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Yi B, Jatczak J, Deng W, Poirier YP, Yao W, Witek ME, Molitoris JK, Zakhary MJ, Zhang B, Biswal NC, Ferris MJ, Mossahebi S. Is noncoplanar plan more robust to inter-fractional variations than coplanar plan in treating bilateral HN tumors with pencil-beam scanning proton beams? J Appl Clin Med Phys 2024; 25:e14186. [PMID: 37974385 PMCID: PMC10860533 DOI: 10.1002/acm2.14186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE Noncoplanar plans (NCPs) are commonly used for proton treatment of bilateral head and neck (HN) malignancies. NCP requires additional verification setup imaging between beams to correct residual errors of robotic couch motion, which increases imaging dose and total treatment time. This study compared the quality and robustness of NCPs with those of coplanar plans (CPs). METHODS AND MATERIALS Under an IRB-approved study, CPs were created retrospectively for 10 bilateral HN patients previously treated with NCPs maintaining identical beam geometry of the original plan but excluding couch rotations. Plan robustness to the inter-fractional variation (IV) of both plans was evaluated through the Dose Volume Histograms (DVH) of weekly quality assurance CT (QACT) sets (39 total). In addition, delivery efficiency for both plans was compared using total treatment time (TTT) and beam-on time (BOT). RESULTS No significant differences in plan quality were observed in terms of clinical target volume (CTV) coverage (D95) or organ-at-risk (OAR) doses (p > 0.4 for all CTVs and OARs). No significant advantage of NCPs in the robustness to IV was found over CP, either. Changes in D95 of QA plans showed a linear correlation (slope = 1.006, R2 > 0.99) between NCP and CP for three CTV data points (CTV1, CTV2, and CTV3) in each QA plan (117 data points for 39 QA plans). NCPs showed significantly higher beam delivery time than CPs for TTT (539 ± 50 vs. 897 ± 142 s; p < 0.001); however, no significant differences were observed for BOT. CONCLUSION NCPs are not more robust to IV than CPs when treating bilateral HN tumors with pencil-beam scanning proton beams. CPs showed plan quality and robustness similar to NCPs while reduced treatment time (∼6 min). This suggests that CPs may be a more efficient planning technique for bilateral HN cancer proton therapy.
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Affiliation(s)
- ByongYong Yi
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Jenna Jatczak
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Wei Deng
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Yannick P. Poirier
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Weiguang Yao
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Matthew E. Witek
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Jason K. Molitoris
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Mark J. Zakhary
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Baoshe Zhang
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Nrusingh C. Biswal
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Matthew J. Ferris
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
| | - Sina Mossahebi
- Department of Radiation OncologyUniversity of Maryland School of MedicineBaltimoreMarylandUSA
- Maryland Proton Treatment CenterBaltimoreMarylandUSA
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Chang S, Liu G, Zhao L, Zheng W, Yan D, Chen P, Li X, Deraniyagala R, Stevens C, Grills I, Chinnaiyan P, Li X, Ding X. Introduce a rotational robust optimization framework for spot-scanning proton arc (SPArc) therapy. Phys Med Biol 2022; 68. [PMID: 36546347 DOI: 10.1088/1361-6560/aca874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/02/2022] [Indexed: 12/03/2022]
Abstract
Objective. Proton dosimetric uncertainties resulting from the patient's daily setup errors in rotational directions exist even with advanced image-guided radiotherapy techniques. Thus, we developed a new rotational robust optimization SPArc algorithm (SPArcrot) to mitigate the dosimetric impact of the rotational setup error in Raystation ver. 6.02 (RaySearch Laboratory AB, Stockholm, Sweden).Approach.The initial planning CT was rotated ±5° simulating the worst-case setup error in the roll direction. The SPArcrotuses a multi-CT robust optimization framework by taking into account of such rotational setup errors. Five cases representing different disease sites were evaluated. Both SPArcoriginaland SPArcrotplans were generated using the same translational robust optimized parameters. To quantitatively investigate the mitigation effect from the rotational setup errors, all plans were recalculated using a series of pseudo-CT with rotational setup error (±1°/±2°/±3°/±5°). Dosimetric metrics such as D98% of CTV, and 3D gamma analysis were used to assess the dose distribution changes in the target and OARs.Main results.The magnitudes of dosimetric changes in the targets due to rotational setup error were significantly reduced by the SPArcrotcompared to SPArc in all cases. The uncertainties of the max dose to the OARs, such as brainstem, spinal cord and esophagus were significantly reduced using SPArcrot. The uncertainties of the mean dose to the OARs such as liver and oral cavity, parotid were comparable between the two planning techniques. The gamma passing rate (3%/3 mm) was significantly improved for CTV of all tumor sites through SPArcrot.Significance.Rotational setup error is one of the major issues which could lead to significant dose perturbations. SPArcrotplanning approach can consider such rotational error from patient setup or gantry rotation error by effectively mitigating the dose uncertainties to the target and in the adjunct series OARs.
