Verification of in-treatment tumor position using kilovoltage cone-beam computed tomography: a preliminary study

Keiichi Nakagawa, Hideomi Yamashita, Kenshiro Shiraishi, Hiroshi Igaki, Atsuro Terahara, Naoki Nakamura, Kuni Ohtomo, Shigeki Saegusa, Takashi Shiraki, Takashi Oritate, Kiyoshi Yoda
International Journal of Radiation Oncology, Biology, Physics 2007 November 15, 69 (4): 970-3
Three-dimensional tumor position during rotational dose delivery was evaluated by acquiring in-treatment kilovoltage (kV) cone-beam CT (CBCT) to ensure treatment quality. The CBCT projection data of a phantom were acquired during rotational megavoltage (MV) dose delivery up to 6 Gy to evaluate image quality under MV beam irradiation. A lung tumor patient was treated with a total dose of 48 Gy in four fractions, each fraction including seven coplanar and noncoplanar beams, as well as a full-angle rotational beam. Tumor registration was performed between a planning CT image and a CBCT image immediately after patient setup. The patient couch was adjusted according to the registration results, and then the registration was repeated three times: immediately before treatment, during treatment, and immediately after treatment. The phantom image quality of the kV CBCT was not visually degraded up to the rotational MV dose of 6 Gy. Tumor position during rotational dose delivery was verified for the first time using kV CBCT.

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