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Glayl AG, Salem KH, Noori HM, Abdul-Zahra DS, Shareef Abdalhussien N, Alkhafaji MA. Evaluation treatment planning system for oropharyngeal cancer patient using machine learning. Appl Radiat Isot 2023; 199:110785. [PMID: 37300928 DOI: 10.1016/j.apradiso.2023.110785] [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: 10/27/2022] [Revised: 02/17/2023] [Accepted: 03/21/2023] [Indexed: 06/12/2023]
Abstract
Oropharyngeal cancer (OPC) comprises a group of various malignant tumours that grow in the throat, larynx, mouth, sinuses, and nose. THE RESEARCH AIMS: to investigate the performance of the OPC VMAT model by comparison to clinical plans in terms of dosimetric parameters and normal tissue complication probabilities. PURPOSE Tune the model which at least matches the performance of clinical created photon treatment plans and analyse and find the most appropriate strategic plan scheme for OPC. METHODS AND MATERIALS The machine learning (ML) plans are compared to the reference plans (clinical plans) based on dose constraints and target coverage. VMAT oropharynx ML model of Raystation development 11B version (non-clinical) was used. A model was trained by using different modalities. A different strategy of machine learning and clinical plans was performed for five patients. The dose Prescribed for OPC is 70 Gy, 2 Gy per fraction (2Gy/Fx). The PTV was derived for the primary tumour and secondary tumour, PTV+7000 cGy and PTV_5425 cGy volumetric modulated arc therapy (VMAT) were used with beams performing a full 360° rotation around the single isocenter. RESULTS Organs at risk were observed that the volume of L-Eye in clinical plan (AF) for the case1 treatment planning could be successfully used ensuring efficiency and lower than MLVMAT and MLVMAT-org plans were 372 cGy, 697 cGy and 667 cGy respectively, while showed case2, case3, case4 and case5 are better to protect the critical organs in ML plan compare with a clinical plan. DHI for the PTV-7000 and PTV-5425 is between 1 and 1.34, While DCI for PTV-7000 and PTV-5425 is between 0.98 and 1.
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Affiliation(s)
- Ahmed Ghanim Glayl
- Department of Radiation Oncology, University Medical Center Groningen, Netherlands
| | - Karrar Hazim Salem
- Pharmacy Department, Al-Mustaqbal University College, 51001, Hillah, Babil, Iraq
| | - Harith Muthanna Noori
- Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkiye
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Dosimetric sensitivity of leaf width on volumetric modulated arc therapy plan quality: an objective approach. Rep Pract Oncol Radiother 2022; 27:76-85. [PMID: 35402026 PMCID: PMC8989436 DOI: 10.5603/rpor.a2022.0001] [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: 11/05/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Several authors investigated a dosimetric impact of leaf width on radiotherapy plan quality subjectively, and concluded that thinner leaf-width multileaf collimators (MLC) are beneficial because of their better coverage of clinically relevant structures. Study aimed to investigate the dosimetric effect of MLC leaf width on volumetric modulated arc therapy plan quality by objective approach. Materials and methods Twelve of each prostate and head-and-neck patients were planned for volumetric modulated arc therapy (VMAT) treatments for MLC leaf widths of 4 mm and 10 mm. Three different VMAT schemes single-arc, dual-arc and two combined independent single-arcs were optimized. Dose volume histogram and Isodose distribution were used for quantitative and qualitative comparison of the treatment plan, respectively. Dose-volume-indices of the planning target volume, organs at risk and number of delivered monitor units were compared. The 4 mm leaf width being reference over 10 mm and results were noted as statistically significant if p ≤ 0.05 using student t-test. Results All VMAT schemes for both tumor sites showed a gain in target coverage, similar organs at risk doses and higher monitor units to be delivered, when changing leaf width from 10 mm to 4 mm. The p-values were significant for majority of head-and-neck dose indices. Conclusion The thinner-leaf MLCs, owing to their better spatial resolution, result in an overall gain for target coverage, while maintaining permissible doses to the organs at risk.
