The consideration about exact set-up with stereotactic radiosurgery for lung cancer

What confirm a patient's set-up precisely is an important factor in stereotactic radiosurgery Especially, the tumor is moved by respiration in case of lung cancer. So it is difficult to confirm a exact location by L-gram or EPID. I will verify a exact patient's set-up about this sort of problem by verification system(exactrac 3.0) The patient that had lung cancer operated on stereotactic radiosurgery is composed of 6 people. The 5 patients use an ABC tool and 1 patient doesn't use it. I got such a patient's L-gram and EPID image by Body frame(elekta, sweden), compared Ant. image with Lat. one, and then confirmed a set-up. I fused DRR image of CT and X-ray image of Verification system(exactrac 3.0) 3 dimensional, analyzed the coordinate value(vertical, longitudinal, lateral), and then confirmed a difference of existing method. In case of L-gram and EPID, we judge an exact of the patient's set-up subjectively, and on we could treat the patient with radiation. As a result of using Verification system(exactrac 3.0), coordinate value(vertical, longitudinal, lateral) of patient's set-up was comprised within 5 mm. We could estimate a difference of the coordinate value visually and objectively. Consequently, Verification system(exactrac 3.0) was useful in judging an exact patient's set-up. In case of Verification system(exactrac 3.0), we can confirm an exact patient's set-up at any time whenever, However, there are several kinds of the demerit. First, it is a complex process of confirmation than the existing process. Second, thickness of CT scan slice is within 3 mm. The last, X-ray image has to have shown itself clearly. If we solve this problem. stereotactic radiosurgery will be useful in treating patients why we can confirm an exact patient's positioning easily.