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Xiong T, Zeng G, Chen Z, Huang YH, Li B, Zhou D, Liu X, Sheng Y, Ren G, Wu QJ, Ge H, Cai J. Automatic planning for functional lung avoidance radiotherapy based on function-guided beam angle selection and plan optimization. Phys Med Biol 2024; 69:155007. [PMID: 38959907 DOI: 10.1088/1361-6560/ad5ef5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/03/2024] [Indexed: 07/05/2024]
Abstract
Objective.This study aims to develop a fully automatic planning framework for functional lung avoidance radiotherapy (AP-FLART).Approach.The AP-FLART integrates a dosimetric score-based beam angle selection method and a meta-optimization-based plan optimization method, both of which incorporate lung function information to guide dose redirection from high functional lung (HFL) to low functional lung (LFL). It is applicable to both contour-based FLART (cFLART) and voxel-based FLART (vFLART) optimization options. A cohort of 18 lung cancer patient cases underwent planning-CT and SPECT perfusion scans were collected. AP-FLART was applied to generate conventional RT (ConvRT), cFLART, and vFLART plans for all cases. We compared automatic against manual ConvRT plans as well as automatic ConvRT against FLART plans, to evaluate the effectiveness of AP-FLART. Ablation studies were performed to evaluate the contribution of function-guided beam angle selection and plan optimization to dose redirection.Main results.Automatic ConvRT plans generated by AP-FLART exhibited similar quality compared to manual counterparts. Furthermore, compared to automatic ConvRT plans, HFL mean dose,V20, andV5were significantly reduced by 1.13 Gy (p< .001), 2.01% (p< .001), and 6.66% (p< .001) respectively for cFLART plans. Besides, vFLART plans showed a decrease in lung functionally weighted mean dose by 0.64 Gy (p< .01),fV20by 0.90% (p= 0.099), andfV5by 5.07% (p< .01) respectively. Though inferior conformity was observed, all dose constraints were well satisfied. The ablation study results indicated that both function-guided beam angle selection and plan optimization significantly contributed to dose redirection.Significance.AP-FLART can effectively redirect doses from HFL to LFL without severely degrading conventional dose metrics, producing high-quality FLART plans. It has the potential to advance the research and clinical application of FLART by providing labor-free, consistent, and high-quality plans.
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Affiliation(s)
- Tianyu Xiong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Guangping Zeng
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Zhi Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Yu-Hua Huang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Bing Li
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, People's Republic of China
| | - Dejun Zhou
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Xi Liu
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Yang Sheng
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States of America
| | - Ge Ren
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
| | - Qingrong Jackie Wu
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States of America
| | - Hong Ge
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, People's Republic of China
| | - Jing Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China
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Kargar N, Zeinali A, Molazadeh M. Impact of Dose Calculation Algorithms and Radiobiological Parameters on Prediction of Cardiopulmonary Complications in Left Breast Radiation Therapy. J Biomed Phys Eng 2024; 14:129-140. [PMID: 38628897 PMCID: PMC11016826 DOI: 10.31661/jbpe.v0i0.2305-1616] [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: 05/05/2023] [Accepted: 12/13/2023] [Indexed: 04/19/2024]
Abstract
Background Breast cancer requires evaluating treatment plans using dosimetric and biological parameters. Considering radiation dose distribution and tissue response, healthcare professionals can optimize treatment plans for better outcomes. Objective This study aimed to evaluate the effects of the different Dose Calculation Algorithms (DCAs) and Biologically Model-Related Parameters (BMRPs) on the prediction of cardiopulmonary complications due to left breast radiotherapy. Material and Methods In this practical study, the treatment plans of 21 female patients were simulated in the Monaco Treatment Planning System (TPS) with a prescribed dose of 50 Gy in 25 fractions. Dose distribution was extracted using the three DCAs [Pencil Beam (PB), Collapsed Cone (CC), and Monte Carlo (MC)]. Cardiopulmonary complications were predicted by Normal Tissue Complication Probability (NTCP) calculations using different dosimetric and biological parameters. The Lyman-Kutcher-Burman (LKB) and Relative-Seriality (RS) models were used to calculate NTCP. The endpoint for NTCP calculation was pneumonitis, pericarditis, and late cardiac mortality. The ANOVA test was used for statistical analysis. Results In calculating Tumor Control Probability (TCP), a statistically significant difference was observed between the results of DCAs in the Poisson model. The PB algorithm estimated NTCP as less than others for all Pneumonia BMRPs. Conclusion The impact of DCAs and BMRPs differs in the estimation of TCP and NTCP. DCAs have a stronger influence on TCP calculation, providing more effective results. On the other hand, BMRPs are more effective in estimating NTCP. Consequently, parameters for radiobiological indices should be cautiously used s to ensure the appropriate consideration of both DCAs and BMRPs.
