Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"Message de la rédactrice en chef","authors":"Amanda Bolderston EdD, MSc, MRT(T), FCAMRT","doi":"10.1016/j.jmir.2024.101829","DOIUrl":"10.1016/j.jmir.2024.101829","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101829"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of radiation exposure in spinal surgeries: Comparing C-Arm, CT navigation, and O-Arm techniques","authors":"Kamran Shirbache , Melika Heidarzadeh , Reihane Qahremani , Amin Karami , Shaghayegh Karami , Elham Madreseh , Julio J. Jauregui , Ebrahim Najafzadeh , Ali Kazemi , Mohammad Hossein Nabian","doi":"10.1016/j.jmir.2024.101831","DOIUrl":"10.1016/j.jmir.2024.101831","url":null,"abstract":"<div><h3>Introduction</h3><div>Advanced imaging techniques, such as C-arm fluoroscopy, O-arm, and CT navigation, are integral to achieving precision in orthopedic surgeries. However, these technologies also expose patients, surgeons, and operating room staff to varying levels of radiation. This systematic review and meta-analysis evaluate the radiation exposure (RE) associated with these imaging modalities and their impact on surgical outcomes.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted following PRISMA guidelines, resulting in 2,725 identified articles. After removing duplicates and screening for eligibility, 24 studies were included in the analysis. Radiation exposure data, measured in milliSieverts (mSv) and milliGray (mGy), were standardized using conversion formulas. Quality assessments were performed using the Newcastle-Ottawa Scale (NOS) and ROB2 tools. Statistical analysis was conducted using random-effects models for comparing radiation exposure and fixed-effects models for secondary outcomes.</div></div><div><h3>Results</h3><div>The meta-analysis included 11 studies: 8 studies comparing C-arm and CT navigation, and 3 studies comparing C-arm and O-arm technologies. The analysis revealed that CT navigation is associated with significantly higher RE compared to C-arm (Standardized Mean Difference (SMD): 4.73, 95% Confidence Interval (CI): 2.44 to 7.03; p < 0.0001). In contrast, there was no significant difference in RE between O-arm and C-arm (SMD: 1.34, 95% CI: -0.17 to 2.85; p = 0.082). Secondary analyses showed no significant differences in surgery duration or hospitalization length between CT navigation and C-arm techniques.</div></div><div><h3>Discussion</h3><div>The results of this meta-analysis underscore the trade-offs between radiation exposure and surgical precision. While CT navigation significantly increases RE compared to C-arm fluoroscopy, it offers superior accuracy, particularly in critical precision surgeries such as spinal interventions. The lack of significant difference in RE between O-arm and C-arm technologies suggests that O-arm may provide a balanced approach, offering enhanced accuracy with radiation levels similar to C-arm. However, the significant heterogeneity among studies and inconsistent reporting of secondary outcomes indicate the need for further research. Future studies should focus on refining imaging techniques to optimize the balance between radiation safety and surgical accuracy.</div></div><div><h3>Conclusion</h3><div>C-arm imaging generally results in lower radiation exposure compared to CT navigation, making it preferable for standard procedures where extreme precision is not as critical. However, CT navigation's superior accuracy justifies its use in precision surgeries despite the higher radiation exposure. O-arm technology, with its comparable RE to C-arm and enhanced accuracy, represents a beneficial option where available. Ongoing research should aim","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101831"},"PeriodicalIF":1.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic segmentation of cardiac structures can change the way we evaluate dose limits for radiotherapy in the left breast","authors":"Murilo Guimarães Borges ,&nbsp;Joyce Gruenwaldt ,&nbsp;Danilo Matheus Barsanelli ,&nbsp;Karina Emy Ishikawa ,&nbsp;Silvia Radwanski Stuart","doi":"10.1016/j.jmir.2024.101844","DOIUrl":"10.1016/j.jmir.2024.101844","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy is a crucial part of breast cancer treatment. Precision in dose assessment is essential to minimize side effects. Traditionally, anatomical structures are delineated manually, a time-consuming process subject to variability. automatic segmentation, including methods based on multiple atlases and deep learning, offers a promising alternative. For the radiotherapy treatment of the left breast, the RTOG 1005 protocol highlights the importance of cardiac delineation and the need to minimize cardiac exposure to radiation. Our study aims to evaluate dose distribution in auto-segmented substructures and establish models to correlate them with dose in the cardiac area.