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Arce P, Lagares JI, Azcona JD, Huesa-Berral C, Burguete J. Precise dosimetric comparison between GAMOS and the collapsed cone convolution algorithm of 4D DOSE accumulated in lung SBRT treatments. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2023.110891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Huesa-Berral C, Juan-Cruz C, van Kranen S, Rossi M, Belderbos J, Diego Azcona J, Burguete J, Sonke JJ. Detailed dosimetric evaluation of inter-fraction and respiratory motion in lung stereotactic body radiation therapy based on daily 4D cone beam CT images. Phys Med Biol 2022; 68. [PMID: 36538287 DOI: 10.1088/1361-6560/aca94d] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
Objective. Periodic respiratory motion and inter-fraction variations are sources of geometric uncertainty in stereotactic body radiation therapy (SBRT) of pulmonary lesions. This study extensively evaluates and validates the separate and combined dosimetric effect of both factors using 4D-CT and daily 4D-cone beam CT (CBCT) dose accumulation scenarios.Approach. A first cohort of twenty early stage or metastatic disease lung cancer patients were retrospectively selected to evaluate each scenario. The planned-dose (3DRef) was optimized on a 3D mid-position CT. To estimate the dosimetric impact of respiratory motion (4DRef), inter-fractional variations (3DAcc) and the combined effect of both factors (4DAcc), three dose accumulation scenarios based on 4D-CT, daily mid-cone beam CT (CBCT) position and 4D-CBCT were implemented via CT-CT/CT-CBCT deformable image registration (DIR) techniques. Each scenario was compared to 3DRef.A separate cohort of ten lung SBRT patients was selected to validate DIR techniques. The distance discordance metric (DDM) was implemented per voxel and per patient for tumor and organs at risk (OARs), and the dosimetric impact for CT-CBCT DIR geometric errors was calculated.Main results.Median and interquartile range (IQR) of the dose difference per voxel were 0.05/2.69 Gy and -0.12/2.68 Gy for3DAcc-3DRefand4DAcc-3DRef.For4DRef-3DRefthe IQR was considerably smaller -0.15/0.78 Gy. These findings were confirmed by dose volume histogram parameters calculated in tumor and OARs. For CT-CT/CT-CBCT DIR validation, DDM (95th percentile) was highest for heart (6.26 mm)/spinal cord (8.00 mm), and below 3 mm for tumor and the rest of OARs. The dosimetric impact of CT-CBCT DIR errors was below 2 Gy for tumor and OARs.Significance. The dosimetric impact of inter-fraction variations were shown to dominate those of periodic respiration in SBRT for pulmonary lesions. Therefore, treatment evaluation and dose-effect studies would benefit more from dose accumulation focusing on day-to-day changes then those that focus on respiratory motion.
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Affiliation(s)
- Carlos Huesa-Berral
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.,Physics and Applied Mathematics, School of Science, University of Navarra, E-31008 Pamplona, Navarra, Spain.,Service of Radiation Physics and Radiation Protection, University of Navarra Clinic, E-31008 Pamplona, Navarra, Spain
| | - Celia Juan-Cruz
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Simon van Kranen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Maddalena Rossi
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - José Belderbos
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Juan Diego Azcona
- Service of Radiation Physics and Radiation Protection, University of Navarra Clinic, E-31008 Pamplona, Navarra, Spain
| | - Javier Burguete
- Physics and Applied Mathematics, School of Science, University of Navarra, E-31008 Pamplona, Navarra, Spain
| | - Jan-Jakob Sonke
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Dossun C, Niederst C, Noel G, Meyer P. Evaluation of DIR algorithm performance in real patients for radiotherapy treatments: A systematic review of operator-dependent strategies. Phys Med 2022; 101:137-157. [PMID: 36007403 DOI: 10.1016/j.ejmp.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/21/2022] [Accepted: 08/16/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The performance of deformable medical image registration (DIR) algorithms has become a major concern. METHODS We aimed to obtain updated information on DIR algorithm performance quantification through a literature review of articles published between 2010 and 2022. We focused only on studies using operator-based methods to treat real patients. The PubMed, Google Scholar and Embase databases were searched following PRISMA guidelines. RESULTS One hundred and seven articles were identified. The mean number of patients and registrations per publication was 20 and 63, respectively. We found 23 different geometric metrics appearing at least twice, and the dosimetric impact of DIR was quantified in 32 articles. Forty-eight different at-risk organs were described, and target volumes were studied in 43 publications. Prostate, head-and-neck and thoracic locations represented more than ¾ of the studied locations. We summarized the type of DIR and the images used, and other key elements. Intra/interobserver variability, threshold values and the correlation between metrics were also discussed. CONCLUSIONS This literature review covers the past decade and should facilitate the implementation of DIR algorithms in clinical practice by providing practical and pertinent information to quantify their performance on real patients.
