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Ishizaka N, Kinoshita T, Sakai M, Tanabe S, Nakano H, Tanabe S, Nakamura S, Mayumi K, Akamatsu S, Nishikata T, Takizawa T, Yamada T, Sakai H, Kaidu M, Sasamoto R, Ishikawa H, Utsunomiya S. Prediction of patient-specific quality assurance for volumetric modulated arc therapy using radiomics-based machine learning with dose distribution. J Appl Clin Med Phys 2024; 25:e14215. [PMID: 37987544 PMCID: PMC10795425 DOI: 10.1002/acm2.14215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/29/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
PURPOSE We sought to develop machine learning models to predict the results of patient-specific quality assurance (QA) for volumetric modulated arc therapy (VMAT), which were represented by several dose-evaluation metrics-including the gamma passing rates (GPRs)-and criteria based on the radiomic features of 3D dose distribution in a phantom. METHODS A total of 4,250 radiomic features of 3D dose distribution in a cylindrical dummy phantom for 140 arcs from 106 clinical VMAT plans were extracted. We obtained the following dose-evaluation metrics: GPRs with global and local normalization, the dose difference (DD) in 1% and 2% passing rates (DD1% and DD2%) for 10% and 50% dose threshold, and the distance-to-agreement in 1-mm and 2-mm passing rates (DTA1 mm and DTA2 mm) for 0.5%/mm and 1.0%.mm dose gradient threshold determined by measurement using a diode array in patient-specific QA. The machine learning regression models for predicting the values of the dose-evaluation metrics using the radiomic features were developed based on the elastic net (EN) and extra trees (ET) models. The feature selection and tuning of hyperparameters were performed with nested cross-validation in which four-fold cross-validation is used within the inner loop, and the performance of each model was evaluated in terms of the root mean square error (RMSE), the mean absolute error (MAE), and Spearman's rank correlation coefficient. RESULTS The RMSE and MAE for the developed machine learning models ranged from <1% to nearly <10% depending on the dose-evaluation metric, the criteria, and dose and dose gradient thresholds used for both machine learning models. It was advantageous to focus on high dose region for predicating global GPR, DDs, and DTAs. For certain metrics and criteria, it was possible to create models applicable for patients' heterogeneity by training only with dose distributions in phantom. CONCLUSIONS The developed machine learning models showed high performance for predicting dose-evaluation metrics especially for high dose region depending on the metric and criteria. Our results demonstrate that the radiomic features of dose distribution can be considered good indicators of the plan complexity and useful in predicting measured dose evaluation metrics.
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Affiliation(s)
- Natsuki Ishizaka
- Department of RadiologyNiigata Prefectural Shibata HospitalShibata CityNiigataJapan
| | - Tomotaka Kinoshita
- Department of Radiological TechnologyNiigata University Graduate School of Health SciencesNiigata CityNiigataJapan
| | - Madoka Sakai
- Department of RadiologyNagaoka Chuo General HospitalNagaokaNiigataJapan
- Department of Radiation OncologyNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
| | - Shunpei Tanabe
- Department of Radiation OncologyNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
| | - Hisashi Nakano
- Department of Radiation OncologyNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
| | - Satoshi Tanabe
- Department of Radiation OncologyNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
| | - Sae Nakamura
- Department of Radiation OncologyNiigata Neurosurgical HospitalNiigata CityNiigataJapan
| | - Kazuki Mayumi
- Department of Radiological TechnologyNiigata University Graduate School of Health SciencesNiigata CityNiigataJapan
| | - Shinya Akamatsu
- Department of Radiological TechnologyNiigata University Graduate School of Health SciencesNiigata CityNiigataJapan
- Department of RadiologyTakeda General HospitalAizuwakamatsu CityFukushimaJapan
| | - Takayuki Nishikata
- Department of Radiological TechnologyNiigata University Graduate School of Health SciencesNiigata CityNiigataJapan
- Division of RadiologyNagaoka Red Cross HospitalNagaoka‐shiNiigataJapan
| | - Takeshi Takizawa
- Department of Radiation OncologyNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
- Department of Radiation OncologyNiigata Neurosurgical HospitalNiigata CityNiigataJapan
| | - Takumi Yamada
- Section of Radiology, Department of Clinical SupportNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical SupportNiigata University Medical and Dental HospitalNiigata CityNiigataJapan
| | - Motoki Kaidu
- Department of Radiology and Radiation OncologyNiigata University Graduate School of Medical and Dental SciencesNiigata CityNiigataJapan
| | - Ryuta Sasamoto
- Department of Radiological TechnologyNiigata University Graduate School of Health SciencesNiigata CityNiigataJapan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation OncologyNiigata University Graduate School of Medical and Dental SciencesNiigata CityNiigataJapan
| | - Satoru Utsunomiya
- Department of Radiological TechnologyNiigata University Graduate School of Health SciencesNiigata CityNiigataJapan
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Nakamura S, Sakai M, Ishizaka N, Mayumi K, Kinoshita T, Akamatsu S, Nishikata T, Tanabe S, Nakano H, Tanabe S, Takizawa T, Yamada T, Sakai H, Kaidu M, Sasamoto R, Ishikawa H, Utsunomiya S. Deep learning-based detection and classification of multi-leaf collimator modeling errors in volumetric modulated radiation therapy. J Appl Clin Med Phys 2023; 24:e14136. [PMID: 37633834 PMCID: PMC10691639 DOI: 10.1002/acm2.14136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE The purpose of this study was to create and evaluate deep learning-based models to detect and classify errors of multi-leaf collimator (MLC) modeling parameters in volumetric modulated radiation therapy (VMAT), namely the transmission factor (TF) and the dosimetric leaf gap (DLG). METHODS A total of 33 clinical VMAT plans for prostate and head-and-neck cancer were used, assuming a cylindrical and homogeneous phantom, and error plans were created by altering the original value of the TF and the DLG by ± 10, 20, and 30% in the treatment planning system (TPS). The Gaussian filters ofσ = 0.5 $\sigma = 0.5$ and 1.0 were applied to the planar dose maps of the error-free plan to mimic the measurement dose map, and thus dose difference maps between the error-free and error plans were obtained. We evaluated 3 deep learning-based models, created to perform the following detections/classifications: (1) error-free versus TF error, (2) error-free versus DLG error, and (3) TF versus DLG error. Models to classify the sign of the errors were also created and evaluated. A gamma analysis was performed for comparison. RESULTS The detection and classification of TF and DLG error were feasible forσ = 0.5 $\sigma = 0.5$ ; however, a considerable reduction of accuracy was observed forσ = 1.0 $\sigma = 1.0$ depending on the magnitude of error and treatment site. The sign of errors was detectable by the specifically trained models forσ = 0.5 $\sigma = 0.5$ and 1.0. The gamma analysis could not detect errors. CONCLUSIONS We demonstrated that the deep learning-based models could feasibly detect and classify TF and DLG errors in VMAT dose distributions, depending on the magnitude of the error, treatment site, and the degree of mimicked measurement doses.