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Affiliation(s)
- Sheng Chang
- Department of Radiation Oncology, Wuhan University, Renmin Hospital, Wuhan, 430060 Hubei Province, People's Republic of China.,Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Gang Liu
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America.,Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430023, People's Republic of China
| | - Lewei Zhao
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Weili Zheng
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Di Yan
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Peter Chen
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Xiangpan Li
- Department of Radiation Oncology, Wuhan University, Renmin Hospital, Wuhan, 430060 Hubei Province, People's Republic of China
| | - Rohan Deraniyagala
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Craig Stevens
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Inga Grills
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Prakash Chinnaiyan
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Xiaoqiang Li
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
| | - Xuanfeng Ding
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48074, United States of America
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Liu M, Cygler JE, Dennis K, Vandervoort E. A dose perturbation tool for robotic radiosurgery: Experimental validation and application to liver lesions. J Appl Clin Med Phys 2022; 23:e13766. [PMID: 36094024 DOI: 10.1002/acm2.13766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/09/2022] [Accepted: 08/04/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND An analytical tool is empirically validated and used to assess the delivered dose to liver lesions accounting for different types of errors in robotic radiosurgery treatment. MATERIAL AND METHODS A tool is proposed to estimate the target doses taking into account the translation, rotation, and deformation of a target. Translational errors are modeled as a spatial convolution of the planned dose with a probability distribution function derived from treatment data. Rotations are modeled by rotating the target volume about the imaging isocenter. Target deformation is simulated as an isotropic target expansion or contraction based on changes in inter-fiducial spacing. The estimated dose is validated using radiochromic film measurements in nine experimental conditions, including in-phase and out-of-phase internal-and-external breathing motion patterns, with and without uncorrectable rotations, and for homogenous and heterogeneous phantoms. The measured dose is compared to the perturbed and planned doses using gamma analyses. This proposed tool is applied to assess the dose coverage for liver treatments using D99/Rx where D99 and Rx are the minimum target and prescription doses, respectively. These metrics are used to evaluate plan robustness to different magnitudes of rotational errors. Case studies are presented to illustrate how to improve plan robustness against delivery errors. RESULTS In the experimental validations, measured dose agrees with the estimated dose at the 2%/2 mm level. When accounting for translational and rotational tracking residual errors using this tool, approximately one-fifth of targets are considered underdosed (D99/Rx < 1.0). If target expansion or contraction is modeled, approximately one-third of targets are underdosed. The dose coverage can be improved if treatments are planned following proposed guidelines. CONCLUSION The dose perturbation model can be used to assess dose delivery accuracy and investigate plan robustness to different types of errors.
