1
|
Li S, Luo H, Tan X, Qiu T, Yang X, Feng B, Chen L, Wang Y, Jin F. The impact of plan complexity on calculation and measurement-based pre-treatment verifications for sliding-window intensity-modulated radiotherapy. Phys Imaging Radiat Oncol 2024; 31:100622. [PMID: 39220115 PMCID: PMC11364123 DOI: 10.1016/j.phro.2024.100622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Background and purpose In sliding-window intensity-modulated radiotherapy, increased plan modulation often leads to increased plan complexities and dose uncertainties. Dose calculation and/or measurement checks are usually adopted for pre-treatment verification. This study aims to evaluate the relationship among plan complexities, calculated doses and measured doses. Materials and methods A total of 53 plan complexity metrics (PCMs) were selected, emphasizing small field characteristics and leaf speed/acceleration. Doses were retrieved from two beam-matched treatment devices. The intended dose was computed employing the Anisotropic Analytical Algorithm and validated through Monte Carlo (MC) and Collapsed Cone Convolution (CCC) algorithms. To measure the delivered dose, 3D diode arrays of various geometries, encompassing helical, cross, and oblique cross shapes, were utilized. Their interrelation was assessed via Spearman correlation analysis and principal component linear regression (PCR). Results The correlation coefficients between calculation-based (CQA) and measurement-based verification quality assurance (MQA) were below 0.53. Most PCMs showed higher correlation rpcm-QA with CQA (max: 0.84) than MQA (max: 0.65). The proportion of rpcm-QA ≥ 0.5 was the largest in the pelvis compared to head-and-neck and chest-and-abdomen, and the highest rpcm-QA occurred at 1 %/1mm. Some modulation indices for the MLC speed and acceleration were significantly correlated with CQA and MQA. PCR's determination coefficients (R2 ) indicated PCMs had higher accuracy in predicting CQA (max: 0.75) than MQA (max: 0.42). Conclusions CQA and MQA demonstrated a weak correlation. Compared to MQA, CQA exhibited a stronger correlation with PCMs. Certain PCMs related to MLC movement effectively indicated variations in both quality assurances.
Collapse
Affiliation(s)
| | | | - Xia Tan
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| | - Tao Qiu
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| | - Xin Yang
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| | - Bin Feng
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| | - Liyuan Chen
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| | - Ying Wang
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| | - Fu Jin
- Departments of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, Republic of China
| |
Collapse
|
2
|
Huang Y, Liu Z. Dosimetric performance evaluation of the Halcyon treatment platform for stereotactic radiotherapy: A pooled study. Medicine (Baltimore) 2023; 102:e34933. [PMID: 37682167 PMCID: PMC10489306 DOI: 10.1097/md.0000000000034933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/04/2023] [Indexed: 09/09/2023] Open
Abstract
With the advancement of radiotherapy equipment, stereotactic radiotherapy (SRT) has been increasingly used. Among the many radiotherapy devices, Halcyon shows promising applications. This article reviews the dosimetric performance such as plan quality, plan complexity, and gamma passing rates of SRT plans with Halcyon to determine the effectiveness and safety of Halcyon SRT plans. This article retrieved the last 5 years of PubMed studies on the effectiveness and safety of the Halcyon SRT plans. Two authors independently reviewed the titles and abstracts to decide whether to include the studies. A search was conducted to identify publications relevant to evaluating the dosimetric performance of SRT plans on Halcyon using the key strings Halcyon, stereotactic radiosurgery, SRT, stereotactic body radiotherapy, and stereotactic ablative radiotherapy. A total of 18 eligible publications were retrieved. Compared to SRT plans on the TrueBeam, the Halcyon has advantages in terms of plan quality, plan complexity, and gamma passing rates. The high treatment speed of SRT plans on the Halcyon is impressive, while the results of its plan evaluation are also encouraging. As a result, Halcyon offers a new option for busy radiotherapy units while significantly improving patient comfort in treatment. For more accurate results, additional relevant publications will need to be followed up in subsequent studies.
