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Vandewinckele L, Reynders T, Weltens C, Maes F, Crijns W. Deep learning based MLC aperture and monitor unit prediction as a warm start for breast VMAT optimisation. Phys Med Biol 2023; 68:225013. [PMID: 37903442 DOI: 10.1088/1361-6560/ad07f6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 11/01/2023]
Abstract
Objective. Automated treatment planning today is focussed on non-exact, two-step procedures. Firstly, dose-volume histograms (DVHs) or 3D dose distributions are predicted from the patient anatomy. Secondly, these are converted in multi-leaf collimator (MLC) apertures and monitor units (MUs) using a generic optimisation to obtain the final treatment plan. In contrast, we present a method to predict volumetric modulated arc therapy (VMAT) MLC apertures and MUs directly from patient anatomy using deep learning. The predicted plan is then provided as initialisation to the optimiser for fine-tuning.Approach. 148 patients (training: 101; validation: 23; test: 24), treated for right breast cancer, are replanned to obtain a homogeneous database of 3-arc VMAT plans (PTVBreast: 45.57 Gy; PTVBoost: 55.86 Gy) according to the clinical protocol, using RapidPlanTMwith automatic optimisation and extended convergence mode (clinical workflow). Projections of the CT and contours are created along the beam's eye view of all control points and given as input to a U-net type convolutional neural networks (CNN). The output are the MLC aperture and MU for all control points, from which a DICOM RTplan is built. This is imported and further optimised in the treatment planning system using automatic optimisation without convergence mode, with clinical PTV objectives and organs-at-risk (OAR) objectives based on the DVHs calculated from the imported plan (CNN workflow).Main results. Mean dose differences between the clinical and CNN workflow over the test set are 0.2 ± 0.5 Gy atD95%and 0.6 ± 0.4 Gy atD0.035ccof PTVBreastand -0.4 ± 0.3 Gy atD95%and 0.7 ± 0.3 Gy atD0.035ccof PTVBoost. For the OAR, they are -0.2 ± 0.2 Gy forDmean,heartand 0.04 ± 0.8 Gy forDmean,ipsilateral lung. The mean computation time is 60 and 25 min respectively.Significance. VMAT optimisation can be initialised by MLC apertures and MUs, directly predicted from patient anatomy using a CNN, reducing planning time with more than half while maintaining clinically acceptable plans. This procedure puts the planner in a supervising role over an AI-based treatment planning workflow.
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Affiliation(s)
- L Vandewinckele
- Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Belgium
- Department of Radiation Oncology, UZ Leuven, Belgium
| | - T Reynders
- Department of Radiation Oncology, UZ Leuven, Belgium
| | - C Weltens
- Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Belgium
- Department of Radiation Oncology, UZ Leuven, Belgium
| | - F Maes
- Department ESAT/PSI, KU Leuven, Belgium
- Medical Imaging Research Center, UZ Leuven, Belgium
| | - W Crijns
- Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Belgium
- Department of Radiation Oncology, UZ Leuven, Belgium
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Daems F, Derdelinckx J, Ceyssens S, Vanden Bossche S, Reynders T, Willekens B. Improved detection of MOG antibody-associated transverse myelitis with 18F-FDG-PET: a case report. Acta Neurol Belg 2022; 123:735-738. [PMID: 36138305 PMCID: PMC9510358 DOI: 10.1007/s13760-022-02101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- F Daems
- Department of Neurology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium.
