1
|
Small-field dosimetry with detector-specific output correction factor for single-isocenter stereotactic radiotherapy of single and multiple brain metastases. Radiol Phys Technol 2023; 16:10-19. [PMID: 36272022 DOI: 10.1007/s12194-022-00684-0] [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: 08/25/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 10/24/2022]
Abstract
Recently, the International Atomic Energy Agency and the American Association of Physicists in Medicine reported correction factors (CFs) for detector-response variation considering the uncertainty in detector readings in small-field dosimetry. In this study, the effect of CFs on small-field dosimetry measurements was evaluated for single-isocenter stereotactic radiotherapy for brain metastases. The output factors (OPFs) were measured with and without CFs in a water-equivalent sphere phantom using TrueBeam with a flattening-filter-free energy of 10 MV. Five detectors were used in a perpendicular orientation: CC01, 3D pinpoint ionization chambers, unshielded SFD detector, shielded EDGE detector, and microDiamond detector. First, the square-field sizes were set to 5-100 mm using a multi-leaf collimator (MLC) field. The OPFs were evaluated in the presence and absence of CFs. Second, single-isocenter stereotactic irradiation was performed on 22 brain metastases in 15 patients following dynamic conformal arc (DCA) treatment. The equivalent field size was calculated using the MLC aperture for each planning target volume. For the OPFs, the mean deviations from the median of the doses measured with detectors other than the CC01 for square-field sizes larger than 10 mm were within ± 4.3% of the median without CFs, and ± 3.3% with CFs. For DCA plans, the deviations without and with CFs were - 2.3 ± 1.9% and - 4.8 ± 2.4% for CC01, - 1.1 ± 3.0% and 1.0 ± 1.6% for 3D pinpoint, 8.8 ± 3.0% and 2.9 ± 2.8% for SFD, - 3.1 ± 3.0% and - 13.5 ± 4.0% for EDGE, and 8.9 ± 2.1% and 0.8 ± 1.9% for microDiamond. This feasibility study confirmed that the deviation of the detectors can be reduced using an appropriate detector with CFs.
Collapse
|
2
|
Oshikane T, Kaidu M, Abe E, Ohta A, Saito H, Nakano T, Honda M, Tanabe S, Utsunomiya S, Sasamoto R, Ishizaki F, Kasahara T, Nishiyama T, Tomita Y, Aoyama H, Ishikawa H. A comparative study of high-dose-rate brachytherapy boost combined with external beam radiation therapy versus external beam radiation therapy alone for high-risk prostate cancer. JOURNAL OF RADIATION RESEARCH 2021; 62:525-532. [PMID: 33823010 PMCID: PMC8127662 DOI: 10.1093/jrr/rrab006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 07/01/2021] [Accepted: 01/15/2020] [Indexed: 06/12/2023]
Abstract
We aimed to compare the outcomes of high-dose-rate brachytherapy (HDR-BT) boost and external beam radiation therapy (EBRT) alone for high-risk prostate cancer. This was a single-center, retrospective and observational study. Consecutive patients who underwent initial radical treatment by HDR-BT boost or EBRT alone from June 2009 to May 2016 at the Niigata University Medical and Dental Hospital, Japan were included. A total of 96 patients underwent HDR-BT boost, and 61 underwent EBRT alone. The prescription dose of HDR-BT boost was set to 18 Gy twice a day with EBRT 39 Gy/13 fractions. The dose for EBRT alone was mostly 70 Gy/28 fractions. The high-risk group received >6 months of prior androgen deprivation therapy. Overall survival, biochemical-free survival, local control and distant metastasis-free survival rates at 5 years were analyzed. The incidence of urological and gastrointestinal late adverse events of Grade 2 and above was also summarized. In the National Comprehensive Cancer Network (NCCN) high-risk calssification, HDR-BT boost had a significantly higher biochemical-free survival rate at 5 years (98.9% versus 90.7%, P = 0.04). Urethral strictures were more common in the HDR-BT boost group. We will continuously observe the progress of the study patients and determine the longer term results.