Collapse
Affiliation(s)
- Yangyang Huang
- Department of Radiotherapy, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zongwen Liu
- Department of Radiotherapy, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
3
|
Ito T, Monzen H, Kubo K, Kosaka H, Yanagi Y, Sakai Y, Inada M, Doi H, Nishimura Y. Dose difference between anisotropic analytical algorithm (AAA) and Acuros XB (AXB) caused by target's air content for volumetric modulated arc therapy of head and neck cancer. Rep Pract Oncol Radiother 2023; 28:399-406. [PMID: 37795404 PMCID: PMC10547402 DOI: 10.5603/rpor.a2023.0032] [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: 01/25/2022] [Accepted: 05/23/2022] [Indexed: 10/06/2023] Open
Abstract
Background We clarified the dose difference between the anisotropic analytical algorithm (AAA) and Acuros XB (AXB) with increasing target's air content using a virtual phantom and clinical cases. Materials and methods Whole neck volumetric modulated arc therapy (VMAT) plan was transferred into a virtual phantom with a cylindrical air structure at the center. The diameter of the air structure was changed from 0 to 6 cm, and the target's air content defined as the air/planning target volume (PTV) in percent (air/PTV) was varied. VMAT plans were recalculated by AAA and AXB with the same monitor unit (MU) and multi-leaf collimator (MLC) motions. The dose at each air/PTV (5%-30%) was compared between each algorithm with D98%, D95%, D50% and D2% for the PTV. In addition, MUs were also compared with the same MLC motions between the D95% prescription with AAA (AAA_D95%), AXB_D95%, and the prescription to 100% minus air/PTV (AXB_D100%-air/PTV) in clinical cases of head and neck (HNC). Results When air/PTV increased (5-30%), the dose differences between AAA and AXB for D98%, D95%, D50% and D2% were 3.08-15.72%, 2.35-13.92%, 0.63-4.59%, and 0.14-6.44%, respectively. At clinical cases with air/PTV of 5.61% and 28.19%, compared to AAA_D95%, the MUs differences were, respectively, 2.03% and 6.74% for AXB_D95% and 1.80% and 0.50% for AXB_D100%-air/PTV. Conclusion The dose difference between AAA and AXB increased as the target's air content increased, and AXB_D95% resulted in a dose escalation over AAA_D95% when the target's air content was ≥ 5%. The D100%-air/PTV of PTV using AXB was comparable to the D95% of PTV using AAA.
Collapse
Affiliation(s)
- Takaaki Ito
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
- Department of Radiological Technology, Kobe City Nishi-Kobe Medical Center, Kobe, Hyogo, Japan
| | - Hajime Monzen
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Kazuki Kubo
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Hiroyuki Kosaka
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Yuya Yanagi
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Yusuke Sakai
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Masahiro Inada
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
| | - Hiroshi Doi
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
| |
Collapse
|
5
|
Salari E, Shuai Xu K, Sperling NN, Parsai EI. Using machine learning to predict gamma passing rate in volumetric-modulated arc therapy treatment plans. J Appl Clin Med Phys 2022; 24:e13824. [PMID: 36495010 PMCID: PMC9924108 DOI: 10.1002/acm2.13824] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/19/2022] [Accepted: 10/05/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aims to develop an algorithm to predict gamma passing rate (GPR) in the volumetric-modulated arc therapy (VMAT) technique. MATERIALS AND METHODS A total of 118 clinical VMAT plans, including 28 mediastina, 25 head and neck, 40 brains intensity-modulated radiosurgery, and 25 prostate cases, were created in RayStation treatment planning system for Edge and TrueBeam linacs. In-house scripts were developed to compute Modulation indices such as plan-averaged beam area (PA), plan-averaged beam irregularity (PI), total monitor unit (MU), leaf travel/arc length, mean dose rate variation, and mean gantry speed variation. Pretreatment verifications were performed on ArcCHECK phantom with SNC software. GPR was calculated with 3%/2 mm and 10% threshold. The dataset was randomly split into a training (70%) and a test (30%) dataset. A random forest regression (RFR) model and support vector regression (SVR) with linear kernel were trained to predict GPR using the complexity metrics as input. The prediction performance was evaluated by calculating the mean absolute error (MAE), R2 , and root mean square error (RMSE). RESULTS RMSEs at γ 3%/2 mm for RFR and SVR were 1.407 ± 0.103 and 1.447 ± 0.121, respectively. MAE was 1.14 ± 0.084 for RFR and 1.101 ± 0.09 for SVR. R2 was equal to 0.703 ± 0.027 and 0.689 ± 0.053 for RFR and SVR, respectively. GPR of 3%/2 mm with a 10% threshold can be predicted with an error smaller than 3% for 94% of plans using RFR and SVR models. The most important metrics that had the greatest impact on how accurately GPR can be predicted were determined to be the PA, PI, and total MU. CONCLUSION In terms of its prediction values and errors, SVR (linear) appeared to be comparable with RFR for this dataset. Based on our results, the PA, PI, and total MU calculations may be useful in guiding VMAT plan evaluation and ultimately reducing uncertainties in planning and radiation delivery.