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Li M, Chen L, Chang C, Tsai J, Lin J. Effect of the simulated half leaf width of a multileaf collimator on volumetric modulated arc therapy plan quality in hippocampal avoidance whole-brain radiotherapy. J Appl Clin Med Phys 2022; 23:e13575. [PMID: 35239259 PMCID: PMC9121030 DOI: 10.1002/acm2.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Whole‐brain radiotherapy (WBRT) is commonly used in patients with multiple brain metastases. Compared with conventional WBRT, hippocampal avoidance WBRT (HA‐WBRT) more favorably preserves cognitive function and the quality of life. The hippocampal volume is considerably small (approximately 3.3 cm3). Therefore, downsizing the leaf width of a multileaf collimator (MLC) may provide higher spatial resolution and better plan quality. Volumetric modulated arc therapy (VMAT) could simulate the half MLC leaf width through couch shifting between arcs. This study investigated changes in VMAT quality for HA‐WBRT with a simulated fine MLC leaf width. Methods We included 18 patients with brain metastasis. All target and avoidance structures were contoured by an experienced radiation oncologist. The prescribed dose was 30 Gy in 10 fractions. For each patient, three different treatment plans were generated for comparison: VMAT with couch‐shift, VMAT without couch‐shift, and TomoTherapy. All treatment plans fulfilled Radiation Therapy Oncology Group (RTOG) 0933 criteria for HA‐WBRT. The Wilcoxon paired signed‐rank test was used to compare different treatment plans. Results VMAT with couch‐shift had the better average conformity index (0.823) with statistically significant difference compared to VMAT without couch‐shift (0.810). VMAT with couch‐shift (0.219) had a more favorable average homogeneity index (HI) than did VMAT without couch‐shift (0.230), although the difference was not significant. TomoTherapy had an optimal average HI of 0.070. In terms of the hippocampus, all three treatment plans met the RTOG 0933 criteria. VMAT with couch‐shift had a lower average Dmax (15.2 Gy) than did VMAT without couch‐shift (15.3 Gy, p = 0.071) and TomoTherapy (15.5 Gy, p = 0.133). The average D100% of hippocampus was the same for both VMAT with and without couch‐shift (8.5 Gy); however, TomoTherapy had a lower average D100% value of 7.9 Gy. The treatment delivery time was similar between VMAT with and without couch‐shift (average, 375.0 and 369.6 s, respectively). TomoTherapy required a long average delivery time of 1489.9 s. Conclusion The plan quality of VMAT for HA‐WBRT was improved by using the couch‐shift technique to simulate the half MLC leaf width. However, the improvement was not statistically significant except conformity index. The downsizing effect decreased with the use of the sophisticated grade of VMAT. TomoTherapy offered superior plan quality but required the longest delivery time.
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Affiliation(s)
- Ming‐Hsien Li
- Department of Radiation OncologyShuang Ho HospitalTaipei Medical UniversityTaipeiTaiwanROC
- Department of RadiologySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwanROC
| | - Li‐Jhen Chen
- Department of Radiation OncologyShuang Ho HospitalTaipei Medical UniversityTaipeiTaiwanROC
| | - Chih‐Chieh Chang
- Department of Radiation OncologyShuang Ho HospitalTaipei Medical UniversityTaipeiTaiwanROC
| | - Jo‐Ting Tsai
- Department of Radiation OncologyShuang Ho HospitalTaipei Medical UniversityTaipeiTaiwanROC
- Department of RadiologySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwanROC
| | - Jang‐Chun Lin
- Department of Radiation OncologyShuang Ho HospitalTaipei Medical UniversityTaipeiTaiwanROC
- Department of RadiologySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwanROC
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Yoosuf AM, Ahmad MB, AlShehri S, Alhadab A, Alqathami M. Investigation of optimum minimum segment width on VMAT plan quality and deliverability: A comprehensive dosimetric and clinical evaluation using DVH analysis. J Appl Clin Med Phys 2021; 22:29-40. [PMID: 34592787 PMCID: PMC8598144 DOI: 10.1002/acm2.13417] [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: 04/19/2021] [Revised: 06/23/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose Minimum segment width (MSW) plays a fundamental role in the shaping of optimized apertures and creation of segments of varying sizes and shapes in complex radiotherapy treatment plans. The purpose of this work was to study the effect of MSW on dose distribution in patients planned with VMAT for various treatment sites using dose volume histogram (DVH) analysis. Materials and methods For the validation of optimum MSW, 125 clinical treatment plans were evaluated. Five groups were identified (brain, head and neck, thorax, pelvis, and extremity), and five cases were chosen from each group. For each case, five plans were created with different MSW (0.5, 0.8, 1.0, 1.25, and 1.5 cm). The quality of treatment plans created using different MSW were compared using dosimetric indicators such as target coverage (D98—dose to 98% of the planning target volume (PTV), maximum dose (D2—maximum dose to 2% of the PTV), monitor units (MU), and DVH parameters related to organs at risk (OAR). The effect of the MSW on delivery accuracy was quantitatively analyzed using the measured fluence utilizing ionization chamber‐based transmission detector and model‐based dose verification system. Traditional global gamma analysis (2%, 2 mm) and dose volume information was gathered for the PTV and organs at risk and compared for different MSWs. Results A total of 125 plans were created and compared across five groups. In terms of treatment plan quality, the plans using MSW of 0.5 cm was found to be superior in all groups. PTV coverage (D98) decreased significantly (p < 0.05) as the MSW increased. Similarly, the maximum dose (D2) was found to be increased significantly (p < 0.05) as the MSW increased from 0.5 cm, with MSW of 1.5 cm being the least in terms of plan quality for both PTVs and OARs. In terms of plan deliverability using DVH analysis, treatment planning system (TPS) compared to measured fluence, VMAT plans produced with MSW of 0.5 cm showed a better dosimetric index and a smaller deviation for both PTVs and OARs. The deliverability of the plans deteriorated as the MSW increased. Conclusion Dose volume histogram (DVH) analysis demonstrated that treatment plans with minimal MSW showed better plan quality and deliverability and provided clinical relevance as compared to gamma index analysis.
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Affiliation(s)
- Ab Mohamed Yoosuf
- Department of Radiation Oncology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Muhammad Bilal Ahmad
- Department of Radiation Oncology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Salem AlShehri
- Department of Radiation Oncology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulrahman Alhadab
- Department of Radiation Oncology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Mamdouh Alqathami
- Department of Radiation Oncology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Park H, Choi HJ, Hee Min C, Kim JI. Monte Carlo simulation of a 2D dynamic multileaf collimator to improve the plan quality in radiotherapy plan: a proof-of-concept study. Phys Med Biol 2019; 64:245009. [PMID: 31726432 DOI: 10.1088/1361-6560/ab57c4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The leaf width of a multileaf collimator (MLC) determines the dose conformity to the target volume. The objective of this study was to investigate the feasibility of a two-dimensional dynamic MLC (2DDMLC) to improve the treatment plan quality with a fixed leaf width. The treatment head of the Clinac™ linear accelerator with the Millennium 120™ MLC was modelled with the Geant4 (for GEometry ANd Tracking) tollkit using the Monte Carlo (MC) method. The 2DDMLC produces a beam aperture by moving the MLC bank vertically to the leaf movement. Thus, the effect of the 2DDMLC motion on beam divergence and beam fluence resolution was evaluated by comparing the dose distributions between the conventional MLC motion and the 2DDMLC. Finally, the 2DDMLC was employed for dynamic conformal arc therapy for 13 brain cancer patients. The dose-volumetric parameters, including the dose delivered to 98% of the target volume (D 98%), percent volume given 20% of the prescribed dose (V 20%), and conformity index (CI) were compared with those of the conventional MLC. For the 6 MV beam of the MC model, the depth dose and lateral dose distribution differed by less than 2% between the simulation and measurement. The 2DDMLC did not significantly influence beam divergence and sharpened the beam. In clinical use, the dose delivered to the target was almost identical between the 2DDMLC and conventional MLC (D 98% = 29.74 Gy versus 29.71 Gy, p = 0.18). The CI was improved with the use of the 2DDMLC (CI = 1.49 versus 1.47, p = 0.14). Moreover, irradiation of normal tissue was reduced with the 2DDMLC compared with conventional MLC (V 20% = 17.22% versus 17.45%, p < 0.001). The 2DDMLC improved the dose conformity to the target volume and reduced the irradiation of the normal tissue compared with the conventional MLC.