Collapse
Affiliation(s)
- Tomoya Oshikane
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Motoki Kaidu
- Corresponding author. Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan. Tel: +81-25-227-2315; Fax: +81-25-227-0788;
| | - Eisuke Abe
- Division of Radiation Oncology, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka 940-8653, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Hirotake Saito
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Moe Honda
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Satoshi Tanabe
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Fumio Ishizaki
- Department of Urology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Takashi Kasahara
- Department of Urology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Tsutomu Nishiyama
- Division of Urology, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan
| | - Yoshihiko Tomita
- Department of Urology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| |
Collapse
|
3
|
Kai Y, Arimura H, Ninomiya K, Saito T, Shimohigashi Y, Kuraoka A, Maruyama M, Toya R, Oya N. Semi-automated prediction approach of target shifts using machine learning with anatomical features between planning and pretreatment CT images in prostate radiotherapy. JOURNAL OF RADIATION RESEARCH 2020; 61:285-297. [PMID: 31994702 PMCID: PMC7246080 DOI: 10.1093/jrr/rrz105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/26/2019] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
The goal of this study was to develop a semi-automated prediction approach of target shifts using machine learning architecture (MLA) with anatomical features for prostate radiotherapy. Our hypothesis was that anatomical features between planning computed tomography (pCT) and pretreatment cone-beam computed tomography (CBCT) images could be used to predict the target, i.e. clinical target volume (CTV) shifts, with small errors. The pCT and daily CBCT images of 20 patients with prostate cancer were selected. The first 10 patients were employed for the development, and the second 10 patients for a validation test. The CTV position errors between the pCT and CBCT images were determined as reference CTV shifts (teacher data) after an automated bone-based registration. The anatomical features associated with rectum, bladder and prostate were calculated from the pCT and CBCT images. The features were fed as the input with the teacher data into five MLAs, i.e. three types of artificial neural networks, support vector regression (SVR) and random forests. Since the CTV shifts along the left-right direction were negligible, the MLAs were developed along the superior-inferior and anterior-posterior directions. The proposed framework was evaluated from the residual errors between the reference and predicted CTV shifts. In the validation test, the mean residual error with its standard deviation was 1.01 ± 1.09 mm in SVR using only one feature (one click), which was associated with positional difference of the upper rectal wall. The results suggested that MLAs with anatomical features could be useful in prediction of CTV shifts for prostate radiotherapy.
Collapse
Affiliation(s)
- Yudai Kai
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582, Japan
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hidetaka Arimura
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582, Japan
| | - Kenta Ninomiya
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582, Japan
| | - Tetsuo Saito
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshinobu Shimohigashi
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Akiko Kuraoka
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masato Maruyama
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Ryo Toya
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Natsuo Oya
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
4
|
Elakshar S, Tsui JMG, Kucharczyk MJ, Tomic N, Fawaz ZS, Bahoric B, Papayanatos J, Chaddad A, Niazi T. Does Interfraction Cone Beam Computed Tomography Improve Target Localization in Prostate Bed Radiotherapy? Technol Cancer Res Treat 2019; 18:1533033819831962. [PMID: 30782085 PMCID: PMC6383090 DOI: 10.1177/1533033819831962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose: In this prospective phase II study, we investigated whether cone beam computed
tomography scan was a superior method of image-guided radiotherapy relative to 2D
orthogonal kilovoltage images in the post-radical prostatectomy setting. Methods: A total of 419 treatment fractions were included in this analysis. The shifts required
to align the patient for each treatment were performed using 3D matching between cone
beam computed tomography scans and the corresponding computed tomography images used for
planning. This was compared with the shifts obtained from 2D orthogonal kilovoltage
images, matching with the corresponding digitally reconstructed radiographs. Patients
did not have fiducials inserted to assist with localization. Interfractional changes in
the bladder and rectal volumes were subsequently measured on the cone beam computed
tomography images for each fraction and compared to the shift differences between
orthogonal kilovoltage and cone beam computed tomography scans. The proportion of
treatment fractions with a shift difference exceeding the planning target volume of 7
mm, between orthogonal kilovoltage and cone beam computed tomography scans, was
calculated. Results: The mean vertical, lateral, and longitudinal shifts resulted from 2D match between
orthogonal kilovoltage images and corresponding digitally reconstructed radiographs were
0.353 cm (interquartile range: 0.1-0.5), 0.346 cm (interquartile range: 0.1-0.5), and
0.289 cm (interquartile range: 0.1-0.4), compared to 0.388 cm (interquartile range:
0.1-0.5), 0.342 cm (interquartile range: 0.1-0.5), and 0.291 cm (interquartile range:
0.1-0.4) obtained from 3D match between cone beam computed tomography and planning
computed tomography scan, respectively. Our results show a significant difference
between the kilovoltage and cone beam computed tomography shifts in the
anterior–posterior direction (P = .01). The proportion of treatment
fractions in which the differences in kilovoltage and cone beam computed tomography
shifts between exceeded the 7 mm planning target volume margin was 6%, 2%, and 3% in the
anterior–posterior, lateral, and superior–inferior directions, respectively. Conclusion: We prospectively demonstrated that the daily use of volumetric cone beam computed
tomography for treatment localization in post-radical prostatectomy patients
demonstrated an increased need for a shift in patient position. This suggests that in
post-radical prostatectomy patients the daily cone beam computed tomography imaging
improved localization of the prostate bed and may have prevented a limited number of
geographic misses, compared to daily kilovoltage imaging that was not assisted with
fiducials.