- Faculty of Medicine and Health Sciences, Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Universiteitsplein 1, Buidling S.2.52, 2610, Wilrijk, Belgium.
| | - J Derdelinckx
- Department of Neurology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
- Faculty of Medicine and Health Sciences, Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Universiteitsplein 1, Buidling S.2.52, 2610, Wilrijk, Belgium
| | - S Ceyssens
- Department of Nuclear Medicine, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
| | - S Vanden Bossche
- Department of Radiology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
- Department of Radiology, Sint-Jan General Hospital, Ruddershove 10, 8000, Brugge, Belgium
| | - T Reynders
- Department of Neurology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
- Faculty of Medicine and Health Sciences, Born-Bunge Institute, Translational Neurosciences Research Group, University of Antwerp, Universiteitsplein 1, Building T.635, 2610, Wilrijk, Belgium
| | - B Willekens
- Department of Neurology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
- Faculty of Medicine and Health Sciences, Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Universiteitsplein 1, Buidling S.2.52, 2610, Wilrijk, Belgium
- Faculty of Medicine and Health Sciences, Born-Bunge Institute, Translational Neurosciences Research Group, University of Antwerp, Universiteitsplein 1, Building T.635, 2610, Wilrijk, Belgium
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Lebeer M, Montagna M, Coito S, Reynders T, Raskin J. A rare case of Opsoclonus-Myoclonus associated with SCLC. Acta Neurol Belg 2020; 120:1017-1019. [PMID: 32557266 DOI: 10.1007/s13760-020-01402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
- M Lebeer
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.
| | - M Montagna
- Neurology and Stroke Unit Department, AZ Rivierenland, Rumst, Belgium
| | - S Coito
- Laboratoire Luxembourgeois d'analyses médicales, LLAM S.A., Luxembourg, Luxembourg
| | - T Reynders
- Department of Neurology, Antwerp University Hospital, Edegem, Belgium
| | - J Raskin
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
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Girardi A, Gevaert T, Jaudet C, Boussaer M, Burghelea M, Dhont J, Reynders T, Tournel K, De Ridder M. PO-0788: First assessment of Delivery Analysis tool for pre-treatment verification on the new Radixact system. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dhont J, Verellen D, Burghelea M, Van Den Begin R, Tournel K, Gevaert T, Engels B, Collen C, Jaudet C, Boussaer M, Reynders T, Storme G, De Ridder M. OC-0484: Variability of breathing-induced tumour motion: 4DCT – a source of misguiding information? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30924-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Burghelea M, Verellen D, Dhont J, Hung C, Poels K, Van den Begin R, Boussaer M, Tournel K, Jaudet C, Reynders T, Gevaert T, Simon V, De Ridder M. OC-0439: Treating patients with Dynamic Wave Arc: first clinical experience. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30881-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Reynders T, Van Parijs H, Heuninckx K, Verellen D, Storme G, De Ridder M. PD-0477: Dosimetric comparison of different non-invasive techniques for additional boost delivery after whole breast RT. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Buleteanu M, Reynders T, Verellen D, Depuydt T, Gevaert T, Poels K, Duchateau M, Van Parijs H, Simon V, De Ridder MM. SU-E-J-166: Combining Dynamic Wave Arc and Tangential Arc for Breast Boost Irradiation with the Vero System. Med Phys 2013. [DOI: 10.1118/1.4814378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Vermeersch SGG, de Hoon J, De Saint-Hubert B, Derdelinckx I, Serdons K, Bormans G, Reynders T, Declercq R, De Lepeleire I, Kennedy W, Blanchard R, Marcantonio E, Hargreaves R, Li CC, Sanabria S, Hostetler E, Joshi A, Evelhoch J, Van Laere K. PET