During Head and Neck treatment, some patients complain of claustrophobia due to the fully closed thermoplastic head masks. Recently introduced open mask solve this by exposing the patients' eyes, nose, and mouth. This study investigates the immobilization capability of open masks and proposes new CTV to PTV expansion margins for them. Open masks were deformed to custom-fit two volunteers using “C” size head pillows on a CT. After a number of days, the volunteers found the most comfortable position on the Linac treatment couch in the mask. A 3-D skin tracking system acquired a reference surface per volunteer. An ROI consisting of the eyes, nose, mouth, and part of cheek was selected per volunteer. The volunteer's setup ROI was tracked and rigidly registered to the reference ROI to calculate the skin surface's translation and rotation relative to the reference surface. The mask was removed, and the volunteer was asked to sit up. The setup was repeated five times to simulate daily setup uncertainties. In a second test, volunteers tried to remain still in the mask for 10 minutes to simulate the duration of a typical treatment. We recorded the translational and rotational real time deltas and the maximum deltas. The Results Table shows, per volunteer, the average deltas over the 5 setups and the corresponding standard deviations. We also report the maximum delta from reference observed during the 10-minute monitoring interval. We observed that the real time deltas increase slightly with time spent on the table, which is to be expected. Using a commonly accepted guideline (2.5×average + 0.7×standard deviation), we calculate the implied CTV to PTV expansion. Open masks generally solve claustrophobia. Based on our preliminary study, the conventional CTV to PTV expansion (3, 3, 3)mm should be altered to (2, 4, 4) mm for open mask usage. The open masks appear to provide sufficient immobilization. More volunteer study is scheduled to be done in the next several months.Poster Viewing Abstract 3389; TableStudy results (real time deltas)VolunteerMetricVertical (mm)Lateral (mm)Longitudinal (mm)Yaw (degrees)Roll (degrees)Pitch (degrees)1Average delta-0.9-1.7-0.3-0.10.41.31St. dev. of delta0.861.190.550.890.840.491Max delta in 10 minutes0.40.60.70.20.3-0.31Expansion1.73.40.50.31.73.62Average delta0.1-0.21.20.50.50.02St. dev. of delta2.120.451.100.520.481.022Max delta in 10 minutes0.40.60.70.20.3-0.32Expansion1.50.23.81.61.71.0 Open table in a new tab
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