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Affiliation(s)
- Ming Liu
- Department of Medical Physics, The Ottawa Hospital Cancer Center, Ottawa, Canada
- Department of Physics, Carleton University, Ottawa, Canada
| | - Joanna E Cygler
- Department of Medical Physics, The Ottawa Hospital Cancer Center, Ottawa, Canada
- Department of Physics, Carleton University, Ottawa, Canada
- Division of Medical Physics, Department of Radiology, The University of Ottawa, Ottawa, Canada
| | - Kristopher Dennis
- Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Canada
| | - Eric Vandervoort
- Department of Medical Physics, The Ottawa Hospital Cancer Center, Ottawa, Canada
- Department of Physics, Carleton University, Ottawa, Canada
- Division of Medical Physics, Department of Radiology, The University of Ottawa, Ottawa, Canada
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Liang J, Liu Q, Grills I, Guerrero T, Stevens C, Yan D. Using previously registered cone beam computerized tomography images to facilitate online computerized tomography to cone beam computerized tomography image registration in lung stereotactic body radiation therapy. J Appl Clin Med Phys 2022; 23:e13549. [PMID: 35112781 PMCID: PMC8992944 DOI: 10.1002/acm2.13549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/23/2021] [Accepted: 01/19/2022] [Indexed: 12/25/2022] Open
Abstract
Purpose In our conventional image registration workflow, the four‐dimensional (4D) CBCT was directly registered to the reference helical CT (HCT) using a dual registration approach within the Elekta XVI software. In this study, we proposed a new HCT–CBCT auto‐registration strategy using a previously registered CBCT (CBCTpre) as the reference image and tested its clinical feasibility. Methods From a previous CBCT session, the registered average 4D CBCT was selected as CBCTpre and the HCT–CBCTpre registration vector from the clinician's manual registration result was recorded. In the new CBCT session, auto‐registration was performed between the new average 4D CBCT (CBCTtx) and CBCTpre (CBCTpre‐CBCTtx). The overall HCT–CBCTtx registration result was then derived by combing the results from two registrations (i.e., HCT–CBCTpre + CBCTpre–CBCTtx). The results from the proposed method were compared with clinician's manually adjusted HCT–CBCTtx registration results (“ground truth”) to evaluate its accuracy using a test dataset consisting of 32 challenging registration cases. Results The uncertainty of the proposed auto‐registration method was −0.1 ± 0.5, 0.1 ± 1.0, and −0.1 ± 0.7 mm in three translational directions (lateral, longitudinal, and vertical) and 0.0° ± 0.9°, 0.3° ± 0.9°, and 0.4° ± 0.7° in three rotation directions, respectively. Two patients (6.3%) had translational uncertainty > 2 mm (max = 3.1 mm) and both occurred in the longitudinal direction. Meanwhile, the uncertainty of the conventional direct HCT–CBCTtx auto‐registration was −0.4 ± 2.6, −0.2 ± 7.4, −1.4 ± 3.6 mm for translations and −0.3° ± 1.2°, 0.0° ± 1.6°, and 0.1 ± 1.1° for rotations. Eleven patients (34.4%) had translation uncertainty > 2 mm (max = 26.2 mm) in at least one direction. Accuracy in translation was improved with the new method, while rotation accuracy stayed in the same order. Conclusion We demonstrated the feasibility of incorporating prior clinical registration knowledge into the online HCT–CBCT registration process. The proposed auto‐registration method provides a quick and reliable starting solution for online HCT–CBCT registration.
