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Chiesa S, Russo R, Beghella Bartoli F, Palumbo I, Sabatino G, Cannatà MC, Gigli R, Longo S, Tran HE, Boldrini L, Dinapoli N, Votta C, Cusumano D, Pignotti F, Lupattelli M, Camilli F, Della Pepa GM, D’Alessandris GQ, Olivi A, Balducci M, Colosimo C, Gambacorta MA, Valentini V, Aristei C, Gaudino S. MRI-derived radiomics to guide post-operative management of glioblastoma: Implication for personalized radiation treatment volume delineation. Front Med (Lausanne) 2023; 10:1059712. [PMID: 36744131 PMCID: PMC9892450 DOI: 10.3389/fmed.2023.1059712] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/03/2023] [Indexed: 01/20/2023] Open
Abstract
Background The glioblastoma's bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification. The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigate the role of radiomic analysis in GB management, to verify if radiomic features in the tissue around the resection cavity may guide the radiation target volume delineation. Materials and methods We retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction. The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologists and reviewed by a neuroradiologist, both with at least 10 years of experience. The Regions of interest (ROI) considered for the analysis were: the surgical cavity ± post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modeling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using features extracted from the Ring to perform a binary classification and predict the PFS at 6 months. A 3-fold cross-validation repeated five times was implemented for internal validation of the model. Results Two-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical test). The ROC curve of the model reported an AUC of 0.78 (95% CI: 0.68-0.88). Conclusion This is the first hypothesis-generating study which applies a radiomic analysis focusing on healthy tissue ring around the surgical cavity on post-operative MRI. This study provides a preliminary model for a decision support tool for a customization of the radiation target volume in GB patients in order to achieve a margin reduction strategy.
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Affiliation(s)
- S. Chiesa
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - R. Russo
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Institute of Radiology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - F. Beghella Bartoli
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - I. Palumbo
- Radiation Oncology Section, University of Perugia, Perugia, Italy,Perugia General Hospital, Perugia, Italy
| | - G. Sabatino
- Department of Neurosurgery, Mater Olbia Hospital, Olbia, Italy,Department of Neurosurgery, Agostino Gemelli University Polyclinic (IRCCS), Rome, Italy
| | - M. C. Cannatà
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy,*Correspondence: M. C. Cannatà,
| | - R. Gigli
- Medical Physics, Mater Olbia Hospital, Olbia, Italy
| | - S. Longo
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - H. E. Tran
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - L. Boldrini
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - N. Dinapoli
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - C. Votta
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - D. Cusumano
- Medical Physics, Mater Olbia Hospital, Olbia, Italy
| | - F. Pignotti
- Department of Neurosurgery, Mater Olbia Hospital, Olbia, Italy,Department of Neurosurgery, Agostino Gemelli University Polyclinic (IRCCS), Rome, Italy
| | | | - F. Camilli
- Radiation Oncology Section, University of Perugia, Perugia, Italy
| | - G. M. Della Pepa
- Department of Neurosurgery, Agostino Gemelli University Polyclinic (IRCCS), Rome, Italy
| | - G. Q. D’Alessandris
- Department of Neurosurgery, Agostino Gemelli University Polyclinic (IRCCS), Rome, Italy
| | - A. Olivi
- Department of Neurosurgery, Agostino Gemelli University Polyclinic (IRCCS), Rome, Italy
| | - M. Balducci
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - C. Colosimo
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Institute of Radiology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - M. A. Gambacorta
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - V. Valentini
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - C. Aristei
- Radiation Oncology Section, University of Perugia, Perugia, Italy,Perugia General Hospital, Perugia, Italy
| | - S. Gaudino
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Institute of Radiology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
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Cannatà M, Russo R, Beghella Bartoli F, Palumbo I, Tran H, Votta C, Lupattelli M, Boldrini L, Dinapoli N, Camilli F, Balducci M, Gambacorta M, Valentini V, Aristei C, Sabatino G, Pignotti F, Gaudino S, Chiesa S. P02.11.B An hypothesis generating study of MRI-Derived Radiomics on tumor and microenvironment tissue heterogeneity to guide post-operative management of glioblastoma: toward personalized radiation treatment volume delineation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The glioblastoma’s bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification.The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigated the role of radiomic analysis in GBM management, to verify if radiomic features in the tissue around the resection cavity which may guide the radiation target volume delineation.
