Accurate Location of Tumor in Head and Neck Cancer Radiotherapy Treatment With Respect to Machine Isocentre

Radiation Therapy has been one of the most common techniques to treat various types of cancers, in particular is Head and Neck Cancer (HNC) which accounts for three percent of all cancers in the United States. During the treatment procedure, the patient is immobilized using immobilization devices such as the full head face mask, bite blocks, stereotactic frame, etc. to get accurate location of tumor. The disadvantage of these devices is that they are very uncomfortable to the patient especially people suffering from Post-Traumatic Stress Disorder (PTSD) and claustrophobia who cannot wear any confined masked system such as the full head mask or bite block during the treatment procedure. To mitigate this problem, there has been a lot of research in modifying such immobilizing devices without neglecting the accurate location of tumor. To this end, the research presented in this thesis focuses on developing a mask less system with accurately locating the position of tumor using the technique of coordinate transformation at the same time fulfilling the three important characteristics: • Comfort • Accuracy • Low price Such a system is comfortable to the patient because no confining mask system is used and we choose minimal contact points on the patient for fixing the patient. Traditionally, such type of cancer treatment is carried out in two stages: Diagnosis stage, which identifies the location of the tumor and the external markers and the Treatment stage where the tumor is treated with immobilization device being common in both the stages. In the new system, the immobilization devices vary at the two stages. The head position is monitored by using pressure sensor assembly where spring and pressure sensor setup detects the amount and direction of head deviation. We also prepare a customized 3D printed nose bridge part for extra referencing in the treatment room. Also, it is important that we use material for our immobilization devices which does not contain any metal and MRI compatible. Once the patient lies down on the treatment couch and is immobilized using the immobilization devices, then tumor location is calculated using the theory of coordinate transformation and transformation matrix in the Diagnosis and Treatment Stage. To validate the system, simulation of immobilization devices used in the new design was carried out using ANSYS Workbench 15.0 and LS-Dyna software’s Explicit Dynamics method. The simulation for the head-fixing device showed a deflection of ±0.1974 mm with respect to machine isocenter with a load of 60 N, which is lower than the customer requirement of ±3 mm with respect to machine isocenter of head deviation. The material used for the external markers for patient positioning was selected to be polyetheretherketone (PEEK) which is a radiolucent and widely used MRI compatible material. The system also takes into consideration the effect of weight loss, which is one of the drawbacks of the current systems. Although still in the development stage, this mask less system holds to be the next new variety of immobilization devices that are comfortable to the patient and less expensive to be implemented in future cancer treatment practices