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Affiliation(s)
- Sae Nakamura
- Department of Radiation OncologyNiigata Neurosurgical Hospital, Nishi‐kuNiigata CityNiigataJapan
| | - Madoka Sakai
- Department of RadiologyNagaoka Chuo General Hospital, NagaokaNagaokaNiigataJapan
- Department of Radiology and Radiation OncologyNiigata University Graduate School of Medical and Dental Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Natsuki Ishizaka
- Department of RadiologyNiigata Prefectural Shibata HospitalShibata CityNiigataJapan
| | - Kazuki Mayumi
- Department of Radiological TechnologyNiigata University Graduate School of Health Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Tomotaka Kinoshita
- Department of Radiological TechnologyNiigata University Graduate School of Health Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Shinya Akamatsu
- Department of Radiological TechnologyNiigata University Graduate School of Health Sciences, Chuo‐kuNiigata CityNiigataJapan
- Department of RadiologyTakeda General Hospital, Aizuwakamatu CityFukushimaJapan
| | - Takayuki Nishikata
- Department of Radiological TechnologyNiigata University Graduate School of Health Sciences, Chuo‐kuNiigata CityNiigataJapan
- Division of RadiologyNagaoka Red Cross HospitalNagaoka CityNiigataJapan
| | - Shunpei Tanabe
- Department of Radiation OncologyNiigata University Medical and Dental Hospital, Chuo‐kuNiigata CityNiigataJapan
| | - Hisashi Nakano
- Department of Radiation OncologyNiigata University Medical and Dental Hospital, Chuo‐kuNiigata CityNiigataJapan
| | - Satoshi Tanabe
- Department of Radiation OncologyNiigata University Medical and Dental Hospital, Chuo‐kuNiigata CityNiigataJapan
| | - Takeshi Takizawa
- Department of Radiation OncologyNiigata Neurosurgical Hospital, Nishi‐kuNiigata CityNiigataJapan
- Department of Radiology and Radiation OncologyNiigata University Graduate School of Medical and Dental Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Takumi Yamada
- Section of RadiologyDepartment of Clinical SupportNiigata University Medical and Dental Hospital, Chuo‐kuNiigata CityNiigataJapan
| | - Hironori Sakai
- Section of RadiologyDepartment of Clinical SupportNiigata University Medical and Dental Hospital, Chuo‐kuNiigata CityNiigataJapan
| | - Motoki Kaidu
- Department of Radiology and Radiation OncologyNiigata University Graduate School of Medical and Dental Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Ryuta Sasamoto
- Department of Radiological TechnologyNiigata University Graduate School of Health Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation OncologyNiigata University Graduate School of Medical and Dental Sciences, Chuo‐kuNiigata CityNiigataJapan
| | - Satoru Utsunomiya
- Department of Radiological TechnologyNiigata University Graduate School of Health Sciences, Chuo‐kuNiigata CityNiigataJapan
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Yamada T, Nakano H, Tanabe S, Sakai T, Tanabe S, Oka T, Sakai H, Oshikane T, Nakano T, Ohta A, Kanazawa T, Kaidu M, Ishikawa H. Verification of Qfix Encompass™ couch modeling using the Acuros XB algorithm and HypeArc™ using a high-spatial-resolution two-dimensional diode array. Med Dosim 2023; 48:261-266. [PMID: 37455221 DOI: 10.1016/j.meddos.2023.06.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/15/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
We modeled the Qfix Encompass™ immobilization system and further verified the calculated dose distribution of the AcurosXB (AXB) dose calculation algorithm using SRS MapCHECKⓇ (SRSMC) in the HyperArc™ (HA) clinical plan. An Encompass system with a StereoPHAN™ QA phantom was scanned by SOMATOM go.Sim and imported to an Eclipse™ treatment planning system to create a treatment plan for Encompass modeling. The Encompass modeling was performed in the StereoPHAN with a pinpoint ion chamber for 6 MV and 6 MV flattening filter free (6 MV FFF), and 2 × 2 cm2, 4 × 4 cm2, and 6 × 6 cm2 irradiation field sizes. The dose calculation algorithm used was AXB ver. 15.5 with a 1.0 mm calculation grid size. The Hounsfield unit (HU) values of the Encompass modeling were set to 400, -100, -200, and -300 for Encompass, and -400, -600, -700, and -800 for the Encompass base. We evaluated the dose distribution after Encompass modeling by SRSMC using gamma analysis in 12 patients. We adopted HU values of -200 for Encompass, -800 for Encompass base for 6 MV, and -200 for Encompass and -700 for Encompass. Base for 6 MV FFF was adopted as the HU values for the Encompass modeling based on the measurement results. The proposed Encompass modeling resulted in a mean pass rate evaluation >98% for both 6 MV and 6 MV FFF when the 1%/1 mm criterion was used, demonstrating that the proposed HU value can be adopted to calculate more accurate dose distributions.
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Affiliation(s)
- Takumi Yamada
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
| | - Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan; Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan.
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Tatsuya Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
| | - Shunpei Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Tetsuya Oka
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
| | - Tomoya Oshikane
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8122, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Tsutomu Kanazawa
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8122, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8122, Japan
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Nakano H, Shiinoki T, Tanabe S, Utsunomiya S, Takizawa T, Kaidu M, Nishio T, Ishikawa H. Mathematical model combined with microdosimetric kinetic model for tumor volume calculation in stereotactic body radiation therapy. Sci Rep 2023; 13:10981. [PMID: 37414844 PMCID: PMC10326039 DOI: 10.1038/s41598-023-38232-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/05/2023] [Indexed: 07/08/2023] Open
Abstract
We proposed a new mathematical model that combines an ordinary differential equation (ODE) and microdosimetric kinetic model (MKM) to predict the tumor-cell lethal effect of Stereotactic body radiation therapy (SBRT) applied to non-small cell lung cancer (NSCLC). The tumor growth volume was calculated by the ODE in the multi-component mathematical model (MCM) for the cell lines NSCLC A549 and NCI-H460 (H460). The prescription doses 48 Gy/4 fr and 54 Gy/3 fr were used in the SBRT, and the effect of the SBRT on tumor cells was evaluated by the MKM. We also evaluated the effects of (1) linear quadratic model (LQM) and the MKM, (2) varying the ratio of active and quiescent tumors for the total tumor volume, and (3) the length of the dose-delivery time per fractionated dose (tinter) on the initial tumor volume. We used the ratio of the tumor volume at 1 day after the end of irradiation to the tumor volume before irradiation to define the radiation effectiveness value (REV). The combination of MKM and MCM significantly reduced REV at 48 Gy/4 fr compared to the combination of LQM and MCM. The ratio of active tumors and the prolonging of tinter affected the decrease in the REV for A549 and H460 cells. We evaluated the tumor volume considering a large fractionated dose and the dose-delivery time by combining the MKM with a mathematical model of tumor growth using an ODE in lung SBRT for NSCLC A549 and H460 cells.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan.