</div></div><div><h3>Methods and materials</h3><div>Anatomical structures were auto-segmented using TotalSegmentator and Limbus AI. The relationship between the volume of the cardiac area and of organs at risk was assessed using log-linear regressions.</div></div><div><h3>Results</h3><div>The mean dose distribution was considerable for LAD (left anterior descending coronary artery), heart, and left ventricle. The volumetric distribution of organs at risk is evaluated for specific RTOG 1005 isodoses. We highlight the greater variability in the absolute volumetric evaluation. Log-linear regression models are presented to estimate dose constraint parameters. We highlight a greater number of highly correlated comparisons for absolute dose-volume assessment.</div></div><div><h3>Conclusions</h3><div>Dose-volume assessment protocols in patients with left breast cancer often neglect cardiac substructures. However, automatic tools can overcome these technical difficulties. In this study, we correlated the dose in the cardiac area with the doses in specific substructures and suggested limits for planning evaluation. Our data also indicates that statistical models could be applied in the assessment of those substructures where an automatic segmentation tool is not available. Our data also shows a benefit in reporting absolute dose-volume thresholds for future cause-effect assessments.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101844"},"PeriodicalIF":1.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term effects of gamma radiation on inflammatory and apoptotic biomarkers in nuclear medicine staff","authors":"Mahdiyeh Mirnam Niha,&nbsp;Mehdi Salehi Barough,&nbsp;Elham Saniei,&nbsp;Nooshin Banaee","doi":"10.1016/j.jmir.2024.101832","DOIUrl":"10.1016/j.jmir.2024.101832","url":null,"abstract":"<div><h3>Background</h3><div>Gamma radiation at low doses might have potential health effects in long-term exposure. The current study was aimed to search cell death pathway and inflammatory biomarkers in nuclear medicine workers with long-term exposure to gamma radiation.</div></div><div><h3>Material and Methods</h3><div>Fifty cases with a history of 10 years’ exposure to gamma radiation and 30 normal individuals were included in the current study. Blood samples were collected and then analyzed for gene expression of apoptotic markers, pro-inflammatory factor TNF-a, and antioxidant enzymes using Real Time PCR (RT-PCR) in both groups. Protein expressions were examined by Western blot and trace elements were analyzed using atomic absorption spectrometry.</div></div><div><h3>Result</h3><div>In exposed group, the expression of pro-apoptotic markers (CASP 8, CASP 3, Casp 9, and BAX genes), the pro-inflammatory factor TNF and antioxidant enzymes such as SOD, CAT, and GPX was increased in comparison with control group (<em>P</em> &lt; 0.05). However, Bcl2 expression was decreased in exposed group. In addition, there was a significant and inverse correlation between serum levels of zinc and selenium in the exposed subjects compared to the control group (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our results revealed the potential role of low and chronic doses of gamma radiation in triggering apoptosis and inflammatory responses. However, more studies are needed to consolidate our findings.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101832"},"PeriodicalIF":1.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographers’ knowledge, clinical expertise and application of pain management strategies in the radiology department – results from a qualitative focus group","authors":"Róisín O’ Regan ,&nbsp;Mohammad Rawashdeh ,&nbsp;Mark F. McEntee ,&nbsp;Niamh Moore ,&nbsp;Ben Treanor ,&nbsp;Magdi Ali ,&nbsp;Andrew England","doi":"10.1016/j.jmir.2024.101833","DOIUrl":"10.1016/j.jmir.2024.101833","url":null,"abstract":"<div><h3>Background</h3><div>Radiographers are frequently involved in imaging patients in pain thus requiring a heightened awareness and focus on this crucial issue.</div></div><div><h3>Purpose</h3><div>To explore the challenges radiographers encounter when imaging patients in pain and to identify strategies that could be implemented to improve overall patient-centered care.</div></div><div><h3>METHODS</h3><div>A qualitative research study with a single focus group (FG) was conducted using six radiographers working within Irish hospitals. The research questions focused on pain management challenges in the radiology department, particularly identifying radiographers' current practices and strategies to address these challenges. The FG was moderated and video-recorded to facilitate comprehensive analysis. The audio obtained from the FG was transcribed and then analyzed thematically.