Abstract

PurposeTo verify the intrafractional tracking accuracy in infrared (IR) marker-based hybrid dynamic tumour tracking irradiation (“IR Tracking”) with the Vero4DRT. Materials and methodsThe gimballed X-ray head tracks a moving target by predicting its future position from displacements of IR markers in real-time. Ten lung cancer patients who underwent IR Tracking were enrolled. The 95th percentiles of intrafractional mechanical (iEM95), prediction (iEP95), and overall targeting errors (iET95) were calculated from orthogonal fluoroscopy images acquired during tracking irradiation and from the synchronously acquired log files. ResultsAveraged intrafractional errors were (left–right, cranio-caudal [CC], anterior–posterior [AP])=(0.1mm, 0.4mm, 0.1mm) for iEM95, (1.2mm, 2.7mm, 2.1mm) for iEP95, and (1.3mm, 2.4mm, 1.4mm) for iET95. By correcting systematic prediction errors in the previous field, the iEP95 was reduced significantly, by an average of 0.4mm in the CC (p<0.05) and by 0.3mm in the AP (p<0.01) directions. ConclusionsPrediction errors were the primary cause of overall targeting errors, whereas mechanical errors were negligible. Furthermore, improvement of the prediction accuracy could be achieved by correcting systematic prediction errors in the previous field.

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