Comparison of CT on Rails With Electronic Portal Imaging for Positioning of Prostate Cancer Patients With Implanted Fiducial Markers

Abstract

Purpose: The objective of this investigation was to measure the agreement between in-room computed tomography (CT) on rails and electronic portal image (EPI) radiography. Methods and Materials: Agreement between the location of the center of gravity (COG) of fiducial markers (FMs) on CT and EPI images was determined in phantom studies and a patient cohort. A secondary analysis between the center of volume (COV) of the prostate on CT and the COG of FMs on CT and EPI was performed. Agreement was defined as the 95% probability of a difference of ≤3.0 mm between images. Systematic and random errors from CT and EPI are reported. Results: From 8 patients, 254 CT and EPI pairs were analyzed. FMs we..