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Affiliation(s)
- Jian Liang
- Beaumont Health System, Royal Oak, Radiation Oncology, Michigan, USA
| | - Qiang Liu
- Beaumont Health System, Royal Oak, Radiation Oncology, Michigan, USA
| | - Inga Grills
- Beaumont Health System, Royal Oak, Radiation Oncology, Michigan, USA
| | - Thomas Guerrero
- Beaumont Health System, Royal Oak, Radiation Oncology, Michigan, USA
| | - Craig Stevens
- Beaumont Health System, Royal Oak, Radiation Oncology, Michigan, USA
| | - Di Yan
- Beaumont Health System, Royal Oak, Radiation Oncology, Michigan, USA
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Rotational positional error-corrected linear set-up margin calculation technique for lung stereotactic body radiotherapy in a dual imaging environment of 4-D cone beam CT and ExacTrac stereoscopic imaging. Radiol Med 2021; 126:979-988. [PMID: 33900527 DOI: 10.1007/s11547-021-01355-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/08/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Accurate calculation of set-up margin is a prerequisite to arrive at the most optimal clinical to planning target volume margin. The aim of this study was to evaluate the compatibility of different on-board and in-room stereoscopic imaging modalities by calculating the set-up margins (SM) in stereotactic body radiotherapy technique accounting and unaccounting for rotational positional errors (PE). Further, we calculated separate SMs one based on residual positional errors and another based on residual + intrafraction positional errors from the imaging data obtained in a dual imaging environment. MATERIALS AND METHODS A total of 22 lung cancer patients were included in this study. For primary image guidance, four-dimensional cone beam computed tomography (4-D CBCT) was used and stereoscopic ExacTrac was used as the auxiliary imaging. Following table position correction (TPC) based on the initial 4-D CBCT, another 4-D CBCT (post-TPC) and a pair of stereoscopic ExacTrac images were obtained. Further, during the treatment delivery, a series of ExacTrac images were acquired to identify the intrafraction PE. If a, b and c were the observed translational shifts in lateral (x-axis), longitudinal (y-axis) and vertical direction (z-axis) and α, β and γ were the rotational shifts in radians about the same axes, respectively, then the resultant translational vectors (A, B and C) were calculated on the basis of translational and rotational values. Set-up margins were calculated using residual errors post-TPC only and also using intrafraction positional errors in addition to the residual errors. RESULTS Residual and residual + intrafraction SM were calculated from a dataset of 82 CBCTs and 189 ExacTrac imaging sessions. CBCT-based mean ± SD shifts in translational and rotational directions were 0.3 ± 1.8 mm, 0.1 ± 1.8 mm, - 0.4 ± 1.6 mm, 0.1 ± 0.4°, 0.0 ± 1.0° and 0.3 ± 0.7°, respectively, and for ExacTrac - 0.1 ± 1.8 mm, 0.2 ± 2.4 mm, - 0.6 ± 1.8 mm, 0.1 ± 1.2°, - 0.2 ± 1.3° and - 0.1 ± 0.6°, respectively. Residual SM without considering the rotational correction in x, y and z directions were 5.0 mm, 4.5 mm and 4.4 mm; rotation-corrected SM were 4.4 mm, 4.0 mm and 5.5 mm, respectively. Residual plus intrafraction SM were 5.5 mm, 6.6 mm and 6.2 mm without considering the rotational corrections, whereas they were 5.0 mm, 6.3 mm and 6.2 mm with rotational errors accounted for. CONCLUSION Accurate calculation of set-up margin is required to find the clinical to planning target volume margin. Primary and auxiliary imaging margins fall in the range of 4.0 to 5.5 mm and 5.0 to 7.0 mm, respectively, indicating a higher SM for X-ray-based planar imaging techniques over three-dimensional cone beam images. This study established the degree of mutual compatibility between two different kinds of widely used set-up imaging modalities, on-board CBCT and in-room stereoscopic imaging ExacTrac. It also describes the technique to calculate the residual and residual plus intrafraction SM and its variation in a dual imaging environment accounting for rotational PE in stereotactic body radiotherapy of lung.