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Affiliation(s)
- Niloofar Kargar
- Department of Medical Physics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Ahad Zeinali
- Department of Medical Physics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mikaeil Molazadeh
- Department of Medical Physics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Varian Clinac 2100 linear accelerator simulation employing PRIMO phase space model. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2023.110859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Development and dosimetric evaluation of the IMRT prostate at outside-the-irradiated field in a heterogeneity male pelvis phantom. JOURNAL OF RADIOTHERAPY IN PRACTICE 2022. [DOI: 10.1017/s146039692200019x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background:
Intensity-modulated radiation therapy (IMRT) treatment delivery requires pre-treatment patient-specific quality assurance (QA) for the dosimetry verification due to its complex multileaf-collimator movement. The prostate target close position between the bladder and rectum requires a tight margin during planning, and mistreatment would have a huge impact on the patient. A commercially available QA tool consists of a homogeneous medium and does not represent an exact photon interaction on the tumour and also on the nearby healthy organ.
Objective:
A heterogeneous male pelvis phantom was developed and investigated the efficiency of the treatment planning system (TPS) calculation on the off-axis region.
Methods:
Polymethyl methacrylate was used for the phantom housing, and the material closed to the bladder, rectum and prostate density was chosen to construct the organ models. The phantom was scanned and validated by the computed tomography number and density. An IMRT treatment was planned in the Monaco TPS, and a thermoluminescent dosimeter (TLD-100) was used to validate the point dosimetry. In addition, an EGSnrc Monte Carlo simulation was carried out to validate the phantom dosimetry.
Results & Discussion:
The dose measurement between TLD-100, TPS, and EGSnrc was compared and validated in the pelvis phantom. In the prostate region, the dose difference was within ± 5%, and the maximum dose difference outside-the-irradiated field was up to 20·07 % and 47·31 % in TPS and TLD-100, respectively. Meanwhile, the measured dose was lower than the calculated dose, and it was apparent for the dose outside-the-irradiated field.
Conclusion:
The developed heterogeneity male pelvis phantom was validated and verified to be an important QA device for validating radiation dosimetry in the pelvis region. The dose outside-the-irradiated field was underestimated by both TPS and TLD, respectively.
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Kolacio MŠ, Rajlić D, Radojčić M, Radojčić ĐS, Obajdin N, Debeljuh DD, Jurković S. Dosimetric accuracy of three dose calculation algorithms for radiation therapy of in situ non-small cell lung carcinoma. Rep Pract Oncol Radiother 2022; 27:86-96. [PMID: 35402037 PMCID: PMC8989458 DOI: 10.5603/rpor.a2022.0013] [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: 11/09/2021] [Accepted: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background Study determines differences in calculated dose distributions for non-small cell lung carcinoma (NSC LC) patients. NSC LC cases were investigated, being the most common lung cancer treated by radiotherapy in our clinical practice. Materials and methods A retrospective study of 15 NSCLC patient dose distributions originally calculated using standard superposition (SS) and recalculated using collapsed cone (CC ) and Monte Carlo (MC) based algorithm expressed as dose to medium in medium (MCDm) and dose to water in medium (MCDw,) was performed so that prescribed dose covers at least 99% of the gross target volume (GTV). Statistical analysis was performed for differences of conformity index (CI), heterogeneity index (HI), gradient index (GI), dose delivered to 2% of the volume (D2%), mean dose (Dmean) and percentage of volumes covered by prescribed dose (V70Gy). For organs at risk (OARs), Dmean and percentage of volume receiving 20 Gy and 5Gy (V20Gy, V5Gy) were analysed. Results Statistically significant difference for GTVs was observed between MCDw and SS algorithm in mean dose only. For planning target volumes (PTVs), statistically significant differences were observed in prescribed dose coverage for CC, MCDm and MCDw. The differences in mean CI value for the CC algorithm and mean HI value for MCDm and MCDw were statistically significant. There is a statistically significant difference in the number of MUs for MCDm and MCDw compared to SS. Conclusion All investigated algorithms succeed in managing the restrictive conditions of the clinical goals. This study shows the drawbacks of the CC algorithm compared to other algorithms used.
