Original paper
Patient positioning for fractionated precision radiation treatment of targets in the head using fiducial markers

https://doi.org/10.1016/0167-8140(94)90088-4Get rights and content

Abstract

When irradiating targets in the brain, an accurately localised dose is often needed. One crucial moment to achieve this is the positioning of the patient. We have developed a positioning method where the patient is immobilised with a bite block and a head mould, and where the position of the target is determined by X-ray imaging of fiducial markers that are placed in the patient's skull. A method for computing the transformation needed to move the target from the observed to the prescribed position and orientation is described. This method uses the information from two orthogonal X-ray images and takes measurement errors and data from three or more markers into account. Results from using the method clinically in proton beam therapy are given.

References (8)

  • W.E. Butler et al.

    Stereotactic alignment for Bragg peak radiosurgery

  • J.I. Fabrikant et al.

    Heavy charged particle Bragg peak radiosurgery for intracranial vascular disorders

    Radiat. Res. (Suppl.)

    (1985)
  • P.K. Gall et al.

    Computer-assisted positioning of radiotherapy patients using implanted radioopaque fiducials

    Med. Phys.

    (1993)
  • M. Goitein et al.

    Planning proton therapy of the eye

    Med. Phys.

    (1983)
There are more references available in the full text version of this article.

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