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-shi, Osaka, Japan.
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1 Ube, Yamaguchi, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-Dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Takeshi Takizawa
- Department of Radiation Oncology, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata-shi, Niigata, Japan
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Teiji Nishio
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-shi, Osaka, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
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Nakano H, Shiinoki T, Tanabe S, Nakano T, Takizawa T, Utsunomiya S, Sakai M, Tanabe S, Ohta A, Kaidu M, Nishio T, Ishikawa H. Multicomponent mathematical model for tumor volume calculation with setup error using single-isocenter stereotactic radiotherapy for multiple brain metastases. Phys Eng Sci Med 2023; 46:945-953. [PMID: 36940064 DOI: 10.1007/s13246-023-01241-8] [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] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/06/2023] [Indexed: 03/21/2023]
Abstract
We evaluated the tumor residual volumes considering six degrees-of-freedom (6DoF) patient setup errors in stereotactic radiotherapy (SRT) with multicomponent mathematical model using single-isocenter irradiation for brain metastases. Simulated spherical gross tumor volumes (GTVs) with 1.0 (GTV 1), 2.0 (GTV 2), and 3.0 (GTV 3)-cm diameters were used. The distance between the GTV center and isocenter (d) was set at 0-10 cm. The GTV was simultaneously translated within 0-1.0 mm (T) and rotated within 0°-1.0° (R) in the three axis directions using affine transformation. We optimized the tumor growth model parameters using measurements of non-small cell lung cancer cell lines' (A549 and NCI-H460) growth. We calculated the GTV residual volume at the irradiation's end using the physical dose to the GTV when the GTV size, d, and 6DoF setup error varied. The d-values that satisfy tolerance values (10%, 35%, and 50%) of the GTV residual volume rate based on the pre-irradiation GTV volume were determined. The larger the tolerance value set for both cell lines, the longer the distance to satisfy the tolerance value. In GTV residual volume evaluations based on the multicomponent mathematical model on SRT with single-isocenter irradiation, the smaller the GTV size and the larger the distance and 6DoF setup error, the shorter the distance that satisfies the tolerance value might need to be.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan. .,Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-Shi, Osaka, Japan.
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1 Ube, Yamaguchi, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Takeshi Takizawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan.,Department of Radiation Oncology, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-Ku, Niigata-Shi, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Madoka Sakai
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Shunpei Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
| | - Teiji Nishio
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-Shi, Osaka, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata-Shi, Niigata, Japan
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Katsura K, Tanabe S, Nakano H, Sakai M, Ohta A, Kaidu M, Soga M, Kobayashi T, Takamura M, Hayashi T. The Relationship between the Contouring Time of the Metal Artifacts Area and Metal Artifacts in Head and Neck Radiotherapy. Tomography 2023; 9:98-104. [PMID: 36648996 PMCID: PMC9844309 DOI: 10.3390/tomography9010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
(1) Background: The impacts of metal artifacts (MAs) on the contouring workload for head and neck radiotherapy have not yet been clarified. Therefore, this study evaluated the relationship between the contouring time of the MAs area and MAs on head and neck radiotherapy treatment planning. (2) Methods: We used treatment planning computed tomography (CT) images for head and neck radiotherapy. MAs were classified into three severities by the percentage of CT images containing MAs: mild (<25%), moderate (25−75%), and severe (>75%). We randomly selected nine patients to evaluate the relationship between MAs and the contouring time of the MAs area. (3) Results: The contouring time of MAs showed moderate positive correlations with the MAs volume and the number of CT images containing MAs. Interobserver reliability of the extracted MAs volume and contouring time were excellent and poor, respectively. (4) Conclusions: Our study suggests that the contouring time of MAs areas is related to individual commitment rather than clinical experience. Therefore, the development of software combining metal artifact reduction methods with automatic contouring methods is necessary to reducing interobserver variability and contouring workload.
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Affiliation(s)
- Kouji Katsura
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
- Correspondence: ; Tel.: +81-25-227-2914
| | - Satoshi Tanabe
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 851-8520, Japan
| | - Hisashi Nakano
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata 851-8520, Japan
| | - Madoka Sakai
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Marie Soga
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Taichi Kobayashi
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Masaki Takamura
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Takafumi Hayashi
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
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Nakano H, Takizawa T, Kawahara D, Tanabe S, Utsunomiya S, Kaidu M, Maruyama K, Takeuchi S, Onda K, Koizumi M, Nishio T, Ishikawa H. Radiobiological evaluation considering the treatment time with stereotactic radiosurgery for brain metastases. BJR Open 2022; 4:20220013. [PMID: 38525167 PMCID: PMC10958663 DOI: 10.1259/bjro.20220013] [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] [Received: 04/01/2022] [Revised: 10/04/2022] [Accepted: 10/27/2022] [Indexed: 12/15/2022] Open
Abstract
Objective We evaluated the radiobiological effect of the irradiation time with the interruption time of stereotactic radiosurgery (SRS) using CyberKnife® (CK) systemfor brain metastases. Methods We used the DICOM data and irradiation log file of the 10 patients with brain metastases from non-small-cell lung cancer (NSCLC) who underwent brain SRS. We defined the treatment time as the sum of the dose-delivery time and the interruption time during irradiations, and we used a microdosimetric kinetic model (MKM) to evaluate the radiobiological effects of the treatment time. The biological parameters, i.e. α0, β0, and the DNA repair constant rate (a + c), were acquired from NCI-H460 cell for the MKM. We calculated the radiobiological dose for the gross tumor volume (GTVbio) to evaluate the treatment time's effect compared with no treatment time as a reference. The D95 (%) and the Radiation Therapy Oncology Group conformity index (RCI) and Paddick conformity index (PCI) were calculated as dosimetric indices. We used several DNA repair constant rates (a + c) (0.46, 1.0, and 2.0) to assess the radiobiological effect by varying the DNA repair date (a + c) values. Results The mean values of D95 (%), RCI, and PCI for GTVbio were 98.8%, 0.90, and 0.80, respectively, and decreased with increasing treatment time. The mean values of D95 (%), RCI, and PCI of GTVbio at 2.0 (a+c) value were 94.9%, 0.71, and 0.49, respectively. Conclusion The radiobiological effect of the treatment time on tumors was accurately evaluated with brain SRS using CK. Advances in knowledge There has been no published investigation of the radiobiological impact of the longer treatment time with multiple interruptions of SRS using a CK on the target dose distribution in a comparison with the use of a linac. Radiobiological dose assessment that takes into account treatment time in the physical dose in this study may allow more accurate dose assessment in SRS for metastatic brain tumors using CK.