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Barrett S, Thirion P, Harper D, Simpkin AJ, Leech M, Hickey K, Ryan L, Marignol L. Dosimetric impact of uncorrected systematic yaw rotation in VMAT for peripheral lung SABR. Rep Pract Oncol Radiother 2019; 24:520-527. [PMID: 31516398 DOI: 10.1016/j.rpor.2019.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/02/2019] [Accepted: 07/30/2019] [Indexed: 12/25/2022] Open
Abstract
Aim This study aimed to evaluate the dosimetric impact of uncorrected yaw rotational error on both target coverage and OAR dose metrics in this patient population. Background Rotational set up errors can be difficult to correct in lung VMAT SABR treatments, and may lead to a change in planned dose distributions. Materials and methods We retrospectively applied systematic yaw rotational errors in 1° degree increments up to -5° and +5° degrees in 16 VMAT SABR plans. The impact on PTV and OARs (oesophagus, spinal canal, heart, airway, chest wall, brachial plexus, lung) was evaluated using a variety of dose metrics. Changes were assessed in relation to percentage deviation from approved planned dose at 0 degrees. Results Target coverage was largely unaffected with the largest mean and maximum percentage difference being 1.4% and 6% respectively to PTV D98% at +5 degrees yaw.Impact on OARs was varied. Minimal impact was observed in oesophagus, spinal canal, chest wall or lung dose metrics. Larger variations were observed in the heart, airway and brachial plexus. The largest mean and maximum percentage differences being 20.77% and 311% respectively at -5 degrees yaw to airway D0.1cc, however, the clinical impact was negligible as these variations were observed in metrics with minimal initial doses. Conclusions No clinically unacceptable changes to dose metrics were observed in this patient cohort but large percentage deviations from approved dose metrics in OARs were noted. OARs with associated PRV structures appear more robust to uncorrected rotational error.
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Affiliation(s)
- Sarah Barrett
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Ireland
| | | | - Dean Harper
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - Andrew J Simpkin
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland
| | - Michelle Leech
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Ireland
| | - Kim Hickey
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - Laoise Ryan
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - Laure Marignol
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Ireland
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Godley A, Zheng D, Rong Y. MR-linac is the best modality for lung SBRT. J Appl Clin Med Phys 2019; 20:7-11. [PMID: 31112368 PMCID: PMC6560235 DOI: 10.1002/acm2.12615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 01/05/2019] [Accepted: 01/05/2019] [Indexed: 12/25/2022] Open
Affiliation(s)
- Andrew Godley
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Dandan Zheng
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yi Rong
- Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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Kanzaki R, Araki F, Kawamura S. Image-guidance technique comparison on respiratory reproducibility and dose indexes for stereotactic body radiotherapy in lung tumor. Med Dosim 2019; 44:385-393. [PMID: 30857654 DOI: 10.1016/j.meddos.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/19/2019] [Accepted: 02/13/2019] [Indexed: 11/17/2022]
Abstract
We investigated respiratory reproducibility from position errors of gold internal fiducial markers for breath-hold (BH) and real-time tumor tracking (RTT) techniques for stereotactic body radiotherapy in lung tumors. The relationship between position errors and dose indexes was checked for both techniques. The stereotactic body radiotherapy plan in lung tumors was planned for 29 patients. The tumor positioning was arranged using 1.5 mm diameter gold internal fiducial markers. First, CT images were acquired to analyze position errors of gold markers for BH and RTT techniques. The offset plans for both techniques were calculated by displacing the mean position errors. The dose indexes (D98, D95, D2, mean dose) in a planning target volume were evaluated from dose volume histograms for the original plan, BH, and RTT offset plans. The relationship between position errors and dose indexes was analyzed using the root mean square (RMS) for both techniques. For the BH, the RMS was 3.29 mm at the lower lobe. Similarly, it was 1.34 mm for the RTT. The difference for D98 by position error for BH was -7.0 ± 10.8% at the lower lobe and the difference of all dose indexes for the RTT was less than 1%. The D2 and mean dose for both techniques were nearly the same as those of the original plan. In conclusion, the adaptation of the BH technique should be ≤2 mm RMS. If the position error is >2 mm RMS, the RTT technique should be used instead of the BH technique.
