is required to account for intrafraction prostate motions. (C) 2002 Elsevier Science Inc.
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