1
|
Tsuchida K, Minohara S, Kusano Y, Kano K, Anno W, Takakusagi Y, Mizoguchi N, Serizawa I, Yoshida D, Imura K, Takayama Y, Kamada T, Katoh H, Ohno T. Interfractional robustness of scanning carbon ion radiotherapy for prostate cancer: An analysis based on dose distribution from daily in-room CT images. J Appl Clin Med Phys 2021; 22:130-138. [PMID: 34046997 PMCID: PMC8200452 DOI: 10.1002/acm2.13275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 01/03/2023] Open
Abstract
Purpose We analyzed interfractional robustness of scanning carbon ion radiotherapy (CIRT) for prostate cancer based on the dose distribution using daily in‐room computed tomography (CT) images. Materials and Methods We analyzed 11 consecutive patients treated with scanning CIRT for localized prostate cancer in our hospital between December 2015 and January 2016. In‐room CT images were taken under treatment conditions in every treatment session. The dose distribution on each in‐room CT image was recalculated, while retaining the pencil beam arrangement of the initial treatment plan. Then, the dose–volume histogram (DVH) parameters including the percentage of the clinical target volume (CTV) with 95% and 90% of the prescribed dose area (V95% of CTV, V90% of CTV) and V80% of rectum were calculated. The acceptance criteria for the CTV and rectum were set at V95% of CTV ≥95%, V90% of CTV ≥98%, and V80% of rectum < 10 ml. Results V95% of CTV, V90% of CTV, and V80% of rectum for the reproduced plans were 98.8 ± 3.49%, 99.5 ± 2.15%, and 4.39 ± 3.96 ml, respectively. Acceptance of V95% of CTV, V90% of CTV, and V80% of rectum was obtained in 123 (94%), 125 (95%) and 117 sessions (89%), respectively. Acceptance of the mean dose of V95% of CTV, V90% of CTV, and V80% of rectum for each patient was obtained in 10 (91%), 10 (91%), and 11 patients (100%), respectively. Conclusions We demonstrated acceptable interfractional robustness based on the dose distribution in scanning CIRT for prostate cancer.
Collapse
Affiliation(s)
- Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Shinichi Minohara
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Koh Imura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yoshiki Takayama
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| |
Collapse
|
2
|
Statistical deformation reconstruction using multi-organ shape features for pancreatic cancer localization. Med Image Anal 2021; 67:101829. [DOI: 10.1016/j.media.2020.101829] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/12/2020] [Accepted: 09/12/2020] [Indexed: 11/20/2022]
|
3
|
Matsushita N, Nakamura M, Sasaki M, Yano S, Yoshimura M, Mizowaki T. Analyses of integrated EPID images for on-treatment quality assurance to account for interfractional variations in volumetric modulated arc therapy. J Appl Clin Med Phys 2020; 21:110-116. [PMID: 31909889 PMCID: PMC6964755 DOI: 10.1002/acm2.12805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/30/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023] Open
Abstract
Purpose To investigate the effects of interfractional variation, such as anatomical changes and setup errors, on dose delivery during treatment for prostate cancer (PC) and head and neck cancer (HNC) by courses of volumetric modulated arc therapy (VMAT) aided by on‐treatment electronic portal imaging device (EPID) images. Methods Seven patients with PC and 20 patients with HNC who had received VMAT participated in this study. After obtaining photon fluence at the position of the EPID for each treatment arc from on‐treatment integrated EPID images, we calculated the differences between the fluence for the first fraction and each subsequent fraction for each arc. The passing rates were investigated based on a tolerance level of 3% of the maximum fluence during the treatment courses and the correlations between the passing rates and anatomical changes. Results In PC, the median and lowest passing rates were 99.8% and 95.2%, respectively. No correlations between passing rates and interfractional variation were found. In HNC, the median passing rate of all fractions was 93.0%, and the lowest passing rate was 79.6% during the 35th fraction. Spearman’s correlation coefficients between the passing rates and changes in weight or neck volume were − 0.77 and − 0.74, respectively. Conclusions Analyses of the on‐treatment EPID images facilitates estimates of the interfractional anatomical variation in HNC patients during VMAT and thus improves assessments of the need for re‐planning or adaptive strategies and the timing thereof.
Collapse
Affiliation(s)
- Norimasa Matsushita
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
| | - Mitsuhiro Nakamura
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Makoto Sasaki
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan.,Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinsuke Yano
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
| | - Michio Yoshimura
- Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Mizowaki
- Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
4
|
Nguyen TTT, Arimura H, Asamura R, Hirose TA, Ohga S, Fukunaga JI. Comparison of volumetric-modulated arc therapy and intensity-modulated radiation therapy prostate cancer plans accounting for cold spots. Radiol Phys Technol 2019; 12:137-148. [PMID: 30805779 DOI: 10.1007/s12194-019-00502-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 11/25/2022]
Abstract
This study compared dosimetric indices of volumetric-modulated arc therapy (VMAT) with intensity-modulated radiation therapy (IMRT) accounting for cold spots in prostate cancer plans. IMRT plans were retrospectively generated from 30 prostate cancer patients with ten cases for each risk group, who received VMAT plans. The mean, maximum, and minimum doses, and conformity and homogeneity indexes were evaluated for planning target volume (PTV) and the mean dose and V20-V70 for organs at risk (OAR) including the rectum, bladder, right and left femoral heads, and rectum overlapped with PTV (ROP) regions. The numbers and volume percentages of cold spots within PTVs and ROP regions were measured using in-house software. Three-dimensional probabilistic distributions of the probability and distributions of cold spots were generated using a centroid matching technique for visualization and analysis. There was a statistically better dose conformity in the PTV, rectum, and bladder dose-sparing in VMAT compared to that in the IMRT plans, whereas VMAT had statistically worse target dose homogeneity, and right and left femoral head dose-sparing than those of the IMRT plans. The average volume percentage of cold spots per PTV for the VMAT was 4.37 ± 2.68%, which was smaller than the 5.72 ± 1.84% observed for IMRT plans (P = 0.007). The volume percentage of cold spots per ROP for the VMAT did not significantly differ from those for the IMRT plans. Compared with IMRT, the VMAT plans achieved better PTV dose conformity, OAR dose-sparing, and smaller cold spots in the treatment of prostate cancer.