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Affiliation(s)
| | - David Rajlić
- Medical Physics Department, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Milan Radojčić
- Clinic for Radiotherapy and Oncology, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Đeni Smilović Radojčić
- Medical Physics Department, Clinical Hospital Center Rijeka, Rijeka, Croatia.,Department of Medical Physics and Biophysics, University of Rijeka Faculty of Medicine, Rijeka, Croatia
| | - Nevena Obajdin
- Medical Physics Department, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Dea Dundara Debeljuh
- Medical Physics Department, Clinical Hospital Center Rijeka, Rijeka, Croatia.,Department of Medical Physics and Biophysics, University of Rijeka Faculty of Medicine, Rijeka, Croatia.,Radiology Department, General Hospital Pula, Pula, Croatia
| | - Slaven Jurković
- Medical Physics Department, Clinical Hospital Center Rijeka, Rijeka, Croatia.,Department of Medical Physics and Biophysics, University of Rijeka Faculty of Medicine, Rijeka, Croatia
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Deshazer G, Narayanasamy G, Bimali M, Galhardo E, Kalantari F, Xia F, Penagaricano JA, Morrill S. A dosimetric comparative analysis of Brainlab elements and Eclipse RapidArc for spine SBRT treatment planning. Biomed Phys Eng Express 2022; 8. [PMID: 35086071 DOI: 10.1088/2057-1976/ac4f97] [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: 12/21/2021] [Accepted: 01/27/2022] [Indexed: 11/12/2022]
Abstract
Purpose:This is a dosimetric study comparing stereotactic body radiotherapy (SBRT) plans of spine tumors using Brainlab Elements Spine planning module against Eclipse RapidArc plans. Dose conformity, dose gradient, dose fall-off, and patient-specific quality assurance (QA) metrics were evaluated.Methods:Twenty patients were immobilized in supine position using half Vac-Lok. A prescription dose of 16 Gy in a single fraction was planned for Varian TrueBeam. Conformal arc plans were generated with Pencil beam (PB), MonteCarlo (MC) in Elements, and RapidArc with Acuros XB algorithm in Eclipse using identical treatment geometry.Results:Eclipse, Elements PB, and Elements MC generated dosimetrically conformal plans having Inverse Paddick Conformity Index (IPCI) <1.3. All plans satisfied the dose constraints to target and OARs. Elements PB had a sharper gradient than Elements MC with average GI of 3.67(95% CI: 3.52-3.82) and 4.06 (95% CI: 3.93-4.20) respectively. Eclipse plans were more homogeneous with mean HI= 1.22 (95% CI: 1.20-1.23) that is lower than others. Average maximum clinical target volume (CTV) doses were higher in Elements MC with 22.31Gy (95% CI: 21.87-22.74), while PB plans have 21.15Gy (95% CI: 20.36-21.96), respectively. Elements MC and PB plans had lower average dose to 0.35 cc of spinal cord (D0.35cc) of 7.60Gy (95% CI: 7.18-8.02) and 8.42Gy (95% CI: 7.83-9.01). All plans had >95% points passing the gamma QA criteria at 3%/2 mm.Conclusion:All treatment plans achieved clinically acceptable target coverage >95% and meet spinal cord dose limits. Smart optimization in Brainlab Elements spine module produced dosimetrically superior plans by better spinal cord sparing.
