An analysis of stabilisation for head and neck image guided IMRT

AimsDaily IGRT using kV imaging has allowed an enhanced field of view for head and neck IMRT patients. This has allowed the treating radiation therapists to note set-up error beyond traditional spatial or translational and include angular error. This study compares two stabilisation methods for head and neck IGRT and compares spatial and angular error between them.Methods and materials9 patients were assessed using a CIVCO S-board and generic Silverman head rest and another 9 patients were assessed using a CIVCO S-board with a CIVCO S-type vac-fix bag. Daily IGRT was undertaken and pre-intervention set-up error collected. This was inclusive of error in the lateral, longitudinal and vertical plans and angular discrepancy between cervical spine 1 and cervical spine 7.ResultsThe vac-fix solution provided a significant reduction in the systematic yaw position (anterior–posterior) (p = 0.04). It also reduced the mean resultant systematic angular error significantly (p = 0.01). The lateral systematic spatial error was decreased significantly by the vac-fix (p = 0.03) whilst the longitudinal and vertical systematic errors were not. The differences in random error between the two stabilisation solutions were not significant.ConclusionkV IGRT has allowed treating radiation therapists to note angular error in the head and neck region. This can be difficult to deal with using only IGRT. Stabilisation solutions in the head and neck region must be able to manage both spatial and angular set-up error. The vac-fix solution has improved the management of angular error for head and neck IMRT patients.