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Affiliation(s)
- Ryuji Kanzaki
- Department of Radiological Technology, Yamaguchi University Hospital, Ube City, Yamaguchi, Japan; Graduate School of Health Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Fujio Araki
- Department of Health Sciences, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan.
| | - Shinji Kawamura
- Graduate School of Health Sciences, Teikyo University, Omuta, Fukuoka, Japan
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A study for the dosimetric evaluation of rotational setup error for
lung stereotactic body radiation therapy. JOURNAL OF RADIOTHERAPY IN PRACTICE 2018. [DOI: 10.1017/s1460396918000250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPurposeTo investigate the necessity of rotational shifts by considering dosimetric
impact of rotational errors on stereotactic body radiation therapy
(SBRT).Materials and methods20 lung patients with the lesion size <5 cm treated with SBRT have
been selected for dosimetric analysis. Three-dimensional dose has been
rotationally shifted (±1°, ±3°,
±5° for pitch, roll and yaw) and overlaid to the original
computed tomography images. The dose–volume histograms of
18-rotational plans of each patient were compared to those of the original
plan.ResultsNo significant dosimetric differences were observed in target coverage. For
all of the cases up to 5° in any couch angle dose differences of
D99 and D95 were
<3%. Variations of conformity index were observed to be less
than 0·05. None of the organ at risk doses exceeded the dose limit.
The V20 differences of the ipsilateral and the
total lungs were less than 0·4%.ConclusionIt has been found to be unnecessary to perform rotational shifts up to
5° for lung SBRT treatments; the translational shift is sufficient
for the cases used in this study. This method may be applied and tested
after planning and before treatment initiation to rule out exceptionally
extreme cases.
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10
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Dosimetric effect of uncorrected rotations in lung SBRT with stereotactic imaging guidance. Phys Med 2017; 42:197-202. [DOI: 10.1016/j.ejmp.2017.09.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/20/2017] [Accepted: 09/23/2017] [Indexed: 12/25/2022] Open
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Zhang Y, Ren L, Vergalasova I, Yin FF. Clinical Study of Orthogonal-View Phase-Matched Digital Tomosynthesis for Lung Tumor Localization. Technol Cancer Res Treat 2017; 16:866-878. [PMID: 28449625 PMCID: PMC5547009 DOI: 10.1177/1533034617705716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background and Purpose: Compared to cone-beam computed tomography, digital tomosynthesis imaging has the benefits of shorter scanning time, less imaging dose, and better mechanical clearance for tumor localization in radiation therapy. However, for lung tumors, the localization accuracy of the conventional digital tomosynthesis technique is affected by the lack of depth information and the existence of lung tumor motion. This study investigates the clinical feasibility of using an orthogonal-view phase-matched digital tomosynthesis technique to improve the accuracy of lung tumor localization. Materials and Methods: The proposed orthogonal-view phase-matched digital tomosynthesis technique benefits from 2 major features: (1) it acquires orthogonal-view projections to improve the depth information in reconstructed digital tomosynthesis images and (2) it applies respiratory phase-matching to incorporate patient motion information into the synthesized reference digital tomosynthesis sets, which helps to improve the localization accuracy of moving lung tumors. A retrospective study enrolling 14 patients was performed to evaluate the accuracy of the orthogonal-view phase-matched digital tomosynthesis technique. Phantom studies were also performed using an anthropomorphic phantom to investigate the feasibility of using intratreatment aggregated kV and beams’ eye view cine MV projections for orthogonal-view phase-matched digital tomosynthesis imaging. The localization accuracy of the orthogonal-view phase-matched digital tomosynthesis technique was compared to that of the single-view digital tomosynthesis techniques and the digital tomosynthesis techniques without phase-matching. Results: The orthogonal-view phase-matched digital tomosynthesis technique outperforms the other digital tomosynthesis techniques in tumor localization accuracy for both the patient study and the phantom study. For the patient study, the orthogonal-view phase-matched digital tomosynthesis technique localizes the tumor to an average (± standard deviation) error of 1.8 (0.7) mm for a 30° total scan angle. For the phantom study using aggregated kV–MV projections, the orthogonal-view phase-matched digital tomosynthesis localizes the tumor to an average error within 1 mm for varying magnitudes of scan angles. Conclusion: The pilot clinical study shows that the orthogonal-view phase-matched digital tomosynthesis technique enables fast and accurate localization of moving lung tumors.