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Affiliation(s)
| | | | - Daisuke Kawahara
- Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi, Hiroshima, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
| | - Katsuya Maruyama
- Department of Radiation Oncology, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata-shi, Niigata, Japan
| | - Shigekazu Takeuchi
- Department of Neurosurgery, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata-shi, Niigata, Japan
| | - Kiyoshi Onda
- Department of Neurosurgery, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata-shi, Niigata, Japan
| | - Masahiko Koizumi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-shi, Osaka, Japan
| | - Teiji Nishio
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-shi, Osaka, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan
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Takizawa T, Tanabe S, Nakano H, Utsunomiya S, Sakai M, Maruyama K, Takeuchi S, Nakano T, Ohta A, Kaidu M, Ishikawa H, Onda K. The impact of target positioning error and tumor size on radiobiological parameters in robotic stereotactic radiosurgery for metastatic brain tumors. Radiol Phys Technol 2022; 15:135-146. [DOI: 10.1007/s12194-022-00655-5] [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] [Received: 10/04/2021] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 12/01/2022]
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Nakano H, Kawahara D, Tanabe S, Utsunomiya S, Takizawa T, Sakai M, Nakano T, Ohta A, Kaidu M, Ishikawa H. Calculated relative biological effectiveness (RBE) for initial DNA double-strand breaks (DSB) from flattening filter and flattening filter-free 6 MV X-ray fields. BJR Open 2021; 3:20200072. [PMID: 34286177 PMCID: PMC8256801 DOI: 10.1259/bjro.20200072] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives We evaluated the radiobiological effectiveness based on the yields of DNA double-strand breaks (DSBs) of field induction with flattening filter (FF) and FF-free (FFF) photon beams. Methods We used the particle and heavy ion transport system (PHITS) and a water equivalent phantom (30 × 30 × 30 cm3) to calculate the physical qualities of the dose-mean lineal energy (yD) with 6 MV FF and FFF. The relative biological effectiveness based on the yields of DNA-DSBs (RBEDSB) was calculated for standard radiation such as 220 kVp X-rays by using the estimating yields of SSBs and DSBs. The measurement points used to calculate the in-field yD and RBEDSB were located at a depth of 3, 5, and 10 cm in the water equivalent phantom on the central axis. Measurement points at 6, 8, and 10 cm in the lateral direction of each of the three depths from the central axis were set to calculate the out-of-field yD and RBEDSB. Results The RBEDSB of FFF in-field was 1.7% higher than FF at each measurement depth. The RBEDSB of FFF out-of-field was 1.9 to 6.4% higher than FF at each depth measurement point. As the distance to out-of-field increased, the RBEDSB of FFF rose higher than those of FF. FFF has a larger RBEDSB than FF based on the yields of DNA-DSBs as the distance to out-of-field increased. Conclusions The out-of-field radiobiological effect of FFF could thus be greater than that of FF since the spreading of the radiation dose out-of-field with FFF could be a concern compared to the FF. Advances in knowledge The RBEDSB of FFF of out-of-field might be larger than FF.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Daisuke Kawahara
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi, Hiroshima, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | | | - Madoka Sakai
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiation Oncology, Niigata Neurosurgical Hospital, Niigata, 3057 Yamada, Nishi-ku, Niigata, Japan
| | - Hiroyuki Ishikawa
- Department of Radiation Oncology, Niigata Neurosurgical Hospital, Niigata, 3057 Yamada, Nishi-ku, Niigata, Japan
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Nakano H, Tanabe S, Sasamoto R, Takizawa T, Utsunomiya S, Sakai M, Nakano T, Ohta A, Kaidu M, Ishikawa H. Radiobiological evaluation considering setup error on single-isocenter irradiation in stereotactic radiosurgery. J Appl Clin Med Phys 2021; 22:266-275. [PMID: 34151498 PMCID: PMC8292684 DOI: 10.1002/acm2.13322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 11/06/2022] Open
Abstract
Purpose We calculated the dosimetric indices and estimated the tumor control probability (TCP) considering six degree‐of‐freedom (6DoF) patient setup errors in stereotactic radiosurgery (SRS) using a single‐isocenter technique. Methods We used simulated spherical gross tumor volumes (GTVs) with diameters of 1.0 cm (GTV 1), 2.0 cm (GTV 2), and 3.0 cm (GTV 3), and the distance (d) between the target center and isocenter was set to 0, 5, and 10 cm. We created the dose distribution by convolving the blur component to uniform dose distribution. The prescription dose was 20 Gy and the dose distribution was adjusted so that D95 (%) of each GTV was covered by 100% of the prescribed dose. The GTV was simultaneously rotated within 0°–1.0° (δR) around the x‐, y‐, and z‐axes and then translated within 0–1.0 mm (δT) in the x‐, y‐, and z‐axis directions. D95, conformity index (CI), and conformation number (CN) were evaluated by varying the distance from the isocenter. The TCP was estimated by translating the calculated dose distribution into a biological response. In addition, we derived the x‐y‐z coordinates with the smallest TCP reduction rate that minimize the sum of squares of the residuals as the optimal isocenter coordinates using the relationship between 6DoF setup error, distance from isocenter, and GTV size. Results D95, CI, and CN were decreased with increasing isocenter distance, decreasing GTV size, and increasing setup error. TCP of GTVs without 6DoF setup error was estimated to be 77.0%. TCP were 25.8% (GTV 1), 35.0% (GTV 2), and 53.0% (GTV 3) with (d, δT,δR) = (10 cm, 1.0 mm, 1.0°). The TCP was 52.3% (GTV 1), 54.9% (GTV 2), and 66.1% (GTV 3) with (d, δT,δR) = (10 cm, 1.0 mm, 1.0°) at the optimal isocenter position. Conclusion The TCP in SRS for multiple brain metastases with a single‐isocenter technique may decrease with increasing isocenter distance and decreasing GTV size when the 6DoF setup errors are exceeded (1.0 mm, 1.0°). Additionally, it might be possible to better maintain TCP for GTVs with 6DoF setup errors by using the optimal isocenter position.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Takeshi Takizawa
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan.,Department of Radiation Oncology, Niigata Neurosurgical Hospital, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Madoka Sakai
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Oshikane T, Kaidu M, Abe E, Ohta A, Saito H, Nakano T, Honda M, Tanabe S, Utsunomiya S, Sasamoto R, Ishizaki F, Kasahara T, Nishiyama T, Tomita Y, Aoyama H, Ishikawa H. A comparative study of high-dose-rate brachytherapy boost combined with external beam radiation therapy versus external beam radiation therapy alone for high-risk prostate cancer. J Radiat Res 2021; 62:525-532. [PMID: 33823010 PMCID: PMC8127662 DOI: 10.1093/jrr/rrab006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 07/01/2021] [Accepted: 01/15/2020] [Indexed: 06/12/2023]
Abstract
We aimed to compare the outcomes of high-dose-rate brachytherapy (HDR-BT) boost and external beam radiation therapy (EBRT) alone for high-risk prostate cancer. This was a single-center, retrospective and observational study. Consecutive patients who underwent initial radical treatment by HDR-BT boost or EBRT alone from June 2009 to May 2016 at the Niigata University Medical and Dental Hospital, Japan were included. A total of 96 patients underwent HDR-BT boost, and 61 underwent EBRT alone. The prescription dose of HDR-BT boost was set to 18 Gy twice a day with EBRT 39 Gy/13 fractions. The dose for EBRT alone was mostly 70 Gy/28 fractions. The high-risk group received >6 months of prior androgen deprivation therapy. Overall survival, biochemical-free survival, local control and distant metastasis-free survival rates at 5 years were analyzed. The incidence of urological and gastrointestinal late adverse events of Grade 2 and above was also summarized. In the National Comprehensive Cancer Network (NCCN) high-risk calssification, HDR-BT boost had a significantly higher biochemical-free survival rate at 5 years (98.9% versus 90.7%, P = 0.04). Urethral strictures were more common in the HDR-BT boost group. We will continuously observe the progress of the study patients and determine the longer term results.
