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dc.contributor.authorGrimwood, A
dc.contributor.authorThomas, K
dc.contributor.authorKember, S
dc.contributor.authorAldis, G
dc.contributor.authorLawes, R
dc.contributor.authorBrigden, B
dc.contributor.authorFrancis, J
dc.contributor.authorHenegan, E
dc.contributor.authorKerner, M
dc.contributor.authorDelacroix, L
dc.contributor.authorGordon, A
dc.contributor.authorTree, A
dc.contributor.authorHarris, EJ
dc.contributor.authorMcNair, HA
dc.date.accessioned2022-01-31T15:21:45Z
dc.date.available2022-01-31T15:21:45Z
dc.identifier.citationPhysics and imaging in radiation oncology, 2021, 18 pp. 68 - 77en_US
dc.identifier.issn2405-6316
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4989
dc.identifier.eissn2405-6316en_US
dc.identifier.eissn2405-6316
dc.identifier.doi10.1016/j.phro.2021.05.003en_US
dc.identifier.doi10.1016/j.phro.2021.05.003
dc.description.abstract<h4>Background and purpose</h4>Transperineal ultrasound (TPUS) is used clinically for directly assessing prostate motion. Factors affecting accuracy and precision in TPUS motion estimation must be assessed to realise its full potential.<h4>Methods and materials</h4>Patients were imaged using volumetric TPUS during the Clarity-Pro trial (NCT02388308). Prostate motion was measured online at patient set-up and offline by experienced observers. Cone beam CT with markers was used as a comparator and observer performance was also quantified. The influence of different clinical factors was examined to establish specific recommendations towards efficacious ultrasound guided radiotherapy.<h4>Results</h4>From 330 fractions in 22 patients, offline observer random errors were 1.5 mm, 1.3 mm, 1.9 mm (left-right, superior-inferior, anteroposterior respectively). Errors increased in fractions exhibiting poor image quality to 3.3 mm, 3.3 mm and 6.8 mm. Poor image quality was associated with inconsistent probe placement, large anatomical changes and unfavourable imaging conditions within the patient. Online matching exhibited increased observer errors of: 3.2 mm, 2.9 mm and 4.7 mm. Four patients exhibited large systematic residual errors, of which three had poor quality images. Patient habitus showed no correlation with observer error, residual error, or image quality.<h4>Conclusions</h4>TPUS offers the unique potential to directly assess inter- and intra-fraction motion on conventional linacs. Inconsistent image quality, inexperienced operators and the pressures of the clinical environment may degrade precision and accuracy. Experienced operators are essential and cross-centre standards for training and QA should be established that build upon current guidance. Greater use of automation technologies may further minimise uncertainties.en_US
dc.formatElectronic-eCollectionen_US
dc.format.extent68 - 77en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.titleFactors affecting accuracy and precision in ultrasound guided radiotherapy.en_US
dc.typeJournal Article
dcterms.dateAccepted2021-05-11
rioxxterms.versionVoRen_US
rioxxterms.versionofrecord10.1016/j.phro.2021.05.003en_US
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.relation.isPartOfPhysics and imaging in radiation oncologyen_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume18en_US
pubs.embargo.termsNot knownen_US
dc.contributor.icrauthorTree, Alisonen_US
dc.contributor.icrauthorMcNair, Helenen_US


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