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Affiliation(s)
- C Dossun
- Department of Radiotherapy, Institut de Cancerologie Strasbourg Europe (ICANS), Strasbourg, France
| | - C Niederst
- Department of Radiotherapy, Institut de Cancerologie Strasbourg Europe (ICANS), Strasbourg, France
| | - G Noel
- Department of Radiotherapy, Institut de Cancerologie Strasbourg Europe (ICANS), Strasbourg, France
| | - P Meyer
- Department of Radiotherapy, Institut de Cancerologie Strasbourg Europe (ICANS), Strasbourg, France; ICUBE, CNRS UMR 7357, Team IMAGES, Strasbourg, France.
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Bierbrier J, Gueziri HE, Collins DL. Estimating medical image registration error and confidence: A taxonomy and scoping review. Med Image Anal 2022; 81:102531. [PMID: 35858506 DOI: 10.1016/j.media.2022.102531] [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: 10/28/2021] [Revised: 06/16/2022] [Accepted: 07/01/2022] [Indexed: 11/18/2022]
Abstract
Given that image registration is a fundamental and ubiquitous task in both clinical and research domains of the medical field, errors in registration can have serious consequences. Since such errors can mislead clinicians during image-guided therapies or bias the results of a downstream analysis, methods to estimate registration error are becoming more popular. To give structure to this new heterogenous field we developed a taxonomy and performed a scoping review of methods that quantitatively and automatically provide a dense estimation of registration error. The taxonomy breaks down error estimation methods into Approach (Image- or Transformation-based), Framework (Machine Learning or Direct) and Measurement (error or confidence) components. Following the PRISMA guidelines for scoping reviews, the 570 records found were reduced to twenty studies that met inclusion criteria, which were then reviewed according to the proposed taxonomy. Trends in the field, advantages and disadvantages of the methods, and potential sources of bias are also discussed. We provide suggestions for best practices and identify areas of future research.
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Affiliation(s)
- Joshua Bierbrier
- Department of Biomedical Engineering, McGill University, Montreal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, Montreal, QC, Canada.
| | - Houssem-Eddine Gueziri
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, Montreal, QC, Canada
| | - D Louis Collins
- Department of Biomedical Engineering, McGill University, Montreal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, Montreal, QC, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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Ferris WS, Chao EH, Smilowitz JB, Kimple RJ, Bayouth JE, Culberson WS. Using 4D dose accumulation to calculate organ-at-risk dose deviations from motion-synchronized liver and lung tomotherapy treatments. J Appl Clin Med Phys 2022; 23:e13627. [PMID: 35486094 PMCID: PMC9278681 DOI: 10.1002/acm2.13627] [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: 02/16/2022] [Revised: 03/22/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022] Open
Abstract
Tracking systems such as Radixact Synchrony change the planned delivery of radiation during treatment to follow the target. This is typically achieved without considering the location changes of organs at risk (OARs). The goal of this work was to develop a novel 4D dose accumulation framework to quantify OAR dose deviations due to the motion and tracked treatment. The framework obtains deformation information and the target motion pattern from a four-dimensional computed tomography dataset. The helical tomotherapy treatment plan is split into 10 plans and motion correction is applied separately to the jaw pattern and multi-leaf collimator (MLC) sinogram for each phase based on the location of the target in each phase. Deformable image registration (DIR) is calculated from each phase to the references phase using a commercial algorithm, and doses are accumulated according to the DIR. The effect of motion synchronization on OAR dose was analyzed for five lung and five liver subjects by comparing planned versus synchrony-accumulated dose. The motion was compensated by an average of 1.6 cm of jaw sway and by an average of 5.7% of leaf openings modified, indicating that most of the motion compensation was from jaw sway and not MLC changes. OAR dose deviations as large as 19 Gy were observed, and for all 10 cases, dose deviations greater than 7 Gy were observed. Target dose remained relatively constant (D95% within 3 Gy), confirming that motion-synchronization achieved the goal of maintaining target dose. Dose deviations provided by the framework can be leveraged during the treatment planning process by identifying cases where OAR doses may change significantly from their planned values with respect to the critical constraints. The framework is specific to synchronized helical tomotherapy treatments, but the OAR dose deviations apply to any real-time tracking technique that does not consider location changes of OARs.
