Evaluation of the Effect of Patient-Specific Factors on Setup Errors in Different Patient Groups Treated with Image-Guided Radiotherapy
DOI:
https://doi.org/10.63187/ampas.46Keywords:
Patient Positioning, Setup Errors, Geometrical Uncertainties, BMI, Patient Specific Factors.Abstract
In contrast to conventional radiotherapy techniques, recently developed radiotherapy treatment systems incorporate integrated imaging technologies that enable the detection and correction of setup uncertainties during radiation delivery, thereby improving geometric accuracy and treatment conformality. Image-Guided Radiotherapy (IGRT) systems allow on-treatment imaging for precise target localization, facilitating radiation delivery to accurately defined target volumes while enhancing normal tissue sparing and enabling dose escalation with reduced geometric margins (1).
This study aimed to determine the patient specific parameters affecting setup errors in various patient groups treated with IGRT. This study conducted at the Department of Radiation Oncology, University of Health Sciences Gülhane Training and Research Hospital, and imaging data obtained from different patient groups treated with the Elekta Synergy IGRT system were evaluated to calculate setup errors. For statistical analysis of these setup errors SPSS (Statistical Package for the Social Sciences 20.0) was used.
Based on the analyses this study, patient-specific factors such as gender, body mass index (BMI), age, and treatment area has no effect on setup errors.
References
Xing, L.,Thorndyke, B.,Schreıbmann, E.,Yang, Y., Li, T., Kim, G., Luxton, G.,and Koong, A.2006. Overview of Image –Guided Radiation Therapy. Med.Dosi. 31(2), 91-112.
Gündem E. Utilization of Image Guided Radiation Therapy (IGRT) Systems In Patient Treatment And Quality Assurance. Ankara University Graduate School of Nuclear Sciences Department of Medical Physics Master Thesis. 2011.
Verellen, D.. Radiotherapy & Imaging. European Oncological Disease. 2007. Belgium
Sorcini B., Tilikidis A.. Clinical application of image-guided radiotherapy, IGRT. Cancer/Radiotherapie. 10. 252-257. 2006.
Herman M.G., Kruse J.J., and hagness C.R.. Guide to clinical use of portal imaging. Journal of Applied Clinical Medical Physics. 2000.1(2). 38-57.
Herman M.G., Balter J.M., Jaffray D.A., et al. Clinical use of electronic portal imaging: report of AAPM Radiation Therapy Committee Task Group 58. Med Phys. 2001.28;712–37.
J. J. Haslam, B.S.,Anthony, E. Lujan, A. J. Mundt, D. V. Bonta And J. C. Roeske. Setup Errors In Patients Treated With Intensity Modulated Whole Pelvic Radiation Therapy For Gynecological Malignancies. Medical Dosimetry, Vol. 30, No. 1, pp. 36-42, 2005.
Yo-Liang L., Shih-Neng Y., Ji-An L., Yao-Ching W., Chun-Yen Y., Ching-Hsiung S. and Shang-Wen C. Impact of body-mass factors on setup displacement in patients with head and neck cancer treated with radiotherapy using daily on-line image guidance. Radiation Oncology 2014, 9:19.
Johansen J., Bertelsen A., C. R. Hansen, Westberg J., Hansen O., Brink C. Set-up errors in patients undergoing image guided radiation treatment.Relationship to body mass index and weight loss. Acta Oncologica, 2008; 47: 1454_1458.
Zhao J., Zhang M.,| Zhai F., Wang H.,| Li X. Setup errors in radiation therapy for thoracic tumor patients of different body mass index. J Appl Clin Med Phys 2018; 19:3:27–31.
Mandal A., Singh P., Bera S., Kumar A., Singh D., Verma M., Rakesh A., Sinha A. Set-up Errors and Determination of Planning Target Volume Margins Protocol for Different Anatomical Sites in a Newly Established Tertiary Radiotherapy Centre in India. Asian J Oncol 2020;6:81–87.
Rudat V., Shi Y., Zhao R., Xu S. and Yu W. Setup accuracy and margins for surface-guided radiotherapy (SGRT) of head, thorax, abdomen, and pelvic target volumes. Scientific Reports | (2023) 13:17018
Xiao Y, Li Y, Wang M, Zhang L, Zhu J. Setup error analysis in pelvic VMAT using kV CBCT: impact of patient characteristics. Radiother Oncol. 2024;178:25–33.
Mulla F, Khan M, Ahmed S, et al. Influence of body mass and anthropometric factors on setup uncertainties in gynecologic radiotherapy. Adv Radiat Oncol. 2023;8(2):310–318.
Costin CJ, Marcu L. Correlation of BMI and setup errors in breast radiotherapy with portal imaging. Radiat Oncol J. 2025;43(1):14–22.
Johansen J, Ferris WS, Simpson DR. Setup errors and anthropometric factors: a quantitative IGRT analysis. Int J Radiat Oncol Biol Phys. 2022;112(3):710–717.
Zhao X, Wang Q, Chen J, Li R, Zhao Y. Thoracic tumor setup errors related to BMI and margin optimization. Radiother Oncol. 2025;183:17–26.
Mandal S, Verma V, Singh R, et al. Treatment site-specific PTV margin determination and setup accuracy. J Med Phys. 2025;50(1):58–67.
Ruan D, Li H, Zhao X, et al. Evaluation of setup errors and immobilization techniques for rectal cancer with daily CBCT. Med Phys. 2025;52(6):4421–4430.
Rudat V, Sommer M, Lüdemann L, et al. Multi-site assessment of setup accuracy and margin determination using SGRT and CBCT. Sci Rep. 2023;13(1):9982.
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