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Affiliation(s)
- Hyojun Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, Republic of Korea
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K BT, Ganesh KM, A P. Is High Definition MLC Dosimetrically Superior to Standard Definition MLC for SIB-SBRT for Carcinoma Prostate. Asian Pac J Cancer Prev 2019; 20:3817-3823. [PMID: 31870127 PMCID: PMC7173375 DOI: 10.31557/apjcp.2019.20.12.3817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 11/28/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The study was conducted to quantitatively evaluate the dosimetric effects of high definition (2.5 mm) and standard definition (5.0 mm) MLC on the quality of SBRT plans using SIB-IMRT and SIB-VMAT technique for carcinoma prostate and also to evaluate the dosimetric advantage of one technique over the other. MATERIALS AND METHODS Seventeen annonymized planning CT data sets were used to generate plans for both VMAT and IMRT techniques using 2.5 mm and 5.0 mm MLC.The prescription to the nodule was 45Gy in 5 fractions and to the prostate was 35Gy in 5 fractions.CI, GI, D2%, D98%, D50% and V95% for target; D2%, Dmean, V80%, V20% for OAR's; V5% of the irradiated volume, and delivered MU's were analyzed.An independent t-test was used to compare the plans. Patient specific QA for all plans were also performed and analyzed. RESULTS Minor difference in dosimetric indices was observed between 2.5mm and 5mm MLC VMAT plans, except D2% (PTV35) and D98% (GTV45) were better in 2.5mm MLC plans (p.
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Affiliation(s)
- Bijina T K
- Research and Development center, Bharathiar University, Coimbatore,
- Department of Radiation Oncology, Healthcare Global Enterprises,
| | - K M Ganesh
- Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, India.
| | - Pichandi A
- Department of Radiation Oncology, Healthcare Global Enterprises,
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Park JM, Wu HG, Kim HJ, Choi CH, Kim JI. Comparison of treatment plans between IMRT with MR-linac and VMAT for lung SABR. Radiat Oncol 2019; 14:105. [PMID: 31196120 PMCID: PMC6567463 DOI: 10.1186/s13014-019-1314-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/31/2019] [Indexed: 12/25/2022] Open
Abstract
Background The aim of this study was to compare the plan quality of magnetic-resonance image-based intensity modulated radiation therapy (MRI-based-IMRT) with the MRIdian Linac system to that of volumetric modulated arc therapy (VMAT) with the TrueBeam STx system for lung stereotactic ablative radiotherapy (SABR). Methods A total of 22 patients with tumors located in the lower lobe were retrospectively selected for the study. For each patient, both the MRI-based-IMRT and VMAT plans were generated using an identical CT image set and identical structures with the exception of the planning target volume (PTV). The PTVs of the MRI-based-IMRT were generated by adding an isotropic margin of 3 mm from the gross tumor volume, whereas those of VMAT were generated by adding an isotropic margin of 5 mm from the internal target volume. For both the MRI-based-IMRT and VMAT, the prescription doses to the PTVs were 60 Gy in four fractions. Results The average PTV volume of the MRI-based-IMRT was approximately 4-times smaller than that of VMAT (p < 0.001). The maximum dose to the bronchi for the MRI-based-IMRT was smaller than that for the VMAT (20.4 Gy versus 24.2 Gy, p < 0.001). In addition, V40Gy of the rib for the MRI-based-IMRT was smaller than that for the VMAT (1.8 cm3 versus 7.7 cm3, p = 0.008). However, the maximum doses to the skin and spinal cord for the MRI-based-IMRT (33.0 Gy and 14.5 Gy, respectively) were larger than those for the VMAT (27.8 Gy and 11.0 Gy, respectively) showing p values of less than 0.02. For the ipsilateral lung, the mean dose, V20Gy, V10Gy, and V5Gy for the MRI-based-IMRT were smaller than those for the VMAT (all with p < 0.05). For the contralateral lung, V5Gy, V10Gy, D1500cc, and D1000cc for the MRI-based-IMRT were larger than those for the VMAT (all with p < 0.05). The mean dose and V50% of the whole body for the MRI-based-IMRT were smaller than those for the VMAT (0.9 Gy versus 1.2 Gy, and 78.7 cm3 versus 103.5 cm3, respectively, all at p < 0.001). Conclusions The MRI-based-IMRT using the MRIdian Linac system could reduce doses to bronchi, rib, ipsilateral lung, and whole body compared to VMAT for lung SABR when the tumor was located in the lower lobe.