</div></div><div><h3>Results</h3><div>Data from the FG identified four main themes: <em>1) consequences of pain management, 2) communication, 3) professional experience</em>, and <em>4) barriers</em>. In addition, the study highlighted the absence of current protocols, policies, and guidelines in practice for the effective management of challenges associated with imaging patients in pain within the radiology department.</div></div><div><h3>Conclusion</h3><div>The primary challenges identified include the stress experienced by both staff and patients, the potential for obtaining suboptimal images, concerns regarding patient safety, and adverse effects on image quality. This study elucidates the manner in which patient discomfort adversely impacts the imaging process and delineates the potential implications for radiographers aiming to achieve optimal image quality. At present, there are no established policies or procedures within the radiology department to direct the imaging of patients in pain.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101833"},"PeriodicalIF":1.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence education in medical imaging: A scoping review","authors":"Su Jean Loi ,&nbsp;Wenhui Ng ,&nbsp;Christopher Lai,&nbsp;Eric Chern-Pin Chua","doi":"10.1016/j.jmir.2024.101798","DOIUrl":"10.1016/j.jmir.2024.101798","url":null,"abstract":"<div><h3>Background</h3><div>The rise of Artificial intelligence (AI) is reshaping healthcare, particularly in medical imaging. In this emerging field, clinical imaging personnel need proper training. However, formal AI education is lacking in medical curricula, coupled with a shortage of studies synthesising the availability of AI curricula tailored for clinical imaging personnel. This study therefore addresses the question “what are the current AI training programs or curricula for clinical imaging personnel?”</div></div><div><h3>Methods</h3><div>This review follows Arksey &amp; O'Malley's framework and the PRISMA Extension for Scoping Reviews checklist. Six electronic databases were searched between June and September 2023 and the screening process comprised two stages. Data extraction was performed using a standardised charting form. Data was summarised in table format and thematically.</div></div><div><h3>Results</h3><div>Twenty-two studies were included in this review. The goals of the curriculum include enhancing AI knowledge through the delivery of educational content and encouraging practical application and skills development in AI. The learning objectives comprise technical proficiency and model development, foundational knowledge and understanding, literature review and information utilisation, and practical application and problem-solving skills. Course content spanned nine areas, from fundamentals of AI to imaging informatics. Most curricula adopted an online mode of delivery, and the program duration varied significantly. All programs utilised didactic presentations, with several incorporating additional teaching methods and activities to fulfil curriculum goals. The target audiences and participants primarily involved radiology residents, while the creators and instructors comprised a multidisciplinary team of radiology and AI personnel. Various tools and resources were utilised, encompassing online courses and cloud-based notebooks. The curricula were well-received by participants, and time constraint emerged as a major challenge.</div></div><div><h3>Conclusion</h3><div>This scoping review provides an overview of the AI educational programs from existing literature to guide future developments in AI educational curricula. Future education efforts should prioritise evidence-based curriculum design, expand training offerings to radiographers, increase content offerings in imaging informatics, and effectively utilise different teaching strategies and training tools and resources in the curriculum.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101798"},"PeriodicalIF":1.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary clinical evaluation (PCE): A transnational scoping review of current radiography practice","authors":"Messiah Anudjo ,&nbsp;Sharon Docherty ,&nbsp;Theophilus Akudjedu","doi":"10.1016/j.jmir.2024.101815","DOIUrl":"10.1016/j.jmir.2024.101815","url":null,"abstract":"<div><h3>Introduction</h3><div>Image interpretation by radiographers has gained widespread recognition; however, current evidence provides very limited knowledge of the state and scope of practice transnationally. This study therefore sought to explore the current state and scope of preliminary clinical evaluation (PCE) practice to further understand international best practices in terms of policy, training and education, and practice competence of radiographers when carrying out PCE.