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Affiliation(s)
- Tomoya Oshikane
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Motoki Kaidu
- Corresponding author. Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan. Tel: +81-25-227-2315; Fax: +81-25-227-0788;
| | - Eisuke Abe
- Division of Radiation Oncology, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka 940-8653, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Hirotake Saito
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Moe Honda
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Satoshi Tanabe
- Division of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Fumio Ishizaki
- Department of Urology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Takashi Kasahara
- Department of Urology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Tsutomu Nishiyama
- Division of Urology, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan
| | - Yoshihiko Tomita
- Department of Urology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
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Sakai M, Nakano H, Kawahara D, Tanabe S, Takizawa T, Narita A, Yamada T, Sakai H, Ueda M, Sasamoto R, Kaidu M, Aoyama H, Ishikawa H, Utsunomiya S. Detecting MLC modeling errors using radiomics-based machine learning in patient-specific QA with an EPID for intensity-modulated radiation therapy. Med Phys 2021; 48:991-1002. [PMID: 33382467 DOI: 10.1002/mp.14699] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/27/2020] [Accepted: 12/18/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE We sought to develop machine learning models to detect multileaf collimator (MLC) modeling errors with the use of radiomic features of fluence maps measured in patient-specific quality assurance (QA) for intensity-modulated radiation therapy (IMRT) with an electric portal imaging device (EPID). METHODS Fluence maps measured with EPID for 38 beams from 19 clinical IMRT plans were assessed. Plans with various degrees of error in MLC modeling parameters [i.e., MLC transmission factor (TF) and dosimetric leaf gap (DLG)] and plans with an MLC positional error for comparison were created. For a total of 152 error plans for each type of error, we calculated fluence difference maps for each beam by subtracting the calculated maps from the measured maps. A total of 837 radiomic features were extracted from each fluence difference map, and we determined the number of features used for the training dataset in the machine learning models by using random forest regression. Machine learning models using the five typical algorithms [decision tree, k-nearest neighbor (kNN), support vector machine (SVM), logistic regression, and random forest] for binary classification between the error-free plan and the plan with the corresponding error for each type of error were developed. We used part of the total dataset to perform fourfold cross-validation to tune the models, and we used the remaining test dataset to evaluate the performance of the developed models. A gamma analysis was also performed between the measured and calculated fluence maps with the criteria of 3%/2 and 2%/2 mm for all of the types of error. RESULTS The radiomic features and its optimal number were similar for the models for the TF and the DLG error detection, which was different from the MLC positional error. The highest sensitivity was obtained as 0.913 for the TF error with SVM and logistic regression, 0.978 for the DLG error with kNN and SVM, and 1.000 for the MLC positional error with kNN, SVM, and random forest. The highest specificity was obtained as 1.000 for the TF error with a decision tree, SVM, and logistic regression, 1.000 for the DLG error with a decision tree, logistic regression, and random forest, and 0.909 for the MLC positional error with a decision tree and logistic regression. The gamma analysis showed the poorest performance in which sensitivities were 0.737 for the TF error and the DLG error and 0.882 for the MLC positional error for 3%/2 mm. The addition of another type of error to fluence maps significantly reduced the sensitivity for the TF and the DLG error, whereas no effect was observed for the MLC positional error detection. CONCLUSIONS Compared to the conventional gamma analysis, the radiomics-based machine learning models showed higher sensitivity and specificity in detecting a single type of the MLC modeling error and the MLC positional error. Although the developed models need further improvement for detecting multiple types of error, radiomics-based IMRT QA was shown to be a promising approach for detecting the MLC modeling error.
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Affiliation(s)
- Madoka Sakai
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Daisuke Kawahara
- Radiation Therapy Section, Department of Clinical Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Takeshi Takizawa
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan.,Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata, 950-1101, Japan
| | - Akihiro Narita
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, 951-8518, Japan
| | - Takumi Yamada
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Masataka Ueda
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, 951-8518, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, 951-8518, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.,Department of Radiation Oncology, Faculty of Medicine, Hokkaido University, N15 W7 Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, 951-8518, Japan
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Nakano H, Tanabe S, Yamada T, Utsunomiya S, Takizawa T, Sakai M, Sasamoto R, Sakai H, Nakano T, Saito H, Ohta A, Kaidu M, Ishikawa H. Maximum distance in single-isocenter technique of stereotactic radiosurgery with rotational error using margin-based analysis. Radiol Phys Technol 2021; 14:57-63. [PMID: 33393057 DOI: 10.1007/s12194-020-00602-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022]
Abstract
Through geometrical simulation, we evaluated the effect of rotational error in patient setup on geometrical coverage and calculated the maximum distance between the isocenter and target, where the clinical PTV margin secures geometrical coverage with a single-isocenter technique. We used simulated spherical GTVs with diameters of 1.0 (GTV 1), 1.5 (GTV 2), 2.0 (GTV 3), and 3.0 cm (GTV 4). The location of the target center was set such that the distance between the target and isocenter ranged from 0 to 15 cm. We created geometrical coverage vectors so that each target was entirely covered by 100% of the prescribed dose. The vectors of the target positions were simultaneously rotated within a range of 0°-2.0° around the x-, y-, and z-axes. For each rotational error, the reduction in geometrical coverage of the targets was calculated and compared with that obtained for a rotational error of 0°. The tolerance value of the geometrical coverage reduction was defined as 5% of the GTV. The maximum distance that satisfied the 5% tolerance value for different values of rotational error at a clinical PTV margin of 0.1 cm was calculated. When the rotational errors were 0.5° for a 0.1 cm PTV margin, the maximum distances were as follows: GTV 1: 7.6 cm; GTV 2: 10.9 cm; GTV 3: 14.3 cm; and GTV 4: 21.4 cm. It might be advisable to exclude targets that are > 7.6 cm away from the isocenter with a single-isocenter technique to satisfy the tolerance value for all GTVs.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan.