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Affiliation(s)
- Jong Min Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.,Institute for Smart System, Robotics Research Laboratory for Extreme Environments, Advanced Institutes of Convergence Technology, Suwon, South Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.,Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Hak Jae Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.,Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Chang Heon Choi
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea. .,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea. .,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
| | - Jung-In Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea. .,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea. .,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
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Park JM, Park SY, Wu HG, Kim JI. Improvement of VMAT plan quality for head and neck cancer with high resolution fluences generated by couch shift between arcs. Phys Med 2018. [PMID: 29519394 DOI: 10.1016/j.ejmp.2018.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To investigate the changes in quality of the volumetric modulated arc therapy (VMAT) plans with couch-shift between arcs by half of a multi-leaf collimator (MLC) leaf width. METHODS A total of 22 patients with head-and-neck cancer were retrospectively selected. Since the smallest MLC leaf width was 5 mm in this study, the couch was shifted by 2.5 mm in the longitudinal-direction between arcs to increase the resolution of fluence map. A total of three types of VMAT plans were generated for each patient; the three types of plans were a two-full-arc plan without couch-shift (NS plan), a two-half-arc-pair plan with couch-shift (HAS plan), and a two-full-arc pair plan with couch-shift (FAS plan). Changes in the dose-volumetric parameters were investigated. RESULTS The FAS plan showed the best plan quality for the target volumes and organs at risk compared to the NS and HAS plans. However, the magnitudes of differences among the three types of plans were minimal, and every plan was clinically acceptable. The average integral doses of the NS, HAS, and FAS plans were 160,549 ± 37,600 Gy-cc, 147,828 ± 33,343 Gy-cc, and 156,030 ± 36,263 Gy-cc, respectively. The average monitor unit of the NS, HAS, and FAS plans were 717 ± 120 MU, 648 ± 100 MU, and 763 ± 158 MU, respectively. CONCLUSIONS The HAS plan was better than the others in terms of normal tissue sparing and plan efficiency. By shifting the couch by half of the MLC leaf width in the longitudinal direction between arcs, the VMAT plan quality could be improved.
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Affiliation(s)
- Jong Min Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Robotics Research Laboratory for Extreme Environments, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
| | - So-Yeon Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-In Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
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Shende R, Patel G. Validation of Dosimetric Leaf Gap (DLG) prior to its implementation in Treatment Planning System (TPS): TrueBeam™ millennium 120 leaf MLC. Rep Pract Oncol Radiother 2017; 22:485-494. [PMID: 29070960 DOI: 10.1016/j.rpor.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/14/2017] [Accepted: 09/27/2017] [Indexed: 11/28/2022] Open
Abstract
AIM Objective of present study is to determine optimum value of DLG and its validation prior to being incorporated in TPS for Varian TrueBeam™ millennium 120 leaves MLC. BACKGROUND Partial transmission through the rounded leaf ends of the Multi Leaf Collimator (MLC) causes a conflict between the edges of the light field and radiation field. Parameter account for this partial transmission is called Dosimetric Leaf Gap (DLG). The complex high precession technique, such as Intensity Modulated Radiation Therapy (IMRT), entails the modeling of optimum value of DLG inside Eclipse Treatment Planning System (TPS) for precise dose calculation. MATERIALS AND METHODS Distinct synchronized uniformed extension of sweeping dynamic MLC leaf gap fields created by Varian MLC shaper software were use to determine DLG. DLG measurements performed with both 0.13 cc semi-flex ionization chamber and 2D-Array I-Matrix were used to validate the DLG; similarly, values of DLG from TPS were estimated from predicted dose. Similar mathematical approaches were employed to determine DLG from delivered and TPS predicted dose. DLG determined from delivered dose measured with both ionization chamber (DLGIon) and I-Matrix (DLGI-Matrix) compared with DLG estimate from TPS predicted dose (DLGTPS). Measurements were carried out for all available 6MV, 10MV, 15MV, 6MVFFF and 10MVFFF beam energies. RESULTS Maximum and minimum DLG deviation between measured and TPS calculated DLG was found to be 0.2 mm and 0.1 mm, respectively. Both of the measured DLGs (DLGIon and DLGI-Matrix) were found to be in a very good agreement with estimated DLG from TPS (DLGTPS). CONCLUSIONS Proposed method proved to be helpful in verifying and validating the DLG value prior to its clinical implementation in TPS.
