Purpose:Accurate patient positioning is crucial in radiation therapy. To fully benefit from the preciseness of proton therapy, image guided patient positioning and verification system is typically utilized in proton therapy. The purpose of this study is to evaluate the inter-observer variability of image alignment using a commercially available patient positioning and verification system in proton therapy.
Methods:The VeriSuite patient positioning and verification system (MedCom GmbH, Darmstadt, Germany) provides a six degrees of freedom correction vector by registering two orthogonal x-ray images to digitally reconstructed radiograph (DRR) images that are rendered in real time from the planning computed tomography (CT) images. Six cases of various disease sites, including brain, head & neck, lung, prostate, pelvis, and bladder, were used in this study. For each case, the planning CT images and a daily orthogonal x-ray portal image pair were loaded into the VeriSuite system. The same set of x-ray images and CT images for each case were reviewed and aligned separately by each of the 10 radiation therapist, following the clinical procedure for the corresponding disease site. The resulting correction vectors were then recorded and analyzed.
Results:Our study shows that the inter-observer variation (One standard deviation) in image alignment using the VeriSuite system ranged from 1.2 to 2.0 mm for translational correction and from 0.6 to 1.3 degrees for rotational correction for the six cases. The use of fiducial markers for prostate patient alignment achieved the least inter-observer variation while the bladder case produced the largest.
Conclusions:Inter-observer variation in image alignment could be relatively large, depending on the complexity of patient anatomy, image alignment approach, and user experience and software limitations. Automatic registration and fiducial markers could potentially be used to align patient more accurately and consistently. To ensure adequate tumor coverage in proton therapy, inter-observer variability in patient alignment should be carefully evaluated and accounted for in patient setup uncertainty analysis and treatment planning margin determination.
I would like to thank this journal for publishing my Research Article. Something I really appreciate about this journal is, they did not take much time from the day of Submission to the publishing date. Looking forward to have more publications in future.
Ayush Chandra
It was a great experience publishing through JCICM. The article has reached out to several institutions. Appreciate your professional work. Hope to work with you again
Anas Wardeh
I am delighted and satisfied with. Heighten Science Publications as my manuscript was thoroughly assessed and published on time without delay. Keep up the good work.
Ido-Ekiti/Afe Babalola University, Nigeria
Dr. Shuaib Kayode Aremu
I was very pleased with the quick editorial process. We are sure that our paper will have great visibility, among other things due to its open access. We believe in science accessible to all.
Anderson Fernando de Souza
In 2017, I submitted a manuscript to the journal Archives of Biotechnology and Biomedicine belonging to Heighten Science Publications Corporation. Within one week I already received the response from the editor. All processing steps were really fast so in terms of a speedy publication I can particularly recommend the journal Archives of Biotechnology and Biomedicine. The responsible contact person of the journal was always available, which gives a trustworthy impression to the author. Also the peer review process was clear and constructive. So from my experience with Heighten Science Publications Corporation I can recommend publishing there.
University of Tubingen, Germany
Yvonne Mast
During the process your positive communication, prompt feedback and professional approach is very highly appreciated.
We would like to thank you very much for your support.
Can Vuran
It was a real pleasure working with your team. The review was done fast, and it was very clear, the editing was flawless, the article was published quickly compared to other journals, and everyone was understanding and helpful. I will gladly recommend this journal to my acquaintances in academia.
Alexandra Cozma
This is to specify that I have had an extensive and detailed interaction with the Editorial team of Annals of Clinical Gastroenterology and Hepatology, USA, lasting over a significant period of time. My interaction has been extremely pleasant, especially with Ms Allie Smith, as I find the communication quite inspiring and crystal clear. The attitude of aforesaid individuals is quite helpful and guiding in pertinent instances. It has been a commemorative journey so far working with the Journal and I hope that the symbiosis will continue, evolve and flourish in the forthcoming years.
I wish the journal, related personnel and aforementioned individuals a fruitful, successful run.
New Delhi, India
Anubha Bajaj
The editorial process was quickly done. The galley proof was sent within a week after being accepted for publication.
The editorial team was very helpful and responded promptly.
India
Rohit Kulshrestha
I would like to thank JPRA for taking this decision. I understand the effort it represents for you. I'm truly happy to have the paper published in JPRA. And I'll certainly consider JPRA for my next publications as I was satisfied of the service provided, the efficiency and promptness of the interactions we had.
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."