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Affiliation(s)
- William S Ferris
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Jennifer B Smilowitz
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Randall J Kimple
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.,University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - John E Bayouth
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Wesley S Culberson
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Huesa-Berral C, Burguete J, Moreno-Jiménez M, Diego Azcona J. A method using 4D dose accumulation to quantify the interplay effect in lung stereotactic body radiation therapy. Phys Med Biol 2021; 66:035025. [PMID: 33264758 DOI: 10.1088/1361-6560/abd00f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to devise and evaluate a method to quantify the dosimetric uncertainty produced by the interplay between the movement of multileaf collimator and respiratory motion in lung stereotactic body radiation therapy. The method calculates the dose distribution for all control points from a dynamic treatment in all respiratory phases. The methodology includes some characteristics of a patient's irregular breathing patterns. It selects, for each control point, the phases with maximum and minimum mean dose over the tumor and their corresponding adjacent phases, whenever necessary. According to this selection, the dose matrices from each control point are summed up to obtain two dose distributions in each phase, which are accumulated in the reference phase subsequently by deformable image registration (DIR). D 95 and [Formula: see text] were calculated over those accumulated dose distributions for Gross Tumor Volume (GTV), Planning Target Volume-based on Internal Target Volume approach-and Evaluation Target Volume (ETV), a novel concept that applies to 4D dose accumulation. With the ETV, DIR and interplay uncertainties are separated. The methodology also evaluated how variations in the breathing rate and field size affects the mean dose received by the GTV. The method was applied retrospectively in five patients treated with intensity modulated radiotherapy-minimum area defined by the leaves configuration at any control point was at least 4 cm2. Uncertainties in tumor coverage were small (in most patients, changes on D 95 and [Formula: see text] were below 2% for GTV and ETV) but significant over- and under-dosages near ETV, which can be accentuated by highly irregular breathing. Uncertainties in mean dose for GTV tended to decrease exponentially with increasing field size and were reduced by an increase of breathing rate. The implementation of this method would be helpful to assess treatment quality in patients with irregular breathing. Furthermore, it could be used to study interplay uncertainties when small field sizes are used.
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Affiliation(s)
- Carlos Huesa-Berral
- Department of Physics and Applied Mathematics, School of Sciences, Universidad de Navarra. C/ Irunlarrea, E-31008 Pamplona, Navarra, Spain.,Service of Radiation Physics and Radiation Protection, Clínica Universidad de Navarra, Avda. Pío XII, E-31008 Pamplona, Navarra, Spain
| | - Javier Burguete
- Department of Physics and Applied Mathematics, School of Sciences, Universidad de Navarra. C/ Irunlarrea, E-31008 Pamplona, Navarra, Spain
| | - Marta Moreno-Jiménez
- Service of Radiation Oncology, Clínica Universidad de Navarra, Avda. Pío XII, E-31008 Pamplona, Navarra, Spain
| | - Juan Diego Azcona
- Service of Radiation Physics and Radiation Protection, Clínica Universidad de Navarra, Avda. Pío XII, E-31008 Pamplona, Navarra, Spain
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Xiao F, Chang Y, Zhang S, Yang Z. Integrating CVH and LVH metrics into an optimization strategy for the selection of Iris collimator for Cyberknife Xsight lung tracking treatment. J Appl Clin Med Phys 2021; 22:210-217. [PMID: 33428813 PMCID: PMC7856519 DOI: 10.1002/acm2.13136] [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: 07/26/2020] [Revised: 10/26/2020] [Accepted: 12/02/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE We conducted this study to construct a target coverage-volume histogram (CVH) and leakage-volume histogram (LVH) metrics and optimization strategy for the selection of the Iris collimator in Cyberknife Xsight lung tracking treatment through a retrospective analysis of target structures and clinical data. METHODS AND MATERIALS CVH and LVH metrics were retrospectively analyzed for 37 lung cancer patients. CVH and LVH were the same as dose-volume histogram (DVH), but with a coverage and leakage replacing dose. For each patient, Iris collimator was optimized and selected based on CVH and LVH metrics. The CVH and LVH metrics were then compared to ascertain differences in 95% (C95) or 90% (C90) of the target coverage thresholds. The planning target volume (PTV) C95 and C90 coverage, absolute mean leakage value, leakage/coverage ratio, selected collimator diameter (Φ), Φ/length of the long axis of PTV (Amax ), and Φ/length of the short axis (Amin ) of PTV were compared. The correlation of the absolute mean leakage value, leakage/coverage ratio, Φ/Amin and Φ/Amax were evaluated. RESULTS For each patient, the PTV C95 coverage (70.45 vs 63.19) and C90 coverage (77.25 vs 69.96) were higher in the C95 coverage threshold group compared to the C90 coverage threshold group. The leakage/coverage ratio (0.56 vs 0.69) and absolute mean leakage value (0.56 vs 0.61) were lower in C90 coverage threshold group than in C95 coverage threshold group. The Spearmen correlation test showed the Φ/Amin were significantly correlated with leakage/coverage ratio and absolute mean leakage value. Upon analysis of the selected collimator diameters, the mean value of Φ/Amin of the optimized collimator diameters was found to be 1.10. CONCLUSION The CVH and LVH analysis is able to quantitatively evaluate the tradeoff between target coverage and normal tissue sparing.
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Affiliation(s)
- Feng Xiao
- Medical Physics, School of Physics and Technology, Wuhan University, Wuhan, 430072, China
| | - Yu Chang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Sheng Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zhiyong Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
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