A pilot study evaluating the effectiveness of dual registration image guided radiotherapy in patients with oropharyngeal cancer

Goldsworthy, S. , Dakers, M. , Higgins, S. , Barnes, T. , Jankowska, P. , Dogramadzi, S. and Latour, J. M. (2017) A pilot study evaluating the effectiveness of dual registration image guided radiotherapy in patients with oropharyngeal cancer. Journal of Medical Imaging and Radiation Sciences, 48 (4). pp. 377-384. ISSN 1939-8654 Available from: http://eprints.uwe.ac.uk/31908

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PURPOSE: To determine the impact of Dual Registration (DR) image guided radiotherapy (IGRT) on clinical judgement and treatment delivery for patients with oropharyngeal cancer prior to implementation. METHODS Sixty four Cone Beam Computed Tomography images from ten retrospective patients were matched using standard clipbox registration (SCR) and DR. Three image guided radiotherapy specialist radiographers performed all registrations and evaluated by; intra-class correlation to determine interrater agreement, Bland-Altman with 95% Limits of Agreement to determine differences between SCR and DR procedures, changes in clinical judgment, time taken to perform registrations and radiographer satisfaction. RESULTS: Interrater agreement between radiographers using both SCR and DR was high (0.867 and 0.917 p=<0.0001). The 95% Limits of Agreement between SCR and DR procedures in the medio-lateral, cranial caudal, and ventro-dorsal translational directions were -6.40 to +4.91, -7.49 to +6.05, and -7.00 to +5.44 mm respectively. The medio-lateral direction demonstrated significant proportional bias (p=<0.001) suggesting non-agreement between SCR and DR. 80% of DR matches resulted in a change in clinical judgement to ensure maximum target coverage. Mean registration times for SCR and DR were 94 and 115 seconds respectively and radiographer’s found DR feasible and satisfactory. CONCLUSION: The standard method using SCR in patients with oropharyngeal cancer underestimates the deviation in the lower neck. In these patients DR is an effective IGRT tool to ensure target coverage of the inferior neck nodes, and has demonstrated acceptability to radiotherapy clinical practice.

Item Type: Article
Faculty/Department: Faculty of Health and Applied Sciences > Department of Allied Health Professions
Depositing User: Mr S. Goldsworthy
Date Deposited: 30 May 2017 08:27
Last Modified: 12 Dec 2017 13:51
URI: http://eprints.uwe.ac.uk/id/eprint/31908


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