Material and Methods
We retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction.The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologist reviewed by a neuroradiologist, both with at least 10 years of experience. The Region of interest (ROI) considered for the analysis were: the surgical cavity +/- post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modelling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using the 226 features extracted from the Ring to perform a binary classification and predict the PFS at 6 months (statistical, morphological and textural features). A 3-fold cross-validation repeated five times was implemented for internal validation of the model.
Results
Two-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical test). The ROC curve of the model reported an AUC of 0.78 (95% CI: 0.68 - 0.88).
Conclusion
This is the first hypothesis-generating study who applies a radiomic analysis focusing on healthy tissue ring around the surgical cavity on post-operative MRI. This study provides a preliminary model for a decision support tool for a customization of the radiation target volume in GBM patients in order to achieve a margin reduction strategy.
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Affiliation(s)
- M Cannatà
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - R Russo
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - F Beghella Bartoli
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - I Palumbo
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - H Tran
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - C Votta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - M Lupattelli
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - L Boldrini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - N Dinapoli
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - F Camilli
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - M Balducci
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - M Gambacorta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - V Valentini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - C Aristei
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - G Sabatino
- Radiation Oncology, Mater Olbia Hospital , 07026, Olbia , Italy
| | - F Pignotti
- Department of Neurosurgery, Mater Olbia Hospital , Olbia , Italy
| | - S Gaudino
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - S Chiesa
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
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Iezzi M, Cusumano D, Piccari D, Menna S, Catucci F, D'Aviero A, Re A, Di Dio C, Quaranta F, Boschetti A, Marras M, Piro D, Votta C, Sanna E, Flore C, Mattiucci G, Valentini V. PO-1483 A predictive model to quantify the dosimetric impact of inter-fraction variability in breast cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03447-8] [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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Votta C, Boldrini L, Chiloiro G, Romano A, Bonelli E, Autorino R, Bianchi M, Campitelli M, Galofaro E, Nardangeli A, Nardini M, Placidi L, Gambacorta M, Valentini V. MO-0650 Partial irradiation in cervical cancer MRgRT: a dosimetric evaluation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02408-2] [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: 11/16/2022]
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Panza G, Autorino R, Cusumano D, Boldrini L, Gui B, Russo L, Votta C, Dinapoli N, Ferrandina G, Nardangeli A, Campitelli M, Macchia G, Valentini V, Gambacorta M. PO-1343 Radiomic model to predict 2ysOS in Cervical Cancer patients underwent neoadjuvant chemoradiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03307-2] [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: 10/18/2022]
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Boschetti A, Votta C, Re A, Piro D, Marras M, D'Aviero A, Catucci F, Cusumano D, Di Dio C, Menna S, Iezzi M, Quaranta F, Flore C, Sanna E, Piccari D, Mattiucci G, Valentini V. PD-0336 Evaluation of a deep-learning segmentation software in thoracic organs at risk: an early analysis. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02829-8] [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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Piro D, Marras M, D'Aviero A, Boschetti A, Votta C, Re A, Catucci F, Cusumano D, Di Dio C, Menna S, Iezzi M, Quaranta F, Flore C, Sanna E, Piccari D, Mattiucci G, Valentini V. PO-1887 Validation of deep learning auto-segmentation in pelvic organs at risk: a preliminary analysis. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03850-6] [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: 11/26/2022]
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Placidi L, Nardini M, Cusumano D, Boldini L, Chiloiro G, Votta C, Antonelli M, Valentini V, Indovina L. Dosimetric and planning evaluation of IMRT vs VMAT-like plans for magnetic resonance guided radiotherapy treatment. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00168-5] [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: 11/27/2022] Open
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Votta C, Boldrini L, Merola B, Chiloiro G, Romano A, Cusumano D, Turco G, Bianchi M, Cornacchione P, Indovina L, Gambacorta M, Valentini V. PO-1969 The contribution of on-board hybrid MRI for planning optimization: movement analysis of the uterus. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08420-6] [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: 10/20/2022]
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Placidi L, Nardini M, Cusumano D, Boldrini L, Catucci F, Chiloiro G, Votta C, Valentini V, Indovina L. PO-1880 Dosimetric accuracy of dual isocenter irradiation in magnetic resonance guided radiotherapy system. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08331-6] [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: 10/20/2022]
