Open Access Research

Seminal vesicle interfraction displacement and margins in image guided radiotherapy for prostate cancer

Daisy Mak1*, Suki Gill1, Roxby Paul2, Alison Stillie1, Annette Haworth2, Tomas Kron2, Jim Cramb2, Kellie Knight3, Jessica Thomas1, Gillian Duchesne1,4 and Farshad Foroudi1,4

Author Affiliations

1 Radiation Oncology Division, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, East Melbourne, VIC, 8006, Australia

2 Physical Sciences Department, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia

3 Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia

4 Department of Pathology, The University of Melbourne, East Melbourne, VIC, Australia

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Radiation Oncology 2012, 7:139 doi:10.1186/1748-717X-7-139

Published: 13 August 2012

Abstract

Background

To analyze interfraction motion of seminal vesicles (SV), and its motion relative to rectal and bladder filling.

Methods and Materials

SV and prostate were contoured on 771 daily computed tomography “on rails” scans from 24 prostate cancer patients undergoing radiotherapy. Random and systematic errors for SV centroid displacement were measured relative to the prostate centroid. Margins required for complete geometric coverage of SV were determined using isotropic expansion of reference contours. SV motion relative to rectum and bladder was determined.

Results

Systematic error for the SV was 1.9 mm left-right (LR), 2.9 mm anterior-posterior (AP) and 3.6 mm superior-inferior (SI). Random error was 1.4 mm (LR), 2.7 mm (AP) and 2.1 mm (SI). 10 mm margins covered the entire left SV and right SV on at least 90% of fractions in 50% and 33% of patients and 15 mm margins covered 88% and 79% respectively. SV AP movement correlated with movement of the most posterior point of the bladder (mean R2 = 0.46, SD = 0.24) and rectal area (mean R2 = 0.38, SD = 0.21).

Conclusions

Considerable interfraction displacement of SV was observed in this cohort of patients. Bladder and rectal parameters correlated with SV movement.

Keywords:
Seminal vesicle; Interfraction displacement; Margins; Prostate cancer; Radiotherapy