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Takumi Yamada
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Takeshi Takizawa
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan.,Department of Radiation Oncology, Niigata Neurosurgical Hospital, Yamada, Nishi-ku, Niigata, 3057, Japan
| | - Madoka Sakai
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
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Nakano H, Kawahara D, Tanabe S, Utsunomiya S, Takizawa T, Sakai M, Saito H, Ohta A, Kaidu M, Ishikawa H. Radiobiological effects of the interruption time with Monte Carlo Simulation on multiple fields in photon beams. J Appl Clin Med Phys 2020; 21:288-294. [PMID: 33270984 PMCID: PMC7769402 DOI: 10.1002/acm2.13110] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/24/2020] [Accepted: 11/08/2020] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The interruption time is the irradiation interruption that occurs at sites and operations such as the gantry, collimator, couch rotation, and patient setup within the field in radiotherapy. However, the radiobiological effect of prolonging the treatment time by the interruption time for tumor cells is little evaluated. We investigated the effect of the interruption time on the radiobiological effectiveness with photon beams based on a modified microdosimetric kinetic (mMK) model. METHODS The dose-mean lineal energy yD (keV/µm) of 6-MV photon beams was calculated by the particle and heavy ion transport system (PHITS). We set the absorbed dose to 2 or 8 Gy, and the interruption time (τ) was set to 1, 3, 5, 10, 30, and 60 min. The biological parameters such as α0, β0, and DNA repair constant rate (a + c) values were acquired from a human non-small-cell lung cancer cell line (NCI-H460) for the mMK model. We used two-field and four-field irradiation with a constant dose rate (3 Gy/min); the photon beams were paused for interruption time τ. We calculated the relative biological effectiveness (RBE) to evaluate the interruption time's effect compared with no interrupted as a reference. RESULTS The yD of 6-MV photon beams was 2.32 (keV/µm), and there was little effect by changing the water depth (standard deviation was 0.01). The RBE with four-field irradiation for 8 Gy was decreased to 0.997, 0.975, 0.900, and 0.836 τ = 1, 10, 30, 60 min, respectively. In addition, the RBE was affected by the repair constant rate (a + c) value, the greater the decrease in RBE with the longer the interruption time when the (a + c) value was large. CONCLUSION The ~10-min interruption of 6-MV photon beams did not significantly impact the radiobiological effectiveness, since the RBE decrease was <3%. Nevertheless, the RBE's effect on tumor cells was decreased about 30% by increasing the 60 min interruption time at 8 Gy with four-field irradiation. It is thus necessary to make the interruption time as short as possible.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Daisuke Kawahara
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Takeshi Takizawa
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan.,Niigata Neurosurgical Hospital, Niigata, Japan
| | - Madoka Sakai
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyuki Ishikawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Nakano H, Tanabe S, Utsunomiya S, Yamada T, Sasamoto R, Nakano T, Saito H, Takizawa T, Sakai H, Ohta A, Abe E, Kaidu M, Aoyama H. Effect of setup error in the single-isocenter technique on stereotactic radiosurgery for multiple brain metastases. J Appl Clin Med Phys 2020; 21:155-165. [PMID: 33119953 PMCID: PMC7769381 DOI: 10.1002/acm2.13081] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/25/2020] [Accepted: 10/06/2020] [Indexed: 01/22/2023] Open
Abstract
In conventional stereotactic radiosurgery (SRS), treatment of multiple brain metastases using multiple isocenters is time‐consuming resulting in long dose delivery times for patients. A single‐isocenter technique has been developed which enables the simultaneous irradiation of multiple targets at one isocenter. This technique requires accurate positioning of the patient to ensure optimal dose coverage. We evaluated the effect of six degrees of freedom (6DoF) setup errors in patient setups on SRS dose distributions for multiple brain metastases using a single‐isocenter technique. We used simulated spherical gross tumor volumes (GTVs) with diameters ranging from 1.0 to 3.0 cm. The distance from the isocenter to the target's center was varied from 0 to 15 cm. We created dose distributions so that each target was entirely covered by 100% of the prescribed dose. The target's position vectors were rotated from 0°–2.0° and translated from 0–1.0 mm with respect to the three axes in space. The reduction in dose coverage for the targets for each setup error was calculated and compared with zero setup error. The calculated margins for the GTV necessary to satisfy the tolerance values for loss of GTV coverage of 3% to 10% were defined as coverage‐based margins. In addition, the maximum isocenter to target distance for different 6DoF setup errors was calculated to satisfy the tolerance values. The dose coverage reduction and coverage‐based margins increased as the target diameter decreased, and the distance and 6DoF setup error increased. An increase in setup error when a single‐isocenter technique is used may increase the risk of missing the tumor; this risk increases with increasing distance from the isocenter and decreasing tumor size.
