Skip to main content

Advertisement

Log in

Positioning error analysis of the fraxion localization system in the intracranial stereotactic radiotherapy of tumors

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Objective

To investigate positioning error analysis of the Fraxion localization system in the intracranial stereotactic radiotherapy of tumors.

Methods

64 patients were divided into two groups: a control group (36 patients with the standard thermoplastic mask) and a model group (28 patients with the Fraxion localization system). 3D images of the treated position were obtained by cone-beam computed tomography (CBCT). Positioning errors were obtained by, respectively, registering these two sets of CBCT images to planning CT images, using a 6°-freedom robotic patient positioning system (HexaPOD Evo RT System). The changes in positioning errors with the Fraxion localization system and with the standard thermoplastic mask were analyzed.

Results

CBCT scan results of the model group showed that the mean of linear error of three directions [superior-inferior (SI), lateral (LAT), and anterior–posterior (AP)] was 0.710 ± 0.676 mm, 0.817 ± 0.687 mm, and 0.710 ± 0.685 mm, respectively. The corresponding PTV was 1.23 mm, 1.26 mm, and 1.36 mm. The differences between the 3D images and the planned CT images were significant (p < 0.001).

Conclusion

The Fraxion radiotherapy system can not only improve the positioning accuracy and reduce positioning errors but also narrow the PTV margin and reduce the radiated volume of normal tissue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jeong WJ, Park JH, Lee EJ, Kim JH, Kim CJ, Cho YH. Efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases. J Korean Neurosurg Soc. 2015;58:217–24.

    Article  CAS  Google Scholar 

  2. Boman E, Kapanen M, Laaksomaa M, Mäenpää H, Hyödynmaa S, Kellokumpu-Lehtinen PL. Treatment accuracy without rotational setup corrections in intracranial SRT. J Appl Clin Med Phys. 2016;17(4):86–94.

    Article  Google Scholar 

  3. Jin H, Keeling VP, Ali I, Ahmad S. Dosimetric effects of positioning shifts using 6D-frameless stereotactic Brainlab system in hypofractionated intracranial radiotherapy. J Appl Clin Med Phys. 2016;17(1):102–11.

    Article  Google Scholar 

  4. Seravalli E, van Haaren PM, van der Toorn PP, Hurkmans CW. A comprehensive evaluation of treatment accuracy, including end-to-end tests and clinical data, applied to intracranial stereotactic radiotherapy. Radiother Oncol. 2015;116(1):131–8.

    Article  CAS  Google Scholar 

  5. Tanaka Y, Oita M, Inomata S, Fuse T, Akino Y, Shimomura K. Impact of patient positioning uncertainty in noncoplanar intracranial stereotactic radiotherapy. J Appl Clin Med Phys. 2020;21(2):89–97.

    Article  Google Scholar 

  6. Russo M, Owen R, Bernard A, Moutrie V, Foote M. Evaluation of accuracy and reproducibility of a relocatable maxillary fixation system for fractionated intracranial stereotactic radiation therapy. J Med Radiat Sci. 2016;63(1):41–7.

    Article  Google Scholar 

  7. Morimoto CY, Mayer MN, Sidhu N, Bloomfield R, Waldner CL. Residual setup error in the canine intracranial region after megavoltage, kilovoltage, or cone-beam computed tomographic image guidance for radiation therapy. Vet Comp Oncol. 2020;18(2):199–205.

    Article  Google Scholar 

  8. Berndt A, van Prooijen M, Guillot M. COMP report: CPQR technical quality control guidelines for Gamma Knife radiosurgery. J Appl Clin Med Phys. 2018;19(5):365–7.

    Article  Google Scholar 

  9. Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102:312–9.

    Google Scholar 

  10. Ruschin M, Nayebi N, Carlsson P, Brown K, Tamerou M, Li W, Laperriere N, Sahgal A, Cho YB, Ménard C, Jaffray D. Performance of a novel repositioning head frame for gamma knife perfexion and image-guided linac-based intracranial stereotactic radiotherapy. Int J Radiat Oncol Biol Phys. 2010;78:306–13.

    Article  Google Scholar 

  11. Sayer FT, Sherman JH, Yen CP, Schlesinger DJ, Kersh R, Sheehan JP. Initial experience with the eXtend System: a relocatable frame system for multiple-session Gamma Knife radiosurgery. World Neurosurg. 2011;75:665–72.

    Article  Google Scholar 

  12. van Herk M. Errors and margins in radiotherapy. Semin Radiat Oncol. 2004;14(1):52–64.

    Article  Google Scholar 

  13. Zollner B, Heinz C, Pitzler S, Manapov F, Kantz S, Rottler MC, Niyazi M, Ganswindt U, Belka C, Ballhausen H. Stereoscopic X-ray imaging, cone beam CT, and couch positioning in stereotactic radiotherapy of intracranial tumors: preliminary results from a cross-modality pilot installation. Radiat Oncol. 2016;11(1):158.

    Article  Google Scholar 

  14. Wang ZY, Zeng ZL, Tan JW. Electron portal imaging device for the correction of set-up error in intensity-modulated radiotherapy for nasopharyngeal carcinoma and its application. Chin J Med Phys. 2017;34(9):887–92.

    Google Scholar 

  15. Astreinidou E, Bel A, Raaijmakers CP, Terhaard CH, Lagendijk JJ. Adequate margins for random setup uncertainties in head-and-neck IMRT. Int J Radiat Oncol Biol Phys. 2005;61(3):938–44.

    Article  Google Scholar 

  16. Russo M, Owen R, Bernard A, Moutrie V, Foote M. Evaluation of accuracy and reproducibility of a relocatable maxillary fixation system for fractionated intracranial stereotactic radiation therapy. J Med Radiat Sci. 2016;63:41–7.

    Article  Google Scholar 

Download references

Acknowledgements

We wish to thank all the members in our department for their discussion on this project. Revision E. Fraxion™ User Manual. Medical Intelligence Medizintechnik GmbH. Schwabmünchen. Germany 2013.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J.-H. Han.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to report.

Ethical approval

The current study has been approved by the Ethical Committee of our hospital.

Informed consent

All subjects signed written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, DC., Zhu, ZJ., Zhang, XY. et al. Positioning error analysis of the fraxion localization system in the intracranial stereotactic radiotherapy of tumors. Clin Transl Oncol 23, 43–47 (2021). https://doi.org/10.1007/s12094-020-02382-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-020-02382-y

Keywords

Navigation