</div></div><div><h3>Method</h3><div>A comprehensive literature search was completed via federated electronic databases (EBSCOhost and Web of Science) and professional radiography platforms for journal articles and policy or practice guidance documents, respectively. Data were charted from eligible studies following screening of articles in accordance with the predefined eligibility criteria. Themes were generated using inductive narrative analysis.</div></div><div><h3>Results</h3><div>Thirty-one peer reviewed articles and 5 radiography practice policy documents were identified. Over 60% of the included studies were carried out in the United Kingdom and Australia with about 60% focused on projectional radiography of the appendicular and axial skeletons. Three main themes were developed and included: scope of PCE practice and implementation; PCE proficiency indicators; factors influencing PCE participation and performance.</div></div><div><h3>Conclusion</h3><div>Gaps exist around defined scope of practice, standardisation, commenting format and compliance with policy. There is very limited evidence around PCE practice in cross-sectional imaging, thus, it is difficult to ascertain the current state and scope of practice internationally. There is a need for countries to develop standard commenting frameworks as well as enforcement of compliance. Additionally, more research is required to ascertain the competence and benefits of PCE practice within cross sectional imaging.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101815"},"PeriodicalIF":1.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The extended and advanced clinical practices of radiographers worldwide: A scoping review","authors":"Sarah Carlier ,&nbsp;Lucia Fernandes Mendes ,&nbsp;Leonor Pedreira Lago ,&nbsp;Sandrine Ding","doi":"10.1016/j.jmir.2024.101818","DOIUrl":"10.1016/j.jmir.2024.101818","url":null,"abstract":"<div><h3>Aims</h3><div>This scoping review aimed to (1) map the global evidence on extended and advanced clinical practices (ACP) performed by radiographers, and (2) provide an overview of the pillars (clinical practice, leadership and management, education, and research) they relate to, as well as the radiology areas and the geographical location where they were developed.</div></div><div><h3>Methods</h3><div>Articles were searched in MEDLINE, CINAHL and Embase, and grey literature in ProQuest Dissertation and Theses. Studies concerning radiographers or healthcare professionals with an equivalent title (e.g., radiation technologist) performing extended role or an ACP, regardless of their medical imaging setting or country were included. The review was undertaken following JBI methodological guidance for scoping reviews. The titles and abstracts of the retrieved studies, and then the full texts of the selected papers were assessed by two independent reviewers.</div></div><div><h3>Results</h3><div>A total of 2617 records were identified, of which 174 articles were included. Most of them reported practices performed in the UK (63 %), and less in Canada (19 %) and Australia (6 %). Advanced or extended practices were linked to all four pillars, but most concerned the clinical practice pillar. The main activities for this pillar were radiograph reporting (22 %), patient assessment and management (consultation) in radiotherapy (RT; 21 %), RT treatment planning (14 %) and ultrasound practice (13 %). Studies have also shown radiographers performing breast biopsies, medication prescription, and ultrasound and CT scan reports. The main fields of radiology concerned by the changing roles were radiotherapy (42 %) and conventional radiography (36 %). </div></div><div><h3>Conclusion</h3><div>Extended or advanced practices are achieved through a wide variety of activities around the world. This scoping review constitutes a knowledge base on the evolution of the practices of radiographers and should contribute to their recognition and development.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101818"},"PeriodicalIF":1.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of magnetic resonance imaging (MRI) availability and cost in Zimbabwe: Implications and strategies for improvement","authors":"Bornface Chinene ,&nbsp;Leon-say Mudadi ,&nbsp;Farai E. Mutasa ,&nbsp;Paridzai Nyawani","doi":"10.1016/j.jmir.2024.101819","DOIUrl":"10.1016/j.jmir.2024.101819","url":null,"abstract":"<div><h3>Introduction</h3><div>Resolution 60.29 (18) of the 60th United Nations World Health Assembly urges member states to gather, verify, update, and exchange information on health technologies, especially medical devices. This study assesses Zimbabwe's MRI service availability and cost, identifies disparities, and discusses implications for patient care and healthcare equity, proposing evidence-based improvement strategies.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted to capture the specifications of all the MRI equipment, including manufacturer, type of magnet, magnetic field strength, location, and installation year. Data obtained was analyzed using the Stata 13.