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Affiliation(s)
- Hisashi Nakano
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Chuo-ku, Niigata, Japan
| | - Takumi Yamada
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Chuo-ku, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Takeshi Takizawa
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan.,Department of Radiation Oncology, Niigata Neurosurgical Hospital, Nishi-ku, Niigata, Japan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Eisuke Abe
- Department of Radiology, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan.,Department of Radiation Oncology, Faculty of Medicine, Hokkaido University, Kita-ku, Sapporo, Japan
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Kasahara T, Ishizaki F, Kazama A, Yuki E, Yamana K, Maruyama R, Oshikane T, Kaidu M, Aoyama H, Bilim V, Nishiyama T, Tomita Y. High‐dose‐rate brachytherapy and hypofractionated external beam radiotherapy combined with long‐term androgen deprivation therapy for very high‐risk prostate cancer. Int J Urol 2020; 27:800-806. [DOI: 10.1111/iju.14305] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/02/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Takashi Kasahara
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Fumio Ishizaki
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Akira Kazama
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Eri Yuki
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Kazutoshi Yamana
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Ryo Maruyama
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Tomoya Oshikane
- Department of Radiology and Radiation Oncology Niigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology Niigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology Niigata University Graduate School of Medical and Dental Sciences NiigataJapan
| | - Vladimir Bilim
- Department of Urology Kameda Daiichi Hospital NiigataJapan
| | | | - Yoshihiko Tomita
- Division of Molecular Oncology Department of UrologyNiigata University Graduate School of Medical and Dental Sciences NiigataJapan
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Nakano T, Aoyama H, Saito H, Tanabe S, Tanaka K, Maruyama K, Oshikane T, Ohta A, Abe E, Kaidu M. The neurocognitive function change criteria after whole-brain radiation therapy for brain metastasis, in reference to health-related quality of life changes: a prospective observation study. BMC Cancer 2020; 20:66. [PMID: 31996182 PMCID: PMC6988195 DOI: 10.1186/s12885-020-6559-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 01/20/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We sought to construct the optimal neurocognitive function (NCF) change criteria sensitive to health-related quality of life (HR-QOL) in patients who have undergone whole-brain radiation therapy (WBRT) for brain metastasis. METHODS We categorized the patients by the changes of NCF into groups of improvement versus deterioration if at least one domain showed changes that exceeded the cut-off while other domains remained stable. The remaining patients were categorized as stable, and the patients who showed both significant improvement and deterioration were categorized as 'both.' We examined the clinical meaning of NCF changes using the cut-off values 1.0, 1.5, and 2.0 SD based on the percentage of patients whose HR-QOL changes were ≥ 10 points. RESULTS Baseline, 4-month and 8-month data were available in 78, 41 (compliance; 85%), and 29 (81%) patients, respectively. At 4 months, improvement/stable/deterioration/both was seen in 15%/12%/41%/32% of the patients when 1.0 SD was used; 19%/22%/37%/22% with 1.5 SD, and 17%/37%/37%/9% with 2.0 SD. The HR-QOL scores on the QLQ-C30 functional scale were significantly worse in the deterioration group versus the others with 1.0 SD (p = 0.013) and 1.5 SD (p = 0.015). With 1.5 SD, the HR-QOL scores on the QLQ-BN20 was significantly better in the improvement group versus the others (p = 0.033). However, when 'both' was included in 'improvement' or 'deterioration,' no significant difference in HR-QOL was detected. CONCLUSIONS The NCF cut-off of 1.5 SD and the exclusion of 'both' patients from the 'deterioration' and 'improvement' groups best reflects HR-QOL changes.
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Affiliation(s)
- Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental hospital, Niigata, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental hospital, Niigata, Japan
| | - Kensuke Tanaka
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Katsuya Maruyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Tomoya Oshikane
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental hospital, Niigata, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
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Saito H, Shodo R, Yamazaki K, Katsura K, Ueki Y, Nakano T, Oshikane T, Yamana N, Tanabe S, Utsunomiya S, Ohta A, Abe E, Kaidu M, Sasamoto R, Aoyama H. The association between oral candidiasis and severity of chemoradiotherapy-induced dysphagia in head and neck cancer patients: A retrospective cohort study. Clin Transl Radiat Oncol 2019; 20:13-18. [PMID: 31737796 PMCID: PMC6849117 DOI: 10.1016/j.ctro.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 11/27/2022] Open
Abstract
Oral candidiasis (OC) aggravated dysphagia in chemoradiation for HNC. OC patients required higher doses of opioids. Early diagnosis of chemoradiation-associated OC seems difficult. Antifungal prophylaxis may reduce the severity of mucositis and dysphagia.
Background and purpose Concurrent chemoradiotherapy (CCRT) for head and neck cancer (HNC) is a risk factor for oral candidiasis (OC). As Candida spp. are highly virulent, we conducted a retrospective study to determine whether OC increases the severity of dysphagia related to mucositis in HNC patients. Patients and methods We retrospectively analyzed the cases of consecutive patients with carcinomas of the oral cavity, pharynx, and larynx who underwent CCRT containing cisplatin (CDDP) at our hospital. The diagnosis of OC was based on gross mucosal appearance. We performed a multivariate analysis to determine whether OC was associated with the development of grade 3 dysphagia in the Radiation Therapy Oncology Group (RTOG) Acute Toxicity Criteria. The maximum of the daily opioid doses was compared between the patients with and without OC. Results We identified 138 HNC patients. OC was observed in 51 patients (37%). By the time of their OC diagnosis, 19 (37%) had already developed grade 3 dysphagia. Among the 30 patients receiving antifungal therapy, 12 (40%) showed clinical deterioration. In the multivariate analysis, OC was independently associated with grade 3 dysphagia (OR 2.75; 95%CI 1.22–6.23; p = 0.015). The patients with OC required significantly higher morphine-equivalent doses of opioids (45 vs. 30 mg/day; p = 0.029). Conclusion Candida infection causes refractory dysphagia. It is worth investigating whether antifungal prophylaxis reduces severe dysphagia related to candidiasis.
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Affiliation(s)
- Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Ryusuke Shodo
- Departments of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Kouji Katsura
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Yushi Ueki
- Departments of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Tomoya Oshikane
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Nobuko Yamana
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Satoru Utsunomiya
- Department of Radiologic Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Ryuta Sasamoto
- Department of Radiologic Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