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Affiliation(s)
- Garron Deshazer
- FirstHealth of the Carolinas, 155 Memorial Dr, Pinehurst, North Carolina, 28374-3000, UNITED STATES
| | - Ganesh Narayanasamy
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St Slot 771, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Milan Bimali
- Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Edvaldo Galhardo
- Radiation Oncology Center, University of Arkansas for Medical Sciences, 4301 W Markham St Slot 771, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Faraz Kalantari
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St Slot 771, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Fen Xia
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, Arkansas, 72205-7101, UNITED STATES
| | - Jose A Penagaricano
- Department of Radiation Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida, 33612-9416, UNITED STATES
| | - Steven Morrill
- Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, Arkansas, 72205-7101, UNITED STATES
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Dose calculation accuracy for photon small fields in treatment planning systems with comparison by Monte Carlo simulations. POLISH JOURNAL OF MEDICAL PHYSICS AND ENGINEERING 2021. [DOI: 10.2478/pjmpe-2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Purpose: Advanced radiation therapy techniques use small fields in treatment planning and delivery. Small fields have the advantage of more accurate dose delivery, but with the cost of some complications in dosimetry. Different dose calculation algorithms imported in various treatment planning systems (TPSs) which each of them has different accuracy. Monte Carlo (MC) simulation has been reported as one of the accurate methods for calculating dose distribution in radiation therapy. The aim of this study was the evaluation of TPS dose calculation algorithms in small fields against 2 MC codes.
Methods: A linac head was simulated in 2 MC codes, MCNPX, and GATE. Then three small fields (0.5×0.5, 1×1 and 1.5×1.5 cm2) were simulated with 2 MC codes, and also these fields were planned with different dose calculation algorithms in Isogray and Monaco TPS. PDDs and lateral dose profiles were extracted and compared between MC simulations and dose calculation algorithms.
Results: For 0.5×0.5 cm2 field mean differences in PDDs with MCNPX were 2.28, 4.6, 5.3, and 7.4% and with GATE were -0.29, 2.3, 3 and 5% for CCC, superposition, FFT and Clarkson algorithms respectively. For 1×1 cm2 field mean differences in PDDs with MCNPX were 1.58, 0.6, 1.1 and 1.4% and with GATE were 0.77, 0.1, 0.6 and 0.9% for CCC, superposition, FFT and Clarkson algorithms respectively. For 1.5×1.5 cm2 field mean differences in PDDs with MCNPX were 0.82, 0.4, 0.6 and -0.4% and with GATE were 2.38, 2.5, 2.7 and 1.7% for CCC, superposition, FFT and Clarkson algorithms respectively.
Conclusions: Different dose calculation algorithms were evaluated and compared with MC simulation in small fields. Mean differences with MC simulation decreased with the increase of field sizes for all algorithms.
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Pimenta EB, Nogueira LB, de Campos TPR. Dose measurements in a thorax phantom at 3DCRT breast radiation therapy. ACTA ACUST UNITED AC 2021; 26:242-250. [PMID: 34211775 DOI: 10.5603/rpor.a2021.0037] [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: 05/31/2019] [Accepted: 02/04/2021] [Indexed: 11/25/2022]
Abstract
Background The anthropomorphic and anthropometric phantom developed by the research group NRI (Núcleo de Radiações Ionizantes) can reproduce the effects of the interactions of radiation occurring in the human body. The whole internal radiation transport phenomena can be depicted by film dosimeters in breast RT. Our goal was to provide a dosimetric comparison of a radiation therapy (RT) plan in a 4MV 3D-conformal RT (4MV-3DCR T) and experimental data measured in a breast phantom. Materials and methods The RT modality was two parallel opposing fields for the left breast with a prescribed dose of 2.0 Gy in 25 fractions. The therapy planning system (TPS) was performed on CA T3D software. The dose readings at points of interest (POI) pre-established in TPS were recorded. An anthropometric thorax-phantom with removal breast was used. EBT2 radiochromic films were inserted into the ipisilateral breast, contralateral breast, lungs, heart and skin. The irradiation was carried out on 4/80 Varian linear accelerator at 4MV. Results The mean dose at the OAR's presented statistically significant differences (p < 0.001) of 34.24%, 37.96% and 63.47% for ipsilateral lung, contralateral lung, and heart, respectively. The films placed at the skin-surface interface in the ipsilateral breast also showed statistically significant differences (p < 0.001) of 16.43%, -10.16%, -14.79% and 15.67% in the four quadrants, respectively. In contrast, the PTV dosimeters, representative of the left breast volume, encompassed by the electronic equilibrium, presented a non-significant difference with TPS, p = 0.20 and p = 0.90. Conclusion There was a non-significant difference of doses in PTV with electronic equilibrium; although no match is achieved outside electronic equilibrium.