imaging in healthy subjects and migraineurs suggests CGRP receptor antagonists do not have to act centrally to achieve clinical efficacy. J Headache Pain 2013. [DOI: 10.1186/1129-2377-14-s1-p224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vermeersch SGG, de Hoon J, De Saint-Hubert B, Derdelinckx I, Serdons K, Bormans G, Reynders T, Declercq R, De Lepeleire I, Kennedy W, Blanchard R, Marcantonio E, Hargreaves R, Li CC, Sanabria S, Hostetler E, Joshi A, Evelhoch J, Van Laere K. PET imaging in healthy subjects and migraineurs suggests CGRP receptor antagonists do not have to act centrally to achieve clinical efficacy. J Headache Pain 2013. [PMCID: PMC3620296 DOI: 10.1186/1129-2377-1-s14-p224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- SGG Vermeersch
- Center for Clinical Pharmacology, Campus Gasthuisberg, University Hospitals Leuven (KU Leuven), Leuv, Belgium
| | - J de Hoon
- Center for Clinical Pharmacology, Campus Gasthuisberg, University Hospitals Leuven (KU Leuven), Leuv, Belgium
| | - B De Saint-Hubert
- Center for Clinical Pharmacology, Campus Gasthuisberg, University Hospitals Leuven (KU Leuven), Leuv, Belgium
| | - I Derdelinckx
- Center for Clinical Pharmacology, Campus Gasthuisberg, University Hospitals Leuven (KU Leuven), Leuv, Belgium
| | - K Serdons
- Nuclear Medicine Department, UZ and KU Leuven, Belgium
| | - G Bormans
- Laboratory for Radiopharmacy, KU Leuven, Belgium
| | - T Reynders
- Merck Sharp & Dohme (Europe) Inc., Brussels, Belgium
| | - R Declercq
- Merck Sharp & Dohme (Europe) Inc., Brussels, Belgium
| | | | - W Kennedy
- Merck Research Laboratories, Upper Gwynedd PA, USA
| | - R Blanchard
- Merck Research Laboratories, Upper Gwynedd PA, USA
| | | | | | - CC Li
- Merck Research Laboratories, West Point PA, USA
| | - S Sanabria
- Merck Research Laboratories, West Point PA, USA
| | - E Hostetler
- Merck Research Laboratories, West Point PA, USA
| | - A Joshi
- Merck Research Laboratories, West Point PA, USA
| | - J Evelhoch
- Merck Research Laboratories, West Point PA, USA
| | - K Van Laere
- Nuclear Medicine Department, UZ and KU Leuven, Belgium
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Vermeersch SGG, de Hoon J, De Saint-Hubert B, Derdelinckx I, Serdons K, Bormans G, Reynders T, Declercq R, De Lepeleire I, Kennedy W, Blanchard R, Marcantonio E, Hargreaves R, Li CC, Sanabria S, Hostetler E, Joshi A, Evelhoch J, Van Laere K. PET imaging in healthy subjects and migraineurs suggests CGRP receptor antagonists do not have to act centrally to achieve clinical efficacy. J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p224] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Depuydt T, Gevaert T, Verellen D, Poels K, Duchateau M, Tournel K, Reynders T, De Ridder M. Geometric accuracy of real-time tumor tracking with the gimbal Linac system of the novel VERO SBRT system. Phys Med 2012. [DOI: 10.1016/j.ejmp.2012.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gevaert T, Boussaer M, Engels B, Heuninckx K, Duchateau M, Tournel K, Reynders T, Verellen D, De Ridder M. PO-0890 CLINICAL EVALUATION OF A ROBOTIC 6-DEGREE OF FREEDOM TREATMENT COUCH FOR FRAMELESS RADIOSURGERY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gevaert T, Engels B, Garibaldi C, Boussaer M, Verellen D, Deconinck P, Duchateau M, Reynders T, Depuydt T, Deridder M. PO-0920 IMPLEMENTATION OF HYBRIDARC TREATMENT TECHNIQUE IN PREOPERATIVE RADIOTHERAPY OF RECTAL CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71253-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Van Parijs H, Miedema G, Vinh-Hung V, Verbanck S, Adriaenssens N, Kerkhove D, Reynders T, Storme G, Verellen D, De Ridder M. EP-1017 HYPOFRACTIONATION WITH SIMULTANEOUS INTEGRATED BOOST FOR STAGE I-II BREAST CANCER, RANDOMIZED CLINICAL TRIAL. