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Jung, Cho, Kim, Moon, Min, Kim, Lee, Jung, Suh, and Choe: Analysis of Pitch and Yaw Deviations Using an Aid-Pillow for the Head and Neck Cancer on the TomoTherapy
Original Article

Progress in Medical Physics 2013;24(1):54-60.

Published online: 20 March 2013

DOI: https://doi.org/10.14316/pmp.2013.24.1.54

Analysis of Pitch and Yaw Deviations Using an Aid-Pillow for the Head and Neck Cancer on the TomoTherapy

Jae Hong Jung∗, †, Kwang Hwan Cho∗, Yong Ho Kim∗, Seong Kwon Moon∗, Chul Kee Min∗, Eun Seog Kim∗, Kyung Bae Lee†, Joo Young Jung†, Tae Suk Suh†, Bo Young Choe†,

∗Department of Radiation Oncology, College of Medicine, Soonchunhyang University, Bucheon, Korea

†Department of Biomedical Engineering and Research Institute of Biomedical Engineering, The Catholic University of Korea, Seoul, Korea

책임저자：조광환, (420-767) 경기도 부천시 원미구 조마루로 170 순천향대학교 부천병원 방사선종양학과 Tel: 032)621-5881, Fax: 032)621-5885 E-mail: medphy@schmc.ac.kr

Received 12 December 2012       Accepted 6 March 2013

Copyright © 2013 Korean Society of Medical Physics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this study was to analysis of the pitch and yaw deviations with or without using an aid-pillow for the head and neck cancer on the TomoTherapy. A total of 14 head and neck patients were selected to without-group (n=7) and with-group (n=7). A total of 333 MVCT image sets used to evaluate the translational (lateral, longitudinal and vertical) and rotational adjustments (pitch, roll and yaw) with 153 and 180 MVCT image sets at without- and with-group, respectively. Deviations of without- and with-groups were 0.12o and 0.09o, respectively at pitch. And, deviations without- and with-groups were 0.47o and 0.17o, respectively at yaw. In generally, with-group had reduced than without-group for the pitch and yaw deviations. Therefore, using an aid-pillow, it will able to increase the reproducibility of treatment for the head and neck cancer patients on the TomoTherapy.

Keywords: TomoTherapy, Head and neck cancer, Aid-pillow, Pitch, Yaw

References

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Fig. 1.
The sagittal view of kVCT image (a) with- and (b) without using an aid-pillow. Arrow indicates the location each of without or with aid-pillow (Wedge type; approximately 100 mm×250 mm 40 mm; angle=approximately 22°).
pmp-24-54f1.tif
Fig. 2.
These 4-spilt figures are (a) kVCT (gray) and (b∼d) MVCT images (cyan) for head and neck patients without using an aid-pillow. Dots are spinal cord (green), mandible (blue), tongue (violet) and another normal tissue as OARs. Arrow (red) indicates the vicinity of the cervical 7th area in MVCT image and, the location curvature area on same level in overall images. Here, the sagittal view of (c) MVCT image with the curvature of neck area through daily MVCT imaging.
pmp-24-54f2.tif
Fig. 3.
The box plots show that the mean, standard deviation, and minimal/maximal values of pitch and yaw deviations from a total of 14 patients in this study (without aid-pillow and with aid-pillow groups).
pmp-24-54f3.tif
Table 1.
Patient characteristics with and without using an aid-pillow.
Patient Sex Diagnosis Aid-pillow (N/Y) Fractions (#) MVCT image set (#) Tumor length (mm)
1 M Oropaharynx N 28 43 180
2 F Nasopharynx N 10 42 170
3 M Nasopharynx N 30 44 220
4 M Nasopharynx N 23 51 215
5 M Nasopharynx N 28 43 185
6 M Tonsilar N 24 42 180
7 M Tonsilar N 10 41 155
8 M Oropaharynx Y 25 39 165
9 M Nasopharynx Y 12 37 115
10 M Nasopharynx Y 30 42 210
11 M Nasopharynx Y 33 44 170
12 M Hypopharynx Y 30 64 165
13 M Tonsilar Y 30 38 150
14 M Tonsilar Y 20 34 170

N: without aid-pillow; Y: with aid-pillow.

Table 2.
Translational and rotational adjustments proposed by Van Herk16) using data from all patients.
Direction Aid-pillow
Without With Without With Without With
Mg Σg σg
Lateral (mm) 2.73 2.07 1.17 1.09 3.38 0.78
Longitudinal (mm) 1.84 1.38 1.17 0.56 1.13 1.59
Vertical (mm) 4.59 2.83 2.04 1.54 4.48 1.02
Pitch (o) 0.36 0.29 0.12 0.09 0.39 0.28
Roll (o) 0.47 0.37 0.18 0.14 0.50 0.29
Yaw (o) 0.55 0.33 0.47 0.17 0.26 0.36

Mg: group systematic error; Σg: SD of systematic error, σg: SD of random error.

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