{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:05:41Z","timestamp":1790319941408,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1146","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJR"],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec><jats:title>Objectives:<\/jats:title><jats:p> To measure the magnitude of intra-fraction prostate motion (IFPM) during stereotactic radiotherapy (SBRT) delivered without intra-fraction tracking. To assess if current margins adequately cover IFPM. To derive margins using new guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> IFPM was determined in 20 patients receiving 36.25\u2009Gy in 5 fractions using 97 pairs of pre- and post-treatment cone beam CT (CBCT) scans. Correlation of time between CBCT acquisitions and motion was determined. The magnitude of IFPM was compared to current margins (6\u2009mm isotropic, 3\u2009mm posterior). Margins were calculated using IFPM alone and updated guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> The averaged 3D root mean square IFPM was 2.5\u2009mm (4.2\u2009mm). Independent prostate motion was predominantly posterior (70%) and inferior (63%). There was weak correlation between posterior (\u03c1 = 0.38) and inferior (\u03c1 = 0.36) IFPM and time. IFPM greater than current margins occurred in 8 of 97 fractions, six in the posterior direction. Margins were \u22643.5\u2009mm using IFPM alone and \u22643.3\u2009mm Left 3.5 mm Right, 7.0\u2009mm inferior, 3.7\u2009mm superior, 4.4\u2009mm anterior and 3.3\u2009mm posterior using new guidelines, compensating for motion in 92% of fractions. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> Our current SBRT margins account for 92% of IFPM, predominantly posterior and inferior. Although updated guidelines suggest an increase in margins inferiorly, any increase must be balanced against the possibility of increased toxicity, particularly if biochemical control and side-effects are favourable with current practice. <\/jats:p><\/jats:sec><jats:sec><jats:title>Advances in knowledge:<\/jats:title><jats:p> The difference between current clinical margins and those determined using updated guidance is demonstrated. The implications must be considered against clinical outcomes. <\/jats:p><\/jats:sec>","DOI":"10.1259\/bjr.20220852","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T20:18:02Z","timestamp":1680293882000},"source":"Crossref","is-referenced-by-count":10,"title":["Prostate stereotactic body radiotherapy: quantifying intra-fraction motion and calculating margins using the new BIR geometric uncertainties in daily online IGRT recommendations"],"prefix":"10.1093","volume":"96","author":[{"given":"Joseph M","family":"McNeice","sequence":"first","affiliation":[{"name":"The Royal Marsden NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandu","family":"Sanilkumar","sequence":"additional","affiliation":[{"name":"The Royal Marsden NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie E","family":"Alexander","sequence":"additional","affiliation":[{"name":"The 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