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Affiliation(s)
- Ravindra Shende
- Department of Radiation Oncology, Capitol Hospital, Jalandhar, India
| | - Ganesh Patel
- Department of Radiation Oncology, AIIMS, Rishikesh, India
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Park JM, Park SY, Choi CH, Chun M, Kim JH, Kim JI. Treatment plan comparison between Tri-Co-60 magnetic-resonance image-guided radiation therapy and volumetric modulated arc therapy for prostate cancer. Oncotarget 2017; 8:91174-91184. [PMID: 29207634 PMCID: PMC5710914 DOI: 10.18632/oncotarget.20039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/25/2017] [Indexed: 12/29/2022] Open
Abstract
To investigate the plan quality of tri-Co-60 intensity-modulated radiation therapy (IMRT) with magnetic-resonance image-guided radiation therapy compared with volumetric-modulated arc therapy (VMAT) for prostate cancer. Twenty patients with intermediate-risk prostate cancer, who received radical VMAT were selected. Additional tri-Co-60 IMRT plans were generated for each patient. Both primary and boost plans were generated with tri-Co-60 IMRT and VMAT techniques. The prescription doses of the primary and boost plans were 50.4 Gy and 30.6 Gy, respectively. The primary and boost planning target volumes (PTVs) of the tri-Co-60 IMRT were generated with 3 mm margins from the primary clinical target volume (CTV, prostate + seminal vesicle) and a boost CTV (prostate), respectively. VMAT had a primary planning target volume (primary CTV + 1 cm or 2 cm margins) and a boost PTV (boost CTV + 0.7 cm margins), respectively. For both tri-Co-60 IMRT and VMAT, all the primary and boost plans were generated that 95% of the target volumes would be covered by the 100% of the prescription doses. Sum plans were generated by summation of primary and boost plans. In sum plans, the average values of V70 Gy of the bladder of tri-Co-60 IMRT vs. VMAT were 4.0% ± 3.1% vs. 10.9% ± 6.7%, (p < 0.001). Average values of V70 Gy of the rectum of tri-Co-60 IMRT vs. VMAT were 5.2% ± 1.8% vs. 19.1% ± 4.0% (p < 0.001). The doses of tri-Co-60 IMRT delivered to the bladder and rectum were smaller than those of VMAT while maintaining identical target coverage in both plans.