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Affiliation(s)
- Elsa Bifano Pimenta
- Department of Nuclear Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Saini A, Pandey VP, Kumar P, Singh A, Pasricha R. Investigation of tube voltage dependence on CT number and its effect on dose calculation algorithms using thorax phantom in Monaco treatment planning system for external beam radiation therapy. J Med Phys 2021; 46:315-323. [PMID: 35261502 PMCID: PMC8853450 DOI: 10.4103/jmp.jmp_124_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 08/29/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction The accuracy of dose calculation algorithms depends on the electron density and computed tomography (CT) number of medium scanned. Our study aimed to verify the impact of different CT scanning protocols on Hounsfield unit (HU) and effect on dose calculation algorithms. Materials and Methods CIRS thorax phantom with different density material plugs was scanned at varying tube voltages from CT scanner and HU values were measured in treatment planning system (TPS). Calibration curves of electron density at different tube voltages were plotted and used for dose calculation with different calculation algorithms at varying high energy megavoltage photon energies. Results Insignificant difference is obtained in electron density curves plotted at different tube voltages. The mean variation in HU values was found at different tube voltages for bone, lung, and water are 896.75 (standard deviation [SD] 122.88), -799.25 (SD 5.74), and -17.5 (SD 0.57), respectively. The estimated P values for change in HU values were 0.089, 0.258, and 0.121 for bone, lung, and water, respectively. Pencil beam (PB) convolution and collapsed cone algorithms show no significant dose difference, i.e., <1% variation and Monte Carlo (MC) shows maximum dose difference up to 1.4%. Conclusion Third-generation algorithms such as MC shows dependence on varying tube voltages in dose calculation. Calibration curves plotted at different kVp in TPS advised to be chosen wisely to avoid any dosimetric errors in different medium.
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Affiliation(s)
- Amit Saini
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India,Department of Medical Physics, Tata Memorial Center, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - V P Pandey
- Department of Medical Physics, Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India,Address for correspondence: Dr. V. P. Pandey, Department of Medical Physics, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India E-mail: aryanbarc@gmailcom
Dr. Pankaj Kumar Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India Centre for Liquid Crystal Research, Chitkara University Research and Innovation Network, Chitkara University, Punjab, India E-mail:
| | - Pankaj Kumar
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India,Centre for Liquid Crystal Research, Chitkara University Research and Innovation Network, Chitkara University, Punjab, India,Address for correspondence: Dr. V. P. Pandey, Department of Medical Physics, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P, India E-mail: aryanbarc@gmailcom
Dr. Pankaj Kumar Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India Centre for Liquid Crystal Research, Chitkara University Research and Innovation Network, Chitkara University, Punjab, India E-mail:
| | - Avtar Singh
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India,Department of Medical Physics, Tata Memorial Center, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Rajesh Pasricha
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Tang D, Yang Z, Dai X, Cao Y. Evaluation of Delta 4DVH Anatomy in 3D Patient-Specific IMRT Quality Assurance. Technol Cancer Res Treat 2020; 19:1533033820945816. [PMID: 32720589 PMCID: PMC7388137 DOI: 10.1177/1533033820945816] [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] [Indexed: 11/08/2022] Open
Abstract
Purpose: To evaluate the performance of Delta4DVH Anatomy in
patient-specific intensity-modulated radiotherapy quality assurance. Materials and Methods: Dose comparisons were performed between Anatomy doses calculated with
treatment plan dose measured modification and pencil beam algorithms,
treatment planning system doses, film doses, and ion chamber measured doses
in homogeneous and inhomogeneous geometries. The sensitivity of Anatomy
doses to machine errors and output calibration errors was also
investigated. Results: For a Volumetric Modulated Arc Therapy (VMAT) plan evaluated on the
Delta4 geometry, the conventional gamma passing rate was
99.6%. For a water-equivalent slab geometry, good agreements were found
between dose profiles in film, treatment planning system, and Anatomy
treatment plan dose measured modification and pencil beam calculations.