Collapse
Affiliation(s)
- Elahheh Salari
- Department of Radiation OncologyUniversity of Toledo Medical CenterToledoOhioUSA
| | - Kevin Shuai Xu
- Department of Computer and Data SciencesCase Western Reserve UniversityClevelandOhioUSA
| | | | - E. Ishmael Parsai
- Department of Radiation OncologyUniversity of Toledo Medical CenterToledoOhioUSA
| |
Collapse
|
6
|
Wang L, Zhang J, Huang M, Xu B, Li X. Radiobiological Comparison of Acuros External Beam and Anisotropic Analytical Algorithm on Esophageal Carcinoma Radiotherapy Treatment Plans. Dose Response 2022; 20:15593258221105678. [PMID: 35832770 PMCID: PMC9272482 DOI: 10.1177/15593258221105678] [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: 11/17/2022] Open
Abstract
Objective The present study aimed to investigate the dose differences and
radiobiological assessment between Anisotropic Analytical Algorithm (AAA)
and Acuros External Beam (AXB) with its 2 calculation models, namely,
dose-to-water (AXB-Dw) and dose-to-medium (AXB-Dm), on esophageal carcinoma
radiotherapy treatment plans. Materials and methods The AXB-Dw and AXB-Dm plans were generated by recalculating the initial 66
AAA plans using the AXB algorithm with the same monitor units and beam
parameters as those in the original plan. The dosimetric and radiobiological
assessment parameters were calculated for the planning target volume (PTV)
and organs at risk (OARs). The gamma agreement for the PTV and the
correlation between it and the volume of the air cavity and bone among the
different algorithms were compared simultaneously. The dose discrepancy
between the theoretical calculation and treatment planning system (TPS) when
switching from AXB-Dm to AXB-Dw was analyzed according to the composition of
the structures. Results The PTV dose of AXB-Dm plans was significantly smaller than that of the AAA
and AXB-Dw plans (P < .05), except for D2. The difference
values for AAA vs AXB-Dm (∆Dx,(AAA-AXB,Dm)) and
AXB-Dw vs AXB-Dm (∆Dx,(AXB,Dw-AXB,Dm)) were
1.94% [1.27%, 2.64%] and 1.95% [1.56%, 2.27%], respectively. For the spinal
cord and heart, there were obvious differences between the AAA vs AXB-Dm
(spinal cord: 1.15%, heart: 2.89%) and AXB-Dw vs AXB-Dm (spinal cord: 1.88%,
heart: 3.25%) plans. For the lung, the differences between AAA vs AXB-Dm and
AAA vs AXB-Dw were significantly larger than those of AXB-Dm vs AXB-Dw.
Compared to the case of AAA and AXB-Dw, the decrease in biologically
effective dose (BED10, αβ=10 ) of AXB-Dm due to dose non-uniformity exceeded 6.5%, even
for a small σ. The average values of equivalent uniform dose in the AAA,
AXB-Dw, and AXB-Dm plans were 52.03±.39 Gy, 52.24 ± .81 Gy, and 51.13 ±
.47 Gy, respectively. The tumor control probability (TCP) results for PTV in
the AAA, AXB-Dw, and AXB-Dm plans were 62.29 ± 1.57%, 62.82 ± 1.69%, and
58.68±1.88%, respectively. With the 2%/2 mm and 3%/3 mm acceptance criteria,
the mean values of ΔγAAAAXB−Dw, ΔγAAAAXB−Dm, and ΔγAXB−DmAXB−Dw were 87.24, 63.3, and 64.81% vs 97.86, 91.77, and 89.25%,
respectively. The dose discrepancy between the theoretical calculation and
TPS when switching from AXB-Dm to AXB-Dw was approximately 1.63%. Conclusions The AAA and AXB-Dw algorithms overestimated the radiobiological parameters
when the tumor particularly consisted of nonuniform tissues. A relatively
small dose difference could cause a significant reduction in the
corresponding TCP. Dose distribution algorithms should be carefully chosen
by physicists and oncologists to improve tumor control, as well as to
optimize OARs protection.
Collapse
Affiliation(s)
- Lin Wang
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China.,Department of Medical Imaging Technology, College of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Fujian Medical University, Fuzhou, China.,Clinical Research Center for Radiology and Radiotherapy of Fujian Province Digestive, Hematological and Breast Malignancies, Fuzhou, China
| | - Jianping Zhang
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China.,Department of Medical Imaging Technology, College of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Fujian Medical University, Fuzhou, China.,Clinical Research Center for Radiology and Radiotherapy of Fujian Province Digestive, Hematological and Breast Malignancies, Fuzhou, China.,Fujian Medical University Union Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Miaoyun Huang
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China.,Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Fujian Medical University, Fuzhou, China.,Clinical Research Center for Radiology and Radiotherapy of Fujian Province Digestive, Hematological and Breast Malignancies, Fuzhou, China
| | - Benhua Xu
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China.,Department of Medical Imaging Technology, College of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Fujian Medical University, Fuzhou, China.,Clinical Research Center for Radiology and Radiotherapy of Fujian Province Digestive, Hematological and Breast Malignancies, Fuzhou, China.,Fujian Medical University Union Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Xiaobo Li
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China.,Department of Medical Imaging Technology, College of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Fujian Medical University, Fuzhou, China.,Clinical Research Center for Radiology and Radiotherapy of Fujian Province Digestive, Hematological and Breast Malignancies, Fuzhou, China.,Fujian Medical University Union Clinical Medicine College, Fujian Medical University, Fuzhou, China
| |
Collapse
|