Impact of intrafraction fiducial tracking on planning target margins during prostate stereotactic body radiotherapy using Brainlab ExacTrac Dynamic with robotic couch correction.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Impact of intrafraction fiducial tracking on planning target margins during prostate stereotactic body radiotherapy using Brainlab ExacTrac Dynamic with robotic couch correction.
Συγγραφείς:	Worth M; Department of Radiation Oncology, The Valley Hospital, One Valley Health Plaza, Paramus, New Jersey, USA., Brancato DC; Department of Radiation Oncology, The Valley Hospital, One Valley Health Plaza, Paramus, New Jersey, USA., Lo J; Department of Radiation Oncology, The Valley Hospital, One Valley Health Plaza, Paramus, New Jersey, USA., Kole TP; Department of Radiation Oncology, The Valley Hospital, One Valley Health Plaza, Paramus, New Jersey, USA.
Πηγή:	Journal of applied clinical medical physics [J Appl Clin Med Phys] 2025 Dec; Vol. 26 (12), pp. e70363.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Wiley on behalf of American Association of Physicists in Medicine Country of Publication: United States NLM ID: 101089176 Publication Model: Print Cited Medium: Internet ISSN: 1526-9914 (Electronic) Linking ISSN: 15269914 NLM ISO Abbreviation: J Appl Clin Med Phys Subsets: MEDLINE
Imprint Name(s):	Publication: 2017- : Malden, MA : Wiley on behalf of American Association of Physicists in Medicine Original Publication: Reston, VA : American College of Medical Physics, c2000-
Ιατρικοί όροι (MeSH):	Radiotherapy Planning, Computer-Assisted/methods , Radiosurgery/methods , Prostatic Neoplasms/surgery , Prostatic Neoplasms/pathology , Prostatic Neoplasms/radiotherapy , Robotics/methods , Robotics/instrumentation , Robotic Surgical Procedures/methods , Fiducial Markers*, Radiotherapy, Intensity-Modulated/methods ; Organs at Risk/radiation effects ; Humans ; Male ; Radiotherapy Dosage ; Retrospective Studies
Περίληψη:	Background: Planning target volume (PTV) margin reduction has been demonstrated to result in decreased acute genitourinary and gastrointestinal toxicity in patients treated with definitive stereotactic body radiotherapy (SBRT) for localized prostate cancer. Purpose: The purpose of this study was to assess the impact of stereoscopic x-ray-based intrafraction prostate fiducial tracking with six degrees of freedom (6DoF) robotic couch correction on PTV margin reduction during gantry-based prostate SBRT. Materials and Methods: Intrafraction prostate position data was analyzed for patients with localized prostate cancer treated using gantry-based SBRT with stereoscopic x-ray intrafraction fiducial monitoring using Brainlab ExacTrac Dynamic (ETD) and 6DoF couch correction at our institution. Fiducial displacements and rotations were calculated between each intrafraction measurement, and mean intrafraction deviations were determined for each fraction, patient, and the overall cohort. Minimum PTV margins required in each dimension were calculated using the van Herk method. Results: There were 2525 intrafraction stereoscopic fiducial verifications within the cohort. Intrafraction fiducial displacements were within 1.5 mm between 98.7%, 96.1%, and 95.1% consecutive fiducial verifications in the left/right (LR), superior/inferior (SI), and anterior/posterior (AP) dimensions, respectively. Rotational deviations were within 2° between 83.3%, 98.3%, and 99.4% consecutive fiducial verifications in the pitch, roll, and yaw directions, respectively. Twenty-three percent of stereoscopic verifications triggered a robotic couch correction based upon specified tolerances. Overall, 56% of treatment fractions required a 6DoF couch correction. Fiducial position verifications requiring couch correction were most often triggered by pitch, which occurred in 72% of instances. This corresponded to required minimum PTV margins of 1.23, 1.73, and 1.44 mm in the LR, SI, and AP dimensions, respectively. Conclusions: Intrafraction fiducial tracking using ETD stereoscopic x-ray verification with 6DoF robotic couch correction allows for reduced PTV margins when treating localized prostate cancer with gantry-based SBRT. (© 2025 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)
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Contributed Indexing:	Keywords: brainlab ExacTrac dynamic; fiducial‐based image guidance; intrafraction motion management; planning target volume (PTV) margin reduction; prostate cancer; six‐degree‐of‐freedom (6DoF) couch correction; stereotactic body radiotherapy (SBRT)
Entry Date(s):	Date Created: 20251118 Date Completed: 20251118 Latest Revision: 20251123
Update Code:	20260130
PubMed Central ID:	PMC12626743
DOI:	10.1002/acm2.70363
PMID:	41253699
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1526-9914
DOI:	10.1002/acm2.70363