Collection of Head Images During Radiotherapy

Study Overview
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Brief Summary
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The primary objective of this observational study is to quantify the translation, rotation, and deformation of patient head positions of head and neck cancer patients over the course of a radiation therapy treatment for head and neck cancer. This objective will be achieved by comparing X-ray images collected during each treatment session with those obtained from the planning CT scan. Secondary objectives include (1) the use of the collected X-ray images to develop realistic artificial X-ray images where patient movement can be simulated and (2) to determine whether motion can be detected from individual X-ray images acquired during radiation therapy treatment.

Detailed Description
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Participants will undergo their radiation therapy treatment for HNC as planned and per the routine clinical management protocol. As part of this routine treatment, multiple x-ray images will be acquired to assist in accurate positioning of the patient for their planned radiation therapy. Normally these images are stored for a few days and then discarded. This study will be collating, storing and analysing these images. These X-ray images will be paired with the corresponding pre-treatment CT scan that is routinely acquired for each patient, as well as the locations of organs of interest, such as the tumour and surrounding structures. The patient treatment plan will also be collated, as it will allow for analysis of how any motion affects the accuracy of dose delivery. The patient radiation treatment delivery record will be collected to help sort and categorise the acquired images. Information on potential confounding or interacting factors will be collected: demographic information will be collected including sex, age, tumour stage and histology.

Official Title
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Collection of Head Images During Radiotherapy (CHIRP)

Conditions
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Head and Neck Neoplasms, Radiation Therapy Complication

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A diagnosis of head and neck cancer (any stage) Age 18 years or greater Receiving radiation therapy to the head and neck with a thermoplastic immobilisation mask An ECOG score in the range of 0 to 2 Any other prior or concurrent therapy allowed Exclusion Criteria: People with cognitive impairment which would preclude them from providing informed consent People who are unable to speak and read English and for whom obtaining consent would be difficult.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Translational head motion between different radiation therapy treatment sessions | Translation error (mm) | 8 weeks | 
| Rotational head motion between different radiation therapy treatment sessions | Rotation error (degree) | 8 weeks | 
| Head deformation between different radiation therapy treatment sessions | Deformation error (mm) | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference in structural similarity (SSIM) indexes between artificial and real X-rays | Image quality metric: Structural Similarity (SSIM) index. | 8 weeks | 
| Difference in mean absolute error between artificial and real X-rays | Image quality metric: Mean Absolute Error. | 8 weeks |