Collapse
Affiliation(s)
- Tran Thi Thao Nguyen
- Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Japan Society for the Promotion of Science, 5-3-1, Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Hidetaka Arimura
- Division of Medical Quantum Science, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Ryosuke Asamura
- Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Taka-Aki Hirose
- Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Saiji Ohga
- Division of Medical Quantum Science, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Jun-Ichi Fukunaga
- Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| |
Collapse
|
5
|
Effect of accounting for interfractional CTV shape variations in PTV margins on prostate cancer radiation treatment plans. Phys Med 2018; 54:66-76. [DOI: 10.1016/j.ejmp.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/01/2018] [Accepted: 09/20/2018] [Indexed: 11/18/2022] Open
|
6
|
Tamihardja J, Zenk M, Flentje M. MRI-guided localization of the dominant intraprostatic lesion and dose analysis of volumetric modulated arc therapy planning for prostate cancer. Strahlenther Onkol 2018; 195:145-152. [PMID: 30209535 DOI: 10.1007/s00066-018-1364-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/23/2018] [Indexed: 01/10/2023]
Abstract
PURPOSE Primary radiation therapy is a curative treatment option for prostate cancer. The aim of this study was to evaluate the detection of the dominant intraprostatic lesion (DIL) with magnetic resonance imaging (MRI) for radiotherapy treatment planning, the comparison with transrectal ultrasound (TRUS)-guided biopsies and the examination of the dose distribution in relation to the DIL location. MATERIALS AND METHODS In all, 54 patients with treatment planning MRI for primary radiotherapy of prostate cancer from 03/2015 to 03/2017 at the Universitätsklinikum Würzburg were identified. The localization of the DIL was based on MRI with T2- and diffusion-weighted imaging. After registration of the MR image sets within Pinnacle3 (Philips Radiation Oncology Systems, Fitchburg, WI, USA), the dose distribution was analyzed. The location of the DIL was compared to the pathology reports in a side-based manner. RESULTS The DIL mean dose (Dmean) was 77.51 ± 0.77 Gy and in 50/51 cases within the tolerance range or exceeded the prescribed dose. There was a significant difference in Dmean between ventral (n = 21) and dorsal (n = 30) DIL (77.87 ± 0.67 vs. 77.26 ± 0.77 Gy; p = 0.005). MRI-guided localization showed an accuracy and sensitivity of up to 78.8% and 82.1% for inclusion of secondary lesions, respectively. CONCLUSION Up to 82.1% of histologically verified intraprostatic lesions were identified in the context of MRI-guided radiotherapy treatment planning. As expected, dorsal DIL tend to be minimally underdosed in comparison to ventral DIL. Adequate dose coverage was achieved in over 98% of patients.
Collapse
Affiliation(s)
- Jörg Tamihardja
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.
| | - Maria Zenk
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - Michael Flentje
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| |
Collapse
|
7
|
Haekal M, Arimura H, Hirose TA, Shibayama Y, Ohga S, Fukunaga J, Umezu Y, Honda H, Sasaki T. Computational analysis of interfractional anisotropic shape variations of the rectum in prostate cancer radiation therapy. Phys Med 2018. [PMID: 29519405 DOI: 10.1016/j.ejmp.2017.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To analyze the uncertainties of the rectum due to anisotropic shape variations by using a statistical point distribution model (PDM). MATERIALS AND METHODS The PDM was applied to the rectum contours that were delineated on planning computed tomography (CT) and cone-beam CT (CBCT) at 80 fractions of 11 patients. The standard deviations (SDs) of systematic and random errors of the shape variations of the whole rectum and the region in which the rectum overlapped with the PTV (ROP regions) were derived from the PDMs at all fractions of each patient. The systematic error was derived by using the PDMs of planning and average rectum surface determined from rectum surfaces at all fractions, while the random error was derived by using a PDM-based covariance matrix at all fractions of each patient. RESULTS Regarding whole rectum, the population SDs were larger than 1.0 mm along all directions for random error, and along the anterior, superior, and inferior directions for systematic error. The deviation is largest along the superior and inferior directions for systematic and random errors, respectively. For ROP regions, the population SDs of systematic error were larger than 1.0 mm along the superior and inferior directions. The population SDs of random error for the ROP regions were larger than 1.0 mm except along the right and posterior directions. CONCLUSIONS The anisotropic shape variations of the rectum, especially in the ROP regions, should be considered when determining a planning risk volume (PRV) margins for the rectum associated with the acute toxicities.
Collapse
Affiliation(s)
- Mohammad Haekal
- Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hidetaka Arimura
- Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Taka-Aki Hirose
- Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yusuke Shibayama
- Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Saiji Ohga
- Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Junichi Fukunaga
- Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoshiyuki Umezu
- Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hiroshi Honda
- Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomonari Sasaki
- Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| |
Collapse
|