Collapse
Affiliation(s)
- Sara Elakshar
- 1 McGill University, Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Nada Tomic
- 4 Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | | | - Ahmad Chaddad
- 2 McGill University Health Centre, Montreal, Quebec, Canada
| | - Tamim Niazi
- 1 McGill University, Jewish General Hospital, Montreal, Quebec, Canada
| |
Collapse
|
5
|
Tanabe S, Utsunomiya S, Abe E, Sato H, Ohta A, Sakai H, Yamada T, Kaidu M, Aoyama H. The impact of the three degrees-of-freedom fiducial marker-based setup compared to soft tissue-based setup in hypofractionated intensity-modulated radiotherapy for prostate cancer. J Appl Clin Med Phys 2019; 20:53-59. [PMID: 31054217 PMCID: PMC6560240 DOI: 10.1002/acm2.12603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 03/21/2019] [Accepted: 04/10/2019] [Indexed: 11/09/2022] Open
Abstract
Purpose We evaluated the setup accuracy of a three‐degree‐of‐freedom fiducial marker (3DOF‐FM)‐based setup compared to a soft tissue (ST)‐based setup in hypofractionated intensity‐modulated radiotherapy (IMRT) for prostate cancer. Materials and Methods We analyzed the setup accuracy for 17 consecutive prostate cancer patients with three implanted FMs who underwent hypofractionated IMRT. The 3DOF‐ST‐based setup using cone‐beam computed tomography (CT) was performed after a six DOF‐bony structure (BS)‐based setup using an ExacTrac x‐ray system. The 3DOF‐FM‐based matching using the ExacTrac x‐ray system was done during the BS‐ and ST‐based setups. We determined the mean absolute differences and the correlation between the FM‐ and ST‐based translational shifts relative to the BS‐based setup position. The rotational mean shifts detected by the ExacTrac x‐ray system were also evaluated. Results The mean differences in the anterior‐posterior (AP), superior‐inferior (SI), and left‐right (LR) dimensions were 0.69, 0.0, and 0.30 mm, respectively. The Pearson correlation coefficients for both shifts were 0.92 for AP, 0.91 for SI, and 0.68 for LR. The percentages of shift agreements within 2 mm were 85% for AP, 93% for SI, and 99% for LR. The absolute values of rotational shifts were 0.1° for AP, 0.3°, and 1.2° for LR. Conclusions The setup accuracy of the 3DOF‐FM‐based setup has the potential to be interchangeable with a ST‐based setup. Our data are likely to be useful in clinical practice along with the popularization of the hypofractionated IMRT in prostate cancer.
Collapse
Affiliation(s)
- Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiraku Sato
- Department of Radiology, Division of Radiation Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Takumi Yamada
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
6
|
Utsunomiya S, Yamamoto J, Tanabe S, Oishi M, Satsuma A, Kaidu M, Abe E, Ohta A, Kushima N, Aoyama H. Complementary Relation Between the Improvement of Dose Delivery Technique and PTV Margin Reduction in Dose-Escalated Radiation Therapy for Prostate Cancer. Pract Radiat Oncol 2019; 9:172-178. [PMID: 30772440 DOI: 10.1016/j.prro.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/07/2019] [Accepted: 02/06/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study is to demonstrate quantitatively the complementary relationship between the introduction of intensity modulated radiation therapy (IMRT) and planning target volume (PTV) margin reduction with an image guided technique in reducing the risk of rectal toxicity in dose-escalating prostate radiation therapy. METHODS AND MATERIALS Three-dimensional conformal radiation therapy (CRT) and IMRT plans were generated for 10 patients with prostate cancer based on 2 PTV margin protocols (10/8 mm and 6/5 mm) and 2 dose prescriptions (70 Gy and 78 Gy). The normal tissue complication probability (NTCP) for each of the 8 scenarios was calculated using the Lyman-Kutcher-Burman model to estimate the risk of rectal and bladder late toxicity. The conformity and homogeneity indices of PTVs were calculated for each plan. RESULTS The IMRT plans showed superiority in conformity and inferiority in homogeneity over 3-dimensional CRT plans. The rectal NTCPs were increased 3.5 to 4.1 times when the prescribed total dose was changed from 70 Gy to 78 Gy and the dose delivery and the image guided radiation therapy techniques remained unchanged. PTV margin reduction was shown to reduce the value of rectal NTCP significantly. Overall, implementing the IMRT technique alone could reduce the NTCP values only by 2.1% to 7.3% from those of 3-dimensional CRT. The introduction of both IMRT and PTV margin reduction was found to be necessary for rectal NTCP to remain <5% in the dose escalation from 70 to 78 Gy. CONCLUSIONS The complementary relationship between the introduction of IMRT and PTV margin reduction was proven. We found that both approaches need to be implemented to safely deliver a curative dose in dose-escalating prostate radiation therapy.
Collapse
Affiliation(s)
- Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan.
| | - Jun Yamamoto
- School of Medicine, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Mayu Oishi
- School of Medicine, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Aruha Satsuma
- School of Medicine, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Eisuke Abe
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Hidefumi Aoyama
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
7
|
Giddings A, Nica L, French J, Davis CA, Smoke M, Bolderston A. Patterns of Practice in Canadian Radiation Treatment Centres: Results of a National Survey. J Med Imaging Radiat Sci 2018; 49:23-30. [DOI: 10.1016/j.jmir.2017.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/03/2017] [Accepted: 10/11/2017] [Indexed: 12/26/2022]
|