Gamma passing rate for Anatomy treatment plan dose measured modification and
pencil beam doses versus treatment planning system doses was 100%. However,
gamma passing rate dropped to 97.2% and 96% for treatment plan dose measured
modification and pencil beam calculations in inhomogeneous head & neck
phantom, respectively. For the 10 patients’ quality assurance plans, good
agreements were found between ion chamber measured doses and the planned
ones (deviation: 0.09% ± 1.17%). The averaged gamma passing rate for
conventional and Anatomy treatment plan dose measured modification and
pencil beam gamma analyses in Delta4 geometry was 99.6% ± 0.89%,
98.54% ± 1.60%, and 98.95% ± 1.27%, respectively, higher than averaged gamma
passing rate of 97.75% ± 1.23% and 93.04% ± 2.69% for treatment plan dose
measured modification and pencil beam in patients’ geometries, respectively.
Anatomy treatment plan dose measured modification dose profiles agreed well
with those in treatment planning system for both Delta4 and
patients’ geometries, while pencil beam doses demonstrated substantial
disagreement in patients’ geometries when compared to treatment planning
system doses. Both treatment planning system doses are sensitive to
multileaf collimator and monitor unit (MU) errors for high and medium dose
metrics but not sensitive to the gantry and collimator rotation error
smaller than 3°. Conclusions: The new Delta4DVH Anatomy with treatment plan dose measured
modification algorithm is a useful tool for the anatomy-based
patient-specific quality assurance. Cautions should be taken when using
pencil beam algorithm due to its limitations in handling heterogeneity and
in high-dose gradient regions.
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Affiliation(s)
- Du Tang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhen Yang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Xunzhang Dai
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Ying Cao
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
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Galpayage Dona KNU, Shang C, Leventouri T. Dosimetric Comparison of Treatment Plans Computed With Finite Size Pencil Beam and Monte Carlo Algorithms Using the InCise™ Multileaf Collimator-Equipped Cyberknife ® System. J Med Phys 2020; 45:7-15. [PMID: 32355430 PMCID: PMC7185708 DOI: 10.4103/jmp.jmp_64_19] [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: 07/24/2019] [Revised: 11/02/2019] [Accepted: 11/19/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: InCise™ multileaf collimator (MLC) was introduced for CyberKnife® (CK) Robotic Radiosurgery System (CK-MLC) in 2015, and finite size pencil beam (FSPB) was the only available dose computation algorithm for treatment plans of CK-MLC system. The more advanced Monte Carlo (MC) dose calculation algorithm of lnCise™ was initially released in 2017 for the CK Precision™ treatment planning system (TPS) (v1.1) with new graphic processing unit (GPU) platform. GPU based TPS of the CK offers more accurate, faster treatment planning time and intuitive user interface with smart three-dimensional editing tools and fully automated autosegmentation tools. The MC algorithm used in CK TPS simulates the energy deposited by each individual photon and secondary particles to calculate more accurate dose. In the present study, the dose disparities between MC and FSPB algorithms for selected Stereotactic Ablative Radiation Therapy (SABR) CK-MLC treatment plans are quantified. Materials and Methods: A total of 80 CK-MLC SABR plans computed with FSPB were retrospectively reviewed and compared with MC computed results, including plans for detached lung cancer (or tumors fully surrounded by lung tissues, n = 21), nondetached lung cancer (or tumor touched the chest wall or mediastinum, n = 23), intracranial (n = 21), and pancreas lesions (n = 15). Dosimetric parameters of each planning target volume and major organs at risk (OAR) are compared in terms of normalized percentage deviations (Ndev). Results: This study revealed an average of 24.4% overestimated D95 values in plans using FSPB over MC for detached lung (n = 21) and 14.9% for nondetached lung (n = 23) lesions. No significant dose differences are found in intracranial (0.3%, n = 21) and pancreatic (0.9%, n = 15) cases. Furthermore, no significant differences were found in Ndev of OARs. Conclusion: In this study, it was found that FSPB overestimates dose to inhomogeneous treatment sites. This indicates, the employment of MC algorithm in CK-MLC-based lung SABR treatment plans is strongly suggested.
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Affiliation(s)
| | - Charles Shang
- Department of Physics, Florida Atlantic University, Boca Raton, Florida, USA.,South Florida Proton Therapy Institute, Delray Beach, Florida, USA
| | - Theodora Leventouri
- Department of Physics, Florida Atlantic University, Boca Raton, Florida, USA
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