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Cusumano D, Lenkowicz J, Votta C, Nardini M, Boldrini L, Placidi L, Catucci F, Dinapoli N, Antonelli M, Romano A, De Luca V, Chiloiro G, Indovina L, Valentini V. OC-0521 A deep learning approach to generate synthetic CT in low field MR-guided radiotherapy for lung cases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06947-4] [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: 10/20/2022]
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Placidi L, Nardini M, Cusumano D, Boldrini L, Chiloiro G, Romano A, Votta C, Antonelli M, Valentini V, Indovina L. PO-1861 Evaluation of VMAT-like planning technique for magnetic resonance guided radiotherapy treatment. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08312-2] [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: 11/25/2022]
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Placidi L, Nardini M, Cusumano D, Boldrini L, Chiloiro G, Romano A, Votta C, Antonelli MV, Valentini V, Indovina L. VMAT-like plans for magnetic resonance guided radiotherapy: Addressing unmet needs. Phys Med 2021; 85:72-78. [PMID: 33979726 DOI: 10.1016/j.ejmp.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE VMAT delivery technique is currently not applicable to Magnetic Resonance-guided radiotherapy (MRgRT) hybrid systems. Aim of this study is to evaluate an innovative VMAT-like (VML) delivery technique. MATERIAL AND METHODS First, planning and dosimetric evaluation of the MRgRT VML treatment have been performed on 10 different disease sites and the results have been compared with the corresponding IMRT plans. Then, in the second phase, 10 of the most dosimetrically challenging locally advanced pancreas treatment plans have been retrospectively re-planned using the VML approach to explore the potentiality of this new delivery technique. Finally, VML robustness was evaluated and compared with the IMRT plans, considering a lateral positioning error of ± 5 mm. RESULTS In phase one, all VML plans were within constraint for all OARs. When PTV coverage is considered, in the 50% of the cases VML PTV coverage is equal or higher than in IMRT plan. In the remaining 50%, the highest target under coverage difference in comparison with IMRT plan is -1.71%. The mean and maximum treatment time differences (VML-IMRT) is 0.2 min and 3.1 min respectively. In phase two, the treatment time variation (VML-IMRT), shows a mean, maximum and minimum variations of 1.3, 4.6 and -0.6 min respectively. All VML plans have a better target coverage if compared with IMRT plans, keeping in any case the OARs constraints within tolerance. VML doesn't increase plan robustness. CONCLUSION VMAT-like treatment approach appeared to be an efficient planning solution and it was decided to clinically implement it in daily practice, especially in the frame of hypo fractionated treatments.
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Affiliation(s)
- L Placidi
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Nardini
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Cusumano
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy.
| | - L Boldrini
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy
| | - G Chiloiro
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy
| | - A Romano
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy
| | - C Votta
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy
| | - M V Antonelli
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy
| | - V Valentini
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Indovina
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Roma, Italy
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Placidi L, Nardini M, Cusumano D, Boldrini L, Catucci F, Chiloiro G, Votta C, Valentini V, Indovina L. Dosimetric accuracy of dual isocenter irradiation in low magnetic field resonance guided radiotherapy system for extended abdominal tumours. Phys Med 2021; 84:149-158. [PMID: 33895666 DOI: 10.1016/j.ejmp.2021.03.037] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Due to limited field size of Magnetic Resonance Linear Accelerators (MR-Linac), some treatments could require a dual-isocenter planning approach to achieve a complete target coverage and thus exploit the benefits of the online adaptation. This study evaluates the dosimetric accuracy of the dual-isocenter intensity modulated radiation therapy (IMRT) delivery technique for MR-Linac. MATERIAL AND METHODS Dual-isocenter multi leaf collimator (MLC) and couch accuracy tests have been performed to evaluate the delivery accuracy of the system. A mono-isocenter plan delivered in clinical practice has then been retrospectively re-planned with dual-isocenter technique. The dual-isocenter plan has been re-calculated and delivered on a 3-dimensional (3D) ArcCHECK phantom and 2-dimensional (2D) films to assess its dosimetric accuracy in terms of gamma analysis. Clinical and planning target volume (CTV and PTV respectively) coverage robustness was then investigated after the introduction of ± 2 mm and ± 5 mm positioning errors by shifting the couch. RESULTS MLC and couch accuracy tests confirmed the system accuracy in delivering a dual-isocenter irradiation. 2D/3D gamma analysis results occurred always to be above 95% if considered a gamma criteria 1%/2 mm and 1%/1 mm respectively for the 2D and 3D analysis. The mean variations for CTV D98% and PTV V95% were 0.2% and 1.1% respectively when positioning error was introduced separately in each direction, while the maximum observed variations were 0.9% (CTV) and 3.7% (PTV). CONCLUSION The dosimetric accuracy of dual-isocenter irradiation has been verified for MR-Linac, achieving accurate and robust treatment strategy and improving dose conformality also in presence of targets whose extension exceeds the nominal maximum field size.
