Migration from full-head mask to "open-face" mask for immobilization of patients with head and neck cancer

Guang Li, D. Michael Lovelock, James Mechalakos, Shyam Rao, Cesar Della-Biancia, Howard Amols, Nancy Lee

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

To provide an alternative device for immobilization of the head while easing claustrophobia and improving comfort, an "open-face" thermoplastic mask was evaluated using video-based optical surface imaging (OSI) and kilovoltage (kV) X-ray radiography. A three-point thermoplastic head mask with a precut opening and reinforced strips was developed. After molding, it provided sufficient visible facial area as the region of interest for OSI. Using real-time OSI, the head motion of ten volunteers in the new mask was evaluated during mask locking and 15minutes lying on the treatment couch. Using a nose mark with reference to room lasers, forced head movement in open-face and full-head masks (with a nose hole) was compared. Five patients with claustrophobia were immobilized with open-face masks, set up using OSI and kV, and treated in 121 fractions, in which 61 fractions were monitored during treatment using real-time OSI. With the open-face mask, head motion was found to be 1.0 ± 0.6 mm and 0.4° ± 0.2° in volunteers during the experiment, and 0.8 ± 0.3 mm and 0.4° ± 0.2° in patients during treatment. These agree with patient motion calculated from pre-/post-treatment OSI and kV data using different anatomical landmarks. In volunteers, the head shift induced by mask-locking was 2.3 ± 1.7 mm and 1.8° ± 0.6°, and the range of forced movements in the open-face and full-head masks were found to be similar. Most (80%) of the volunteers preferred the open-face mask to the full-head mask, while claustrophobic patients could only tolerate the open-face mask. The open-face mask is characterized for its immobilization capability and can immobilize patients sufficiently (< 2 mm) during radiotherapy. It provides a clinical solution to the immobilization of patients with head and neck (HN) cancer undergoing radiotherapy, and is particularly beneficial for claustrophobic patients. This new open-face mask is readily adopted in radiotherapy clinic as a superior alternative to the standard full-head mask.

Original languageEnglish (US)
Pages (from-to)243-254
Number of pages12
JournalJournal of Applied Clinical Medical Physics
Volume14
Issue number5
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Fingerprint

Head and Neck Neoplasms
Masks
immobilization
Immobilization
masks
cancer
Head
Optical Imaging
Imaging techniques
Volunteers
Radiotherapy
radiation therapy
Phobic Disorders
Nose
Thermoplastics
locking
head movement
Patient treatment
X ray radiography
couches

Keywords

  • Image-guided radiotherapy
  • Motion uncertainty
  • Optical surface imaging
  • Patient setup and immobilization
  • Thermoplastic head mask

ASJC Scopus subject areas

  • Radiation
  • Instrumentation
  • Radiology Nuclear Medicine and imaging

Cite this

Migration from full-head mask to "open-face" mask for immobilization of patients with head and neck cancer. / Li, Guang; Lovelock, D. Michael; Mechalakos, James; Rao, Shyam; Della-Biancia, Cesar; Amols, Howard; Lee, Nancy.

In: Journal of Applied Clinical Medical Physics, Vol. 14, No. 5, 01.01.2013, p. 243-254.

Research output: Contribution to journalArticle

Li, Guang ; Lovelock, D. Michael ; Mechalakos, James ; Rao, Shyam ; Della-Biancia, Cesar ; Amols, Howard ; Lee, Nancy. / Migration from full-head mask to "open-face" mask for immobilization of patients with head and neck cancer. In: Journal of Applied Clinical Medical Physics. 2013 ; Vol. 14, No. 5. pp. 243-254.
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