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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1458158

Investigating the Impact of Non-standard Positioning on the Accuracy of Skull Tracking Algorithms using Dual-panel Imaging Systems

Provisionally accepted
He Huang He Huang 1Lian Zhang Lian Zhang 1Yang Dong Yang Dong 2Yunfei Bian Yunfei Bian 1Hongyu Lin Hongyu Lin 1Hui Xu Hui Xu 1Ying Li Ying Li 1*
  • 1 Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China
  • 2 Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    Objective: This study investigates the impact of non-standard positioning on the accuracy of 6D-skull tracking using dual-panel imaging systems. It explores whether positioning patients' heads at various angles during intracranial lesion treatment affects the accuracy of the CyberKnife 6D-skull tracking system.Materials and Methods: A heterogeneous density skull phantom was used to simulate various patient skull positioning angles. To accurately compare 6D-skull tracking and fiducial tracking, their center coordinates were pre-set to be identical in the treatment plan. The phantom was positioned using fiducial tracking, and the offset value recorded. The system was then switched to 6D-skull tracking to observe the corresponding offset. The difference between the two tracking methods was calculated, and a paired-sample T-test was conducted to assess statistical significance across different angles.Additionally, the gamma passing rate (criteria: 3%/3mm) was employed to quantitatively delineate dosimetric disparities attributable to positional variations.Results: Paired sample T-tests on the deviations between rotational and translational parameters of fiducial tracking and skull tracking under identical conditions are detailed in Tables 1-6. The p-values indicate no statistically significant differences between the methods across all selected angles. The minimal deviations and lack of statistical significance demonstrate that both tracking methods are equivalent in skull positioning. Furthermore, the gamma passing rate analysis revealed that in all tested conditions, the rates exceeded 95%, which aligns with clinical requirements. Conclusion: Since fiducial tracking is not affected by patient or phantom positioning, this study compares the registration results of 6D-skull tracking with fiducial tracking under the same conditions. The results show minimal deviations and no statistically significant differences, indicating that 6D-skull tracking is not dependent on the skull's positioning angle. Furthermore, the gamma passing rate analysis was conducted to quantitatively assess the dosimetric differences arising from variations in patient positioning. Our results demonstrated that under all tested conditions, the gamma passing rates exceeded the clinically accepted threshold of 95%, confirming the clinical adequacy of both tracking methods in maintaining treatment precision.In clinical practice, patients do not need to maintain a strict supine position.Clinical recommendations should prioritize patient comfort and safety without imposing overly strict requirements

    Keywords: CyberKnife, skull tracking, non-standard positioning, dual-panel imaging system, Radiotherapy

    Received: 02 Jul 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Huang, Zhang, Dong, Bian, Lin, Xu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ying Li, Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.