{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:50:14Z","timestamp":1770742214840,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,10,9]],"date-time":"2022-10-09T00:00:00Z","timestamp":1665273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Spine stereotactic body radiation therapy (SBRT) uses highly conformal dose distributions and sharp dose gradients to cover targets in proximity to the spinal cord or cauda equina, which requires precise patient positioning and immobilization to deliver safe treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Given some limitations with the BodyFIX system in our practice, we sought to evaluate the accuracy and efficiency of the Klarity SBRT patient immobilization system in comparison to the BodyFIX system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three patients with 26 metastatic spinal lesions (78 fractions) were enrolled in this prospective observational study with one of two systems \u2013 BodyFIX (<jats:italic>n<\/jats:italic>\u00a0=\u00a011) or Klarity (<jats:italic>n<\/jats:italic>\u00a0=\u00a012). All patients were initially set up to external marks and positioned to match bony anatomy on ExacTrac images. Table corrections given by ExacTrac during setup and intrafractional monitoring and deviations from pre\u2010 and posttreatment CBCT images were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For initial setup accuracy, the Klarity system showed larger differences between initial skin mark alignment and the first bony alignment on ExacTrac than BodyFIX, especially in the vertical (mean [SD] of 5.7\u00a0mm [4.1\u00a0mm] for Klarity vs. 1.9\u00a0mm [1.7\u00a0mm] for BodyFIX, <jats:italic>p<\/jats:italic>\u2010value\u00a0&lt;\u00a00.01) and lateral (5.4\u00a0mm [5.1\u00a0mm] for Klarity vs. 3.2\u00a0mm [3.2\u00a0mm] for BodyFIX, <jats:italic>p<\/jats:italic>\u2010value 0.02) directions. For set\u2010up stability, no significant differences (all <jats:italic>p<\/jats:italic>\u2010values\u00a0&gt;\u00a00.05) were observed in the maximum magnitude of positional deviations between the two systems. For setup efficiency, Klarity system achieved desired bony alignment with similar number of setup images and similar setup time (14.4 min vs. 15.8 min, <jats:italic>p<\/jats:italic>\u2010value\u00a0=\u00a00.41). For geometric uncertainty, systematic and random errors were found to be slightly less with Klarity than with BodyFIX based on an analytical calculation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>With image\u2010guided correction of initial alignment by external marks, the Klarity system can provide accurate and efficient patient immobilization. It can be a promising alternative to the BodyFIX system for spine SBRT while providing potential workflow benefits depending on one's practice environment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.13804","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T01:27:22Z","timestamp":1665365242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of setup accuracy and efficiency between the Klarity system and BodyFIX system for spine stereotactic body radiation therapy"],"prefix":"10.1002","volume":"23","author":[{"given":"Enzhuo","family":"Quan","sequence":"first","affiliation":[{"name":"Department of Radiation Physics, The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane P.","family":"Krafft","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics, The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina M.","family":"Briere","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics, The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa J.","family":"Vaccarelli","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics, The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amol J.","family":"Ghia","sequence":"additional","affiliation":[{"name":"Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra N.","family":"Yeboa","sequence":"additional","affiliation":[{"name":"Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Swanson","sequence":"additional","affiliation":[{"name":"Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Young","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics, The University of Texas MD Anderson Cancer Center  Houston Texas 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