Svestad Jørund Graadal, Mikalsen Stine Gyland, Heydari Mojgan, Francke Regine Hjort, Hervani Maziar, Hellebust Taran Paulsen
Department of Medical Physics, Oslo University Hospital, Oslo, Norway.
Department of Oncology, Oslo University Hospital, Oslo, Norway.
Adv Radiat Oncol. 2025 Jun 9;10(9):101829. doi: 10.1016/j.adro.2025.101829. eCollection 2025 Sep.
Real-time video assistance in combination with surface guidance (SG) has been introduced in radiation therapy. In this study, we wanted to investigate the efficiency and accuracy of this new procedure for patients with right-sided locoregional breast cancer with special focus on the arm position.
Twenty-six patients were included. Each patient was positioned using SG with real-time video assistance for half of the fractions. For the other half of the fractions, patient's surface was captured (including arm position) and visually compared to the reference surface before adjusting the patient position. This process was repeated until the patient position was acceptable. Pretreatment cone beam computer tomography (CBCT) was acquired at every fraction. Couch shifts after CBCT match were used to calculate systematic and random errors. CBCTs were also used to compare the actual treatment position of the nodal areas to the planned position. To analyze setup efficiency, 6 time points during the whole treatment procedure were recorded and analyzed.
Our results showed negligible differences in setup accuracy when comparing couch shifts after CBCT match and the treated position of the nodal area. The group mean of the vertical couch shifts was significantly different between the 2 setup procedures ( = .03). The systematic error and the random error, however, were identical or almost identical. No other metrics regarding setup accuracy were significantly different. Setup efficiency was significantly improved using SG with real-time video assistance. By implementing real-time video assistance, setup time was reduced by an average of 40 seconds.
By implementing real-time video assistance in the setup of patients with right-sided locoregional breast cancer using SG, setup time can be significantly reduced without compromising setup accuracy.
放射治疗中已引入实时视频辅助结合体表引导（SG）技术。在本研究中，我们旨在调查这种新方法对右侧局部区域性乳腺癌患者的效率和准确性，特别关注手臂位置。
纳入26例患者。每位患者在一半的分次治疗中使用SG结合实时视频辅助进行定位。对于另一半分次治疗，在调整患者位置之前，采集患者体表（包括手臂位置）并与参考体表进行视觉比较。重复此过程，直到患者位置可接受。每次分次治疗前均获取锥形束计算机断层扫描（CBCT）。利用CBCT匹配后的治疗床移位来计算系统误差和随机误差。CBCT还用于比较淋巴结区域的实际治疗位置与计划位置。为分析摆位效率，记录并分析了整个治疗过程中的6个时间点。
我们的结果显示，比较CBCT匹配后的治疗床移位和淋巴结区域的治疗位置时，摆位准确性的差异可忽略不计。两种摆位程序之间垂直治疗床移位的组均值存在显著差异（ = 0.03）。然而，系统误差和随机误差相同或几乎相同。关于摆位准确性的其他指标均无显著差异。使用SG结合实时视频辅助可显著提高摆位效率。通过实施实时视频辅助，摆位时间平均减少了40秒。
在右侧局部区域性乳腺癌患者摆位过程中实施实时视频辅助结合SG技术，可在不影响摆位准确性的前提下显著减少摆位时间。
