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Proposed Method to Broaden Inclusion Potential of Patients Able to Use the Calypso Tracking System in Prostate Radiotherapy

D Fiedler

D Fiedler*, H Kuo , W Bodner , W Tome , Montefiore Medical Center, Bronx, NY


SU-F-J-142 (Sunday, July 31, 2016) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: To introduce a non-standard method of patient setup, using BellyBoard immobilization, to better utilize the localization and tracking potential of an RF-beacon system with EBRT for prostate cancer.

Methods: An RF-beacon phantom was imaged using a wide bore CT scanner, both in a standard level position and with a known rotation (4° pitch and 7.5° yaw). A commercial treatment planning system (TPS) was used to determine positional coordinates of each beacon, and the centroid of the three beacons for both setups. For each setup at the Linac, kV AP and Rt Lateral images were obtained. A full characterization of the RF-beacon system in clinical mode was completed for various beacons’ array-to-centroid distances, which includes vertical, lateral, and longitudinal offset data, as well as pitch and yaw offset measurements for the tilted phantom. For the single patient who has been setup using the proposed BellyBoard method, a supine simulation was first obtained. When abdominal protrusion was found to be exceeding the limits of the RF-Beacon system through distance-based analysis in the TPS, the patient is re-simulated prone with the BellyBoard. Array to centroid distance is measured again in the TPS, and if found to be within the localization or tracking region it is applied.

Results: Characterization of limitations for the RF-beacon system in clinical mode showed acceptable consistency of offset determination for phantom setup accuracy. The non-standard patient setup method reduced the beacons’ centroid-to-array distance by 8.32cm, from 25.13cm to 16.81cm; completely out of tracking range (greater than 20cm) to within setup tracking range (less than 20cm).

Conclusion: Using the RF-beacon system in combination with this novel patient setup can allow patients who would otherwise not be candidates for beacon enhanced EBRT to now be able to benefit from the reduced PTV margins of this treatment method.

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