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Affiliation(s)
- L Placidi
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Nardini
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
| | - D Cusumano
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy
| | - L Boldrini
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy
| | - F Catucci
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy
| | - G Chiloiro
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy
| | - C Votta
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy
| | - V Valentini
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Indovina
- Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS, Italy
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Placidi L, Pollutri V, Votta C, Cusumano D, Boldrini L, Chiloiro G, Azario L, De Spirito M, Valentini V. PO-1604: Quantitative analysis of treatment process time for MRI-LINAC system gating efficiency optimization. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01622-4] [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: 10/22/2022]
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Votta C, Cusumano D, Boldrini L, Pollutri V, Placidi L, Chiloiro G, Romano A, Antonelli M, Valentini V. PD-0069: Use of prescription isodose boundary to optimise treatment delivery during MR-guided Radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00095-5] [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: 10/22/2022]
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Piro D, Boldrini L, Cornacchione P, Votta C, Bianchi M, Balducci M, Gambacorta MA, Valentini V, Pasini D. Radiation therapy technologists' involvement and opinion in research: A national survey in Italy. Tech Innov Patient Support Radiat Oncol 2020; 15:11-14. [PMID: 32613093 PMCID: PMC7322338 DOI: 10.1016/j.tipsro.2020.05.002] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/04/2020] [Accepted: 05/14/2020] [Indexed: 10/26/2022] Open
Abstract
Introduction This survey describes Italian RTTs' involvement and opinions in research activities related to radiation oncology. Primary aim was to assess the degree of involvement of the national RTTs community in research and to describe how RTTs can integrate their skills collaborating with other professionals. Materials and methods A ten-items multiple-choice questionnaire, with 2-8 possible responses, was developed by a steering committee and generated on a survey platform. Links were sent via email to Italian RTTs.The questions were divided in 3 domains: demographic data; scientific research and activity; opinions about RTTs role in scientific research. The survey started on October 1, 2018 and ended on January 31, 2019. Results One hundred thirty-five out of 509 (26.5%) RTTs responded to the questionnaire at its expiring date; 97.73% think to be valid contributors in radiation oncology research, expressing clear interest in "data collection" tasks (52.71%); 38.64% feel unsupported by other professionals in the research team and 59.85% of the respondents are not members in any scientific society. Conclusions The role of Italian RTTs in research is heterogeneous. Mainly RTTs in the age range from 30 to 40 years responded to the survey showing their interest in scientific research. This might be related to different informatics and educational skills as well as to personal attitudes. RTTs particular skills, like data management and technical hypothesis generation abilities, are of benefit to realize research projects. Therefore, engaging RTTs in research activities is strongly suggested.
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Affiliation(s)
- D Piro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - L Boldrini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - P Cornacchione
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - C Votta
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - M Bianchi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - M Balducci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - M A Gambacorta
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - V Valentini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - D Pasini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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Boldrini L, Colloca G, Cellini F, Chiloiro G, Bellieni A, Mattiucci G, Antonelli M, Pollutri V, Votta C, Massaccesi M, Manfrida S, Fionda B, Frascino V, Masiello V, Petrone A, Catucci F, Luzi S, Villani E, Balducci M, Valentini V. PO-0856: Age and frailty do not limit Magnetic Resonance guided Radiotherapy (MRgRT) in elderly patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31166-6] [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: 10/14/2022]
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Cellini F, Chiloiro G, Boldrini L, Massaccesi M, Mattiucci G, Antonelli M, Frascino V, Luzi S, Manfrida S, Masiello V, Petrone A, Pollutri V, Votta C, Catucci F, Fionda B, Balducci M, Gambacorta M, Valentini V. EP-1501: Feasibility of MRgRT neoadjuvant treatment for locally advanced rectal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31810-3] [Citation(s) in RCA: 1] [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: 11/16/2022]
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