Wen Ting,Li Jing,Li Zhiqiang,Zhang Jinjian,Hou Youxian,Chen Jing,Jia Junsong.Evaluation of the image guided set-up for multiple metastases treated with tomotherapy[J].Chinese Journal of Radiological Medicine and Protection,2014,34(4):289-291
Evaluation of the image guided set-up for multiple metastases treated with tomotherapy
Received:May 21, 2013  
DOI:10.3760/cma.j.issn.0254-5098.2014.04.013
KeyWords:Multiple metastases  Tomotherapy  Image guidance  Setup errors
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Author NameAffiliationE-mail
Wen Ting Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China  
Li Jing Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China jameslijing@163.com 
Li Zhiqiang Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China  
Zhang Jinjian Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China  
Hou Youxian Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China  
Chen Jing Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China  
Jia Junsong Tomotherapy Center in South China, PLA General Hospital, Guangzhou 510000, China  
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Abstract::
      Objective To compare the setup errors between single-site and two-site image guidance in treating multiple metastases using Tomotherapy. Methods A total of 1 220 sets of megavoltage CT (MVCT) images from 50 multiple metastases patients were collected. The setup errors of two anatomic sites were determined by registration of MVCT images with planning images. Bland-Altman plot analysis was used to assess the coincidence of these two methods. Pearson correlation analysis was performed to evaluate the correlation of the setup errors determined by two sets of data and to analyze the deviation values of setup errors.Results The deviation values of setup errors more than 3 mm between two sites were 34%, 46% and 28% in lateral (x), longitudinal (y), vertical (z) directions, respectively. The deviation values of setup errors more than 5 mm were 10%, 16% and 8%,respectively. The Bland-Altman plot analysis showed that the 95% agreement limits of agreement were (9.3, -10.6), (10.5, -11.7), (7.3, -6.9) mm in x, y, z directions, respectively, which were all out of 5 mm tolerance. The Pearson coefficient of correlation along all three directions was less than 0.05, and R2 was 0.074, 0.475, and 0.178 in x, y, z directions, respectively. Conclusions To determine the setup errors for patients with multiple metastases, single-site image guidance method is not consistent, and the two site image guidance method would be recommended.
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