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71350-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Reynders T, Tournel K, Soete G, Duchateau M, Gevaert T, Depuydt T, Leysen K, Gulyban A, Boussaer M, Poels K, Storme G, Verellen D, De Ridder M. SU-E-T-454: Feasibilty of Image-Guided Total Marrow Irradiation Using Helical TomoTherapy. Med Phys 2011. [DOI: 10.1118/1.3612408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gevaert T, Verellen D, Engels B, Depuydt T, Heuninckx K, Tournel K, Duchateau M, Reynders T, Boussaer M, Poels K, DeRidder M. SU-E-J-136: Clinical Evaluation of a Robotic 6-Degree of Freedom Treatment Couch for Frameless Radiosurgery. Med Phys 2011. [DOI: 10.1118/1.3611903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Van Vaerenbergh S, Verellen D, Van De Vondel I, Heuninckx K, Tournel K, Reynders T, Duchateau M, Gevaert T, Leysen K, Depuydt T, Poels K, De Ridder M. SU-E-T-221: An In-House Developed Resettable MOSFET Dosimeter for Radiotherapy. Med Phys 2011. [DOI: 10.1118/1.3612171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Reynders T, Gevaert T, Engels B, Verellen D, De Coninck P, Duchateau M, Tournel K, Depuydt T, Ridder MD. SU-E-T-863: Feasibility Study of Using the HybridArc Treatment Technique for Preoperative Irradiation of Rectal Cancer: Comparison of Dose Patterns in Lesion and Organ at Risk with the Tomotherapy. Med Phys 2011. [DOI: 10.1118/1.3612827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gevaert T, Verellen D, Tournel K, Engels B, Duchateau M, Reynders T, Depuydt T, Boussaer M, Poels K, De Ridder M. Overview of positioning techniques using Image Guided Radiotherapy. Phys Med 2011. [DOI: 10.1016/j.ejmp.2011.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Van De Vondel I, Tournel K, Duchateau M, Reynders T, Van Vaerenbergh S, Boussaer M, Leysen K, Depuydt T, Poels K, Verellen D, De Ridder M. SU-E-T-457: Influence of Changing Magnetron and Injector Current on the Beam Characteristics of a Tomotherapy Hi-Art SYSTEM. Med Phys 2011. [DOI: 10.1118/1.3612411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gevaert T, Engels B, Verellen D, Deconinck P, Duchateau M, Reynders T, Tournel K, Depuydt T, Boussaer M, Poels K, De Ridder M. Feasibility study of using the HybridArc treatment technique for preoperative irradiation for rectal cancer: comparison of dose patterns in lesion and organ at risk with the Tomotherapy. Phys Med 2011. [DOI: 10.1016/j.ejmp.2011.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tournel K, Reynders T, Duchateau M, De Coninck P, Gevaert T, Depuydt T, Boussaer M, Poels K, Verellen D, Leysen K, De Ridder M. SU-E-J-171: The Possibility of Adaptive Breast Treatment on Tomotherapy Using a Patient-Specific Density Calibration. Med Phys 2011. [DOI: 10.1118/1.3611939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Depuydt T, Poels K, Gompel GV, Buls N, Gevaert T, Duchateau M, Reynders T, Tournel K, Verellen D, Ridder MD. SU-E-T-506: Low Dose Fluoroscopy Based Detection of Implanted Marker Position on the VERO System for Real-Time Tumor Tracking. Med Phys 2011. [DOI: 10.1118/1.3612459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tournel K, Duchateau M, Reynders T, Gevaert T, Depuydt T, Boussaer M, Leysen K, Poels K, Verellen D, De Ridder M. SU-E-J-172: The Effect of MVCT Image Quality Parameters on Dose Recalculation for Tomotherapy. Med Phys 2011. [DOI: 10.1118/1.3611940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Poels K, Depuydt T, Gevaert T, Reynders T, Tournel K, Duchateau M, Boussaer M, Verellen D, De Ridder M. SU-E-J-152: Improving 4D CBCT Image Quality by Using Tumor Trajectory Based Rebinning with Orthogonal Dual Source KV Imaging of the Novel VERO System. Med Phys 2011. [DOI: 10.1118/1.3611920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Duchaleau M, Verellen D, Depuydt T, Tournel K, Reynders T, Gevaert T, Leysen K, Gulyban A, Poels K, de Ridder M. 69 speaker 3D DOSIMETRY SYSTEMS-GELS, EPIDS AND OTHERS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70192-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Verellen D, Depuydt T, Gevaert T, Linthout N, Tournel K, Duchateau M, Reynders T, Storme G, De Ridder M. Gating and tracking, 4D in thoracic tumours. Cancer Radiother 2010; 14:446-54. [PMID: 20673737 DOI: 10.1016/j.canrad.2010.06.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Accepted: 06/03/2010] [Indexed: 12/25/2022]