</div></div><div><h3>Results</h3><div>As of 27 April 2024, there were 11 MRI scanner units in Zimbabwe, 9 of the MRI machines were operational, while 2 were not operational. The majority of these scanners (8 [73 %]) are located in the private health sector. All the units are situated in urban provinces. Out of the 11 units, 7 (64 %) are located in the Harare Metropolitan Province, 3 (27 %) are in the Bulawayo Metropolitan Province, and 1 (9 %) is in the Midlands Province. All MRI examinations, except for head scans, were more expensive in the private sector compared to the public sector.</div></div><div><h3>Conclusions</h3><div>The survey on MRI equipment availability and utilization in Zimbabwe revealed major differences in access to this critical diagnostic tool. Strategies for improvement include targeted investments in MRI units, funding programs for healthcare providers, equipment-sharing initiatives, subsidy programs, standardized protocols, and strategic collaborations between Original Equipment Manufacturers and the government.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101819"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immobilisation accuracy of double shell positioning system for stereotactic radiotherapy in patients with brain tumors","authors":"Giddi Mauryakrishna ,&nbsp;Shalini Singh ,&nbsp;Senthil Kumar SK ,&nbsp;KJ Maria Das ,&nbsp;Zafar Neyaz ,&nbsp;Kuntal Kanti Das ,&nbsp;Awadhesh Kumar Jaiswal","doi":"10.1016/j.jmir.2024.101817","DOIUrl":"10.1016/j.jmir.2024.101817","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Non-invasive frameless systems have paved its way for stereotactic radiotherapy treatments compared to gold standard invasive rigid frame-based systems as they are comfortable to patients, do not have risk of pain, bleeding, infection, frame slippage and have similar treatment efficacy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim and objective&lt;/h3&gt;&lt;div&gt;To estimate immobilisation accuracy (interfraction and intrafraction) and PTV margins with double shell positioning system (DSPS) using daily image guidance for stereotactic radiotherapy in patients with brain tumors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and method&lt;/h3&gt;&lt;div&gt;A prospective study was done in 19 cranial tumor patients with KPS ≥70, immobilized by the DSPS with mouth bite and treated with LINAC based image guided stereotactic radiotherapy. A PTV of 2 mm was given from the tumor. Patients were positioned by aligning the treatment room lasers to the marked isocentre on the DSPS. For all patients 3D-image registration (automatic bony anatomy) was performed by matching 1st CBCT images with the simulation reference CT (simCT) images to measure the 3D target displacement prior to the treatment delivery every day. The initial setup deviation/ interfraction motion- translational (medio-lateral-X, cranio-caudal-Y, anterior-posterior-Z) displacements in mm and rotational axis (pitch, roll, yaw) in degrees were documented. All transitional errors were corrected online. For residual Interfraction motion a 2nd CBCT was done after correction of initial setup errors and matched with simCT and treatment executed. To evaluate the intrafraction motion CBCT was done at end of every fraction and compared with 2nd CBCT images. Systematic and random errors were calculated and planning target volume (PTV) margins were estimated using van Herk formula.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 95 CBCT image data sets were evaluated. The initial setup relocation accuracy -mean (±SD) displacements for translational X, Y and Z directions were 1.2 (0.6), 1.0 (0.9), 0.5 (0.6) mm respectively and rotations were 0.6 (± 0.5), 0.1 (± 0.4), 0.60 (± 0.6) degrees for pitch, roll and yaw respectively. Post correction, the residual interfraction mean displacements in X, Y and Z directions were 0.1 (± 0.3), 0.2 (± 0.6), 0.3 (± 0.4) mm respectively. The population systematic and random translational errors were 0.2, 0.3, 0.3 and 0.6, 0.4, 0.4 respectively. For intrafraction motion, the mean (±SD) displacements were 0.3 (± 0.2), 0.3 (± 0.5), 0.4 (± 0.2) mm in X, Y and Z directions respectively with minimal rotations in all axis. The intrafraction population systematic and random errors were &lt;0.5 mm for all displacements. The online corrections decreased the interfraction PTV margins to 1.1, 1.1 and 1.2 mm in X, Y and Z directions respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Frameless DSPS system with mouth bite using image guidance achieved a setup accuracy of a millimeter for stereotactic treatment in cr","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101817"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}