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Affiliation(s)
- Jong Min Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Robotics Research Laboratory for Extreme Environments, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
| | - So-Yeon Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chang Heon Choi
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minsoo Chun
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-In Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Park JM, Park SY, Kim JI, Kang HC, Choi CH. A comparison of treatment plan quality between Tri-Co-60 intensity modulated radiation therapy and volumetric modulated arc therapy for cervical cancer. Phys Med 2017; 40:11-16. [PMID: 28760506 DOI: 10.1016/j.ejmp.2017.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/12/2017] [Accepted: 06/15/2017] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To investigate the plan quality of tri-Co-60 intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) for cervical cancer. METHODS A total of 20 patients who received postoperative radiotherapy for cervical cancer were selected. For each patient, a tri-Co-60 IMRT plan for which the target volume was the planning target volume (PTV) generated by adding 1mm isotropic margins from the clinical target volume (CTV) and a VMAT plan for which the target volume was the PTV generated by adding 7mm and 10mm margins from the CTV were generated. The tri-Co-60 IMRT plans were generated with the ViewRay™ system while the VMAT plans were generated with 15-MV photon beams from a linear accelerator (prescription dose=50.4Gy in 28 fractions). RESULTS The average volumes of the PTVs and CTVs were 704.9cc±87.8cc and 271.6cc±51.6cc, respectively. No noticeable differences in the dose-volumetric parameters for the target volumes were observed between the tri-Co-60 IMRT and VMAT plans. The values of V40Gy for the small bowel and rectal wall, V45Gy of the bladder, and V35Gy of the femoral heads for the VMAT plans were 14.6%±7.8%, 54.4%±4.2%, 30.0%±4.7%, and 8.9%±3.3%, respectively. Those of the tri-Co-60 IMRT plans were 2.8%±2.1%, 23.0%±8.9%, 17.1%±6.1%, and 0.3%±0.4%, respectively. CONCLUSIONS Owing to the target margin reduction capability, the tri-Co-60 IMRT plans were more favorable than the VMAT plans for cervical cancer.
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Affiliation(s)
- Jong Min Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Center for Convergence Research on Robotics, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
| | - So-Yeon Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung-In Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun-Cheol Kang
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chang Heon Choi
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
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12
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Choi CH, Park SY, Kim JI, Kim JH, Kim K, Carlson J, Park JM. Quality of tri-Co-60 MR-IGRT treatment plans in comparison with VMAT treatment plans for spine SABR. Br J Radiol 2016; 90:20160652. [PMID: 27781486 DOI: 10.1259/bjr.20160652] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To investigate the plan quality of tri-Co-60 intensity-modulated radiation therapy (IMRT) plans for spine stereotactic ablative radiotherapy (SABR). METHODS A total of 20 patients with spine metastasis were retrospectively selected. For each patient, a tri-Co-60 IMRT plan and a volumetric-modulated arc therapy (VMAT) plan were generated. The spinal cords were defined based on MR images for the tri-Co-60 IMRT, while isotropic 1-mm margins were added to the spinal cords for the VMAT plans. The VMAT plans were generated with 10-MV flattening filter-free photon beams of TrueBeam STx™ (Varian Medical Systems, Palo Alto, CA), while the tri-Co-60 IMRT plans were generated with the ViewRay™ system (ViewRay inc., Cleveland, OH). The initial prescription dose was 18 Gy (1 fraction). If the tolerance dose of the spinal cord was not met, the prescription dose was reduced until the spinal cord tolerance dose was satisfied. RESULTS The mean dose to the target volumes, conformity index and homogeneity index of the VMAT and tri-Co-60 IMRT were 17.8 ± 0.8 vs 13.7 ± 3.9 Gy, 0.85 ± 0.20 vs 1.58 ± 1.29 and 0.09 ± 0.04 vs 0.24 ± 0.19, respectively. The integral doses and beam-on times were 16,570 ± 1768 vs 22,087 ± 2.986 Gy cm3 and 3.95 ± 1.13 vs 48.82 ± 10.44 min, respectively. CONCLUSION The tri-Co-60 IMRT seems inappropriate for spine SABR compared with VMAT. Advances in knowledge: For spine SABR, the tri-Co-60 IMRT is inappropriate owing to the large penumbra, large leaf width and low dose rate of the ViewRay system.
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Affiliation(s)
- Chang Heon Choi
- 1 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,2 Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,3 Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - So-Yeon Park
- 1 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,2 Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,3 Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung-In Kim
- 1 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,2 Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,3 Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Ho Kim
- 1 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,2 Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,3 Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyubo Kim
- 4 Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Joel Carlson
- 5 Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Jong Min Park
- 1 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.,2 Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,3 Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.,6 Center for Convergence Research on Robotics, Advance Institutes of Convergence Technology, Suwon, Republic of Korea
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