Abstract
The limited ability to control for a tumour's location compromises the accuracy with which radiation can be delivered to tumour-bearing tissue. The resultant requirement for larger treatment volumes to accommodate target uncertainty restricts the radiation dose because more surrounding normal tissue is exposed. With image-guided radiation therapy (IGRT), these volumes can be optimized and tumouricidal doses may be delivered, achieving maximum tumour control with minimal complications. Moreover, with the ability of high precision dose delivery and real-time knowledge of the target volume location, IGRT has initiated the exploration of new indications in radiotherapy such as hypofractionated radiotherapy (or stereotactic body radiotherapy), deliberate inhomogeneous dose distributions coping with tumour heterogeneity (dose painting by numbers and biologically conformal radiation therapy), and adaptive radiotherapy. In short: "individualized radiotherapy". Tumour motion management, especially for thoracic tumours, is a particular problem in this context both for the delineation of tumours and organs at risk as well as during the actual treatment delivery. The latter will be covered in this paper with some examples based on the experience of the UZ Brussel. With the introduction of the NOVALIS system (BrainLAB, Feldkirchen, Germany) in 2000 and consecutive prototypes of the ExacTrac IGRT system, gradually a hypofractionation treatment protocol was introduced for the treatment of lung tumours and liver metastases evolving from motion-encompassing techniques towards respiratory-gated radiation therapy with audio-visual feedback and most recently dynamic tracking using the VERO system (BrainLAB, Feldkirchen, Germany). This evolution will be used to illustrate the recent developments in this particular field of research.
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Affiliation(s)
- D Verellen
- Department of Radiotherapy, UZ Brussel, Oncologisch Centrum, Laarbeeklaan 101, 1090 Brussels, Belgium.
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Verellen D, Van Vaerenbergh S, Tournel K, Duchateau M, Linthout N, Gevaert T, Reynders T, Van de Vondel I, Coppens L, Depuydt T, Storme G. SU-GG-T-369: An In-House Developed MOSFET Dosimeter with Reset Capabilities. Med Phys 2010. [DOI: 10.1118/1.3468766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Linthout N, Verellen D, Tournel K, Gevaert T, Duchateau M, Reynders T, Storme G. RESPIRATORY GATED RADIOTHERAPY OPTIMIZED WITH AUDIOVISUALLY GUIDED VOLUNTARY BREATH-HOLD. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72854-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Duchateau M, Tournel K, Verellen D, Van De Vondel I, Reynders T, Linthout N, Gevaert T. STABILITY ASSESSMENT OF MVCT IMAGES FOR DOSE CALCULATION. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72928-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Reynders T, Tournel K, Heymann S, Vinh-Hung V, Van Parijs H, De Coninck P, Duchateau M, Linthout N, Gevaert T, Verellen D, Storme G. ASSESSMENT OF THE TREATMENT OF BREAST CARCINOMA WITH TOMOTHERAPY. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73150-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Verellen D, De Ridder M, Tournel K, Duchateau M, Reynders T, Gevaert T, Linthout N, Storme G. An overview of volumetric imaging technologies and their quality assurance for IGRT. Acta Oncol 2009; 47:1271-8. [PMID: 18618343 DOI: 10.1080/02841860802244182] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Image-guided radiation therapy (IGRT) aims at frequent imaging in the treatment room during a course of radiotherapy, with decisions made on the basis of this information. The concept is not new, but recent developments and clinical implementations of IGRT drastically improved the quality of radiotherapy and broadened its possibilities as well as its indications. In general IGRT solutions can be classified in planar imaging, volumetric imaging using ionising radiation (kV- and MV- based CT) or non-radiographic techniques. This review will focus on volumetric imaging techniques applying ionising radiation with some comments on Quality Assurance (QA) specific for clinical implementation. By far the most important advantage of volumetric IGRT solutions is the ability to visualize soft tissue prior to treatment and defining the spatial relationship between target and organs at risk. A major challenge is imaging during treatment delivery. As some of these IGRT systems consist of peripheral equipment and others present fully integrated solutions, the QA requirements will differ considerably. It should be noted for instance that some systems correct for mechanical instabilities in the image reconstruction process whereas others aim at optimal mechanical stability, and the coincidence of imaging and treatment isocentre needs special attention. Some of the solutions that will be covered in detail are: (a) A dedicated CT-scanner inside the treatment room. (b) Peripheral systems mounted to the gantry of the treatment machine to acquire cone beam volumetric CT data (CBCT). Both kV-based solutions and MV-based solutions using EPIDs will be covered. (c) Integrated systems designed for both IGRT and treatment delivery. This overview will explain some of the technical features and clinical implementations of these technologies as well as providing an insight in the limitations and QA procedures required for each specific solution.
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Duchateau M, Tournel K, Verellen D, Reynders T, Linthout N, Gevaert T, Storme G. SU-FF-J-144: Stability Assessment of MVCT Imaging for Dose Calculation Purposes. Med Phys 2009. [DOI: 10.1118/1.3181436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bral S, Duchateau M, Tournel K, Linthout N, Verellen D, Gevaert T, Reynders T, Storme G. SU-FF-J-141: Volumetric Response Analysis During Chemoradiation as Predictive Tool for Optimizing Treatment Strategy in Locally Advanced Unresectable NSCLC. Med Phys 2009. [DOI: 10.1118/1.3181433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tournel K, Engels B, De Ridde M, Verellen D, Duchateau M, Linthout N, Reynders T, Gevaert T, Storme G. SU-FF-J-94: Clinical Application of Image Guidance to Radiotherapy of Pre-Operative Rectal Cancer : From Day-To-Day Positioning to Biological Modelling. Med Phys 2009. [DOI: 10.1118/1.3181386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gevaert T, Linthout N, Tournel K, Duchateau M, Reynders T, Verellen D, Storme G. SU-FF-T-551: From Frame-Based to Frameless Radiosurgery. Med Phys 2009. [DOI: 10.1118/1.3182049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Heymann S, Reynders T, Vinh-Hung V, Tournel K, Verellen D, Linthout N, Storme G. SU-FF-T-411: The Place of Helical Tomotherapy in Breast Cancer : A Planning and Positioning Comparison Between Tomotherapy and Conventional Techniques. Med Phys 2007. [DOI: 10.1118/1.2761136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tournel K, De Ridder M, Engels B, Verellen D, Linthout N, Duchateau M, Fierens Y, Reynders T, Storme G. SU-FF-J-91: Assessment of Setup and Internal Margin in the Treatment of Rectum Cancer Patients On Helical Tomotherapy. Med Phys 2007. [DOI: 10.1118/1.2760596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tournel K, Verellen D, Linthout N, Duchateau M, Reynders T, Fierens Y, Voordeckers M, Storme G. SU-FF-T-66: An Assessment of the Use of Skin Flashes in Helical Tomotherapy Using Phantom and In-Vivo Dosimetry. Med Phys 2007. [DOI: 10.1118/1.2760717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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