The accuracy and precision of the KIM motion monitoring system used in the multi-institutional TROG 15.01 Stereotactic Prostate Ablative Radiotherapy with KIM (SPARK) trial

Hewson, EA; Nguyen, DT; O’Brien, R; Kim, JH; Montanaro, T; Moodie, T; Greer, PB; Hardcastle, N; Eade, T; Kneebone, A; Hruby, G; Hayden, AJ; Turner, S; Siva, S; Tai, KH; Hunter, P; Sams, J; Poulsen, PR; Booth, JT; Martin, J; Keall, PJ

The accuracy and precision of the KIM motion monitoring system used in the multi-institutional TROG 15.01 Stereotactic Prostate Ablative Radiotherapy with KIM (SPARK) trial

Hewson, EA Nguyen, DT

O’Brien, R Kim, JH Montanaro, T Moodie, T Greer, PB Hardcastle, N Eade, T Kneebone, A Hruby, G Hayden, AJ Turner, S Siva, S Tai, KH Hunter, P Sams, J Poulsen, PR Booth, JT Martin, J Keall, PJ

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Publication Type:: Journal Article
Citation:: Medical Physics, 2019, 46 (11), pp. 4725 - 4737
Issue Date:: 2019-11-01

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Field	Value	Language
dc.contributor.author	Hewson, EA	en_US
dc.contributor.author	Nguyen, DT https://orcid.org/0000-0003-1581-0359	en_US
dc.contributor.author	O’Brien, R	en_US
dc.contributor.author	Kim, JH	en_US
dc.contributor.author	Montanaro, T	en_US
dc.contributor.author	Moodie, T	en_US
dc.contributor.author	Greer, PB	en_US
dc.contributor.author	Hardcastle, N	en_US
dc.contributor.author	Eade, T	en_US
dc.contributor.author	Kneebone, A	en_US
dc.contributor.author	Hruby, G	en_US
dc.contributor.author	Hayden, AJ	en_US
dc.contributor.author	Turner, S	en_US
dc.contributor.author	Siva, S	en_US
dc.contributor.author	Tai, KH	en_US
dc.contributor.author	Hunter, P	en_US
dc.contributor.author	Sams, J	en_US
dc.contributor.author	Poulsen, PR	en_US
dc.contributor.author	Booth, JT	en_US
dc.contributor.author	Martin, J	en_US
dc.contributor.author	Keall, PJ	en_US
dc.date.accessioned	2020-04-03T03:40:59Z
dc.date.available	2019-08-16	en_US
dc.date.available	2020-04-03T03:40:59Z
dc.date.issued	2019-11-01	en_US
dc.identifier.citation	Medical Physics, 2019, 46 (11), pp. 4725 - 4737	en_US
dc.identifier.issn	0094-2405	en_US
dc.identifier.uri	http://hdl.handle.net/10453/139766
dc.description.abstract	© 2019 American Association of Physicists in Medicine Purpose: Kilovoltage intrafraction monitoring (KIM) allows for real-time image guidance for tracking tumor motion in six-degrees-of-freedom (6DoF) on a standard linear accelerator. This study assessed the geometric accuracy and precision of KIM used to guide patient treatments in the TROG 15.01 multi-institutional Stereotactic Prostate Ablative Radiotherapy with KIM trial and investigated factors affecting accuracy and precision. Methods: Fractions from 44 patients with prostate cancer treated using KIM-guided SBRT were analyzed across four institutions, on two different linear accelerator models and two different beam models (6 MV and 10 MV FFF). The geometric accuracy and precision of KIM was assessed from over 33 000 images (translation) and over 9000 images (rotation) by comparing the real-time measured motion to retrospective kV/MV triangulation. Factors potentially affecting accuracy, including contrast-to-noise ratio (CNR) of kV images and incorrect marker segmentation, were also investigated. Results: The geometric accuracy and precision did not depend on treatment institution, beam model or motion magnitude, but was correlated with gantry angle. The centroid geometric accuracy and precision of the KIM system for SABR prostate treatments was 0.0 ± 0.5, 0.0 ± 0.4 and 0.1 ± 0.3 mm for translation, and −0.1 ± 0.6°, −0.1 ± 1.4° and −0.1 ± 1.0° for rotation in the AP, LR and SI directions respectively. Centroid geometric error exceeded 2 mm for 0.05% of this dataset. No significant relationship was found between large geometric error and CNR or marker segmentation correlation. Conclusions: This study demonstrated the ability of KIM to locate the prostate with accuracy below other uncertainties in radiotherapy treatments, and the feasibility for KIM to be implemented across multiple institutions.	en_US
dc.relation.ispartof	Medical Physics	en_US
dc.relation.isbasedon	10.1002/mp.13784	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Nuclear Medicine & Medical Imaging	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Prostatic Neoplasms	en_US
dc.subject.mesh	Radiosurgery	en_US
dc.subject.mesh	Radiotherapy Planning, Computer-Assisted	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Particle Accelerators	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Radiotherapy, Image-Guided	en_US
dc.subject.mesh	Dose Fractionation, Radiation	en_US
dc.title	The accuracy and precision of the KIM motion monitoring system used in the multi-institutional TROG 15.01 Stereotactic Prostate Ablative Radiotherapy with KIM (SPARK) trial	en_US
dc.type	Journal Article
utslib.citation.volume	11	en_US
utslib.citation.volume	46	en_US
utslib.for	0299 Other Physical Sciences	en_US
utslib.for	0903 Biomedical Engineering	en_US
utslib.for	1112 Oncology and Carcinogenesis	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access	*
pubs.issue	11	en_US
pubs.publication-status	Published	en_US
pubs.volume	46	en_US

Abstract:

© 2019 American Association of Physicists in Medicine Purpose: Kilovoltage intrafraction monitoring (KIM) allows for real-time image guidance for tracking tumor motion in six-degrees-of-freedom (6DoF) on a standard linear accelerator. This study assessed the geometric accuracy and precision of KIM used to guide patient treatments in the TROG 15.01 multi-institutional Stereotactic Prostate Ablative Radiotherapy with KIM trial and investigated factors affecting accuracy and precision. Methods: Fractions from 44 patients with prostate cancer treated using KIM-guided SBRT were analyzed across four institutions, on two different linear accelerator models and two different beam models (6 MV and 10 MV FFF). The geometric accuracy and precision of KIM was assessed from over 33 000 images (translation) and over 9000 images (rotation) by comparing the real-time measured motion to retrospective kV/MV triangulation. Factors potentially affecting accuracy, including contrast-to-noise ratio (CNR) of kV images and incorrect marker segmentation, were also investigated. Results: The geometric accuracy and precision did not depend on treatment institution, beam model or motion magnitude, but was correlated with gantry angle. The centroid geometric accuracy and precision of the KIM system for SABR prostate treatments was 0.0 ± 0.5, 0.0 ± 0.4 and 0.1 ± 0.3 mm for translation, and −0.1 ± 0.6°, −0.1 ± 1.4° and −0.1 ± 1.0° for rotation in the AP, LR and SI directions respectively. Centroid geometric error exceeded 2 mm for 0.05% of this dataset. No significant relationship was found between large geometric error and CNR or marker segmentation correlation. Conclusions: This study demonstrated the ability of KIM to locate the prostate with accuracy below other uncertainties in radiotherapy treatments, and the feasibility for KIM to be implemented across multiple institutions.

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http://hdl.handle.net/10453/139766