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Affiliation(s)
- You Zhang
- Medical Physics Graduate Program, Duke University, Durham, NC, USA
| | - Lei Ren
- Medical Physics Graduate Program, Duke University, Durham, NC, USA.,Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Irina Vergalasova
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Fang-Fang Yin
- Medical Physics Graduate Program, Duke University, Durham, NC, USA.,Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
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Lee J, Kim JI, Ye SJ, Kim HJ, Carlson J, Park JM. Dosimetric effects of roll rotational setup errors on lung stereotactic ablative radiotherapy using volumetric modulated arc therapy. Br J Radiol 2015; 88:20140862. [PMID: 26369834 DOI: 10.1259/bjr.20140862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To evaluate the dosimetric effects of roll-rotational setup errors of stereotactic ablative radiotherapy (SABR) for lung cancer using volumetric modulated arc therapy (VMAT). METHODS A total of 23 lung SABR cases were evaluated retrospectively. Each of the planning CT images was intentionally rotated by ±1°, ±2° and ±3°. After that, to simulate the translational couch correction, rotated CT images were moved along the x, y and z axis to match the centroid of the target volume in the rotated CT images with that in the original CT images. The differences in D95% and V100% of the target volume, D0.35cc of spinal cord, D0.35cc and D5cc of oesophagus and V20Gy of lung between the original and the rotated CT images were calculated. RESULTS The average differences in D95% and V100% of target volume, D0.35cc of spinal cord, D0.35cc and D5cc of oesophagus and V20Gy of lung were -0.3% ± 0.4% and -0.7% ± 2.4%, 1.6 ± 27.9 cGy, -1.6 ± 37.6 cGy, 15.9 ± 25.3 cGy and 0.0% ± 0.1%, respectively. The dosimetric changes in organs at risk (OARs) near the target volume were sometimes considerable due to roll-rotational setup errors, despite the translational correction, and those were patient specific. CONCLUSION In the case of coplanar VMAT for lung SABR, dosimetric changes to the target volume due to roll-rotational setup errors could be compensated by translational correction, whereas those to the OARs could not in some cases. ADVANCES IN KNOWLEDGE Roll-rotational setup errors would increase the dose to OARs despite the translational correction.
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Affiliation(s)
- Jaegi Lee
- 1 Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Seoul National University Graduate School of Convergence Science and Technology, Seoul, Korea.,2 Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-In Kim
- 2 Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea.,3 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.,4 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.,5 Center for Convergence Research on Robotics, Advanced Institutes of Convergence Technology, Suwon, Korea
| | - Sung-Joon Ye
- 1 Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Seoul National University Graduate School of Convergence Science and Technology, Seoul, Korea.,3 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Hak Jae Kim
- 3 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.,4 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.,6 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Joel Carlson
- 1 Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Seoul National University Graduate School of Convergence Science and Technology, Seoul, Korea.,2 Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Min Park
- 2 Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea.,3 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.,4 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.,5 Center for Convergence Research on Robotics, Advanced Institutes of Convergence Technology, Suwon, Korea
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Paganelli C, Lee D, Greer PB, Baroni G, Riboldi M, Keall P. Quantification of lung tumor rotation with automated landmark extraction using orthogonal cine MRI images. Phys Med Biol 2015; 60:7165-78. [DOI: 10.1088/0031-9155/60/18/7165] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Burghelea M, Verellen D, Poels K, Gevaert T, Depuydt T, Tournel K, Hung C, Simon V, Hiraoka M, de Ridder M. Geometric Verification of Dynamic Wave Arc Delivery With the Vero System Using Orthogonal X-ray Fluoroscopic Imaging. Int J Radiat Oncol Biol Phys 2015; 92:754-61. [DOI: 10.1016/j.ijrobp.2015.02.053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/22/2014] [Accepted: 02/26/2015] [Indexed: 11/24/2022]
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