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Oike N, Kawashima H, Ogose A, Hatano H, Ariizumi T, Kaidu M, Aoyama H, Endo N. Long-term outcomes of an extracorporeal irradiated autograft for limb salvage operations in musculoskeletal tumours. Bone Joint J 2019; 101-B:1151-1159. [DOI: 10.1302/0301-620x.101b9.bjj-2019-0090.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Aims We analyzed the long-term outcomes of patients observed over ten years after resection en bloc and reconstruction with extracorporeal irradiated autografts Patients and Methods This retrospective study included 27 patients who underwent resection en bloc and reimplantation of an extracorporeal irradiated autograft. The mean patient age and follow-up period were 31.7 years (9 to 59) and 16.6 years (10.3 to 24.3), respectively. The most common diagnosis was osteosarcoma (n = 10), followed by chondrosarcoma (n = 6). The femur (n = 13) was the most frequently involved site, followed by the tibia (n = 7). There were inlay grafts in five patients, intercalary grafts in 15 patients, and osteoarticular grafts in seven patients. Functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system. Results There were no recurrences in the irradiated autograft and the autograft survived in 24 patients (88.9%). Major complications included nonunion (n = 9), subchondral bone collapse (n = 4), and deep infection (n = 4). Although 34 revision procedures were performed, 25 (73.5%) and four (11.8%) of these were performed less than five years and ten years after the initial surgery, respectively. The mean MSTS score at the last follow-up was 84.3% (33% to 100%). Conclusion Considering long-term outcomes, extracorporeal irradiated autograft is an effective method of reconstruction for malignant musculoskeletal tumours Cite this article: Bone Joint J 2019;101-B:1151–1159
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Affiliation(s)
- N. Oike
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - H. Kawashima
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - A. Ogose
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Orthopaedic Surgery, Uonuma Kikan Hospital, Niigata, Japan
| | - H. Hatano
- Department of Orthopaedic Surgery, Niigata Cancer Hospital, Niigata, Japan
| | - T. Ariizumi
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - M. Kaidu
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - H. Aoyama
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - N. Endo
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Tanabe S, Utsunomiya S, Abe E, Sato H, Ohta A, Sakai H, Yamada T, Kaidu M, Aoyama H. The impact of the three degrees-of-freedom fiducial marker-based setup compared to soft tissue-based setup in hypofractionated intensity-modulated radiotherapy for prostate cancer. J Appl Clin Med Phys 2019; 20:53-59. [PMID: 31054217 PMCID: PMC6560240 DOI: 10.1002/acm2.12603] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 03/21/2019] [Accepted: 04/10/2019] [Indexed: 11/09/2022] Open
Abstract
Purpose We evaluated the setup accuracy of a three‐degree‐of‐freedom fiducial marker (3DOF‐FM)‐based setup compared to a soft tissue (ST)‐based setup in hypofractionated intensity‐modulated radiotherapy (IMRT) for prostate cancer. Materials and Methods We analyzed the setup accuracy for 17 consecutive prostate cancer patients with three implanted FMs who underwent hypofractionated IMRT. The 3DOF‐ST‐based setup using cone‐beam computed tomography (CT) was performed after a six DOF‐bony structure (BS)‐based setup using an ExacTrac x‐ray system. The 3DOF‐FM‐based matching using the ExacTrac x‐ray system was done during the BS‐ and ST‐based setups. We determined the mean absolute differences and the correlation between the FM‐ and ST‐based translational shifts relative to the BS‐based setup position. The rotational mean shifts detected by the ExacTrac x‐ray system were also evaluated. Results The mean differences in the anterior‐posterior (AP), superior‐inferior (SI), and left‐right (LR) dimensions were 0.69, 0.0, and 0.30 mm, respectively. The Pearson correlation coefficients for both shifts were 0.92 for AP, 0.91 for SI, and 0.68 for LR. The percentages of shift agreements within 2 mm were 85% for AP, 93% for SI, and 99% for LR. The absolute values of rotational shifts were 0.1° for AP, 0.3°, and 1.2° for LR. Conclusions The setup accuracy of the 3DOF‐FM‐based setup has the potential to be interchangeable with a ST‐based setup. Our data are likely to be useful in clinical practice along with the popularization of the hypofractionated IMRT in prostate cancer.
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Affiliation(s)
- Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiraku Sato
- Department of Radiology, Division of Radiation Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hironori Sakai
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Takumi Yamada
- Section of Radiology, Department of Clinical Support, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Tasaki M, Kasahara T, Kaidu M, Kawaguchi G, Hara N, Yamana K, Maruyama R, Takizawa I, Ishizaki F, Saito K, Nakagawa Y, Ikeda M, Umezu H, Nishiyama T, Aoyama H, Tomita Y. Low-Dose-Rate and High-Dose-Rate Brachytherapy for Localized Prostate Cancer in ABO-Incompatible Renal Transplant Recipients. Transplant Proc 2019; 51:774-778. [DOI: 10.1016/j.transproceed.2018.10.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 10/09/2018] [Indexed: 02/06/2023]
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Tanabe S, Takahashi H, Saito H, Ohta A, Nakano T, Sasamoto R, Shioi M, Utsunomiya S, Abe E, Kaidu M, Aoyama H. Selection criteria for 3D conformal radiotherapy versus volumetric-modulated arc therapy in high-grade glioma based on normal tissue complication probability of brain. J Radiat Res 2019; 60:249-256. [PMID: 30649406 PMCID: PMC6430244 DOI: 10.1093/jrr/rry106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/20/2018] [Indexed: 06/09/2023]
Abstract
There are no quantitative selection criteria for identifying high-grade glioma (HGG) patients who are suited for volumetric-modulated arc therapy (VMAT). This study aimed to develop selection criteria that can be used for the selection of the optimal treatment modality in HGG. We analyzed 20 patients with HGG treated by 3D conformal radiotherapy (3DCRT). First, VMAT plans were created for each patient retrospectively. For each plan, the normal tissue complication probability (NTCP) for normal brain was calculated. We then divided the patients based on the NTCPs of the 3DCRT plans for normal brain, using the threshold of 5%. We compared the NTCPs of the two plans and the gross tumor volumes (GTVs) of the two groups. For the GTVs, we used receiver operating characteristic curves to identify the cut-off value for predicting NTCP < 5%. We determined the respective correlations between the GTV and the GTV's largest cross-sectional diameter and largest cross-sectional area. In the NTCP ≥ 5% group, the NTCPs for the VMAT plans were significantly lower than those for the 3DCRT plans (P = 0.0011). The NTCP ≥ 5% group's GTV was significantly larger than that of the NTCP < 5% group (P = 0.0016), and the cut-off value of the GTV was 130.5 cm3. The GTV was strongly correlated with the GTV's largest cross-sectional diameter (R2 = 0.82) and largest cross-sectional area (R2 = 0.94), which produced the cut-off values of 7.5 cm and 41 cm2, respectively. It was concluded that VMAT is more appropriate than 3DCRT in cases in which the GTV is ≥130.5 cm3.
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Affiliation(s)
- Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Haruna Takahashi
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
- Department of Radiation Technology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Japan
| | - Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Ryuta Sasamoto
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Miki Shioi
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan
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Utsunomiya S, Yamamoto J, Tanabe S, Oishi M, Satsuma A, Kaidu M, Abe E, Ohta A, Kushima N, Aoyama H. Complementary Relation Between the Improvement of Dose Delivery Technique and PTV Margin Reduction in Dose-Escalated Radiation Therapy for Prostate Cancer. Pract Radiat Oncol 2019; 9:172-178. [PMID: 30772440 DOI: 10.1016/j.prro.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/07/2019] [Accepted: 02/06/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study is to demonstrate quantitatively the complementary relationship between the introduction of intensity modulated radiation therapy (IMRT) and planning target volume (PTV) margin reduction with an image guided technique in reducing the risk of rectal toxicity in dose-escalating prostate radiation therapy. METHODS AND MATERIALS Three-dimensional conformal radiation therapy (CRT) and IMRT plans were generated for 10 patients with prostate cancer based on 2 PTV margin protocols (10/8 mm and 6/5 mm) and 2 dose prescriptions (70 Gy and 78 Gy). The normal tissue complication probability (NTCP) for each of the 8 scenarios was calculated using the Lyman-Kutcher-Burman model to estimate the risk of rectal and bladder late toxicity. The conformity and homogeneity indices of PTVs were calculated for each plan. RESULTS The IMRT plans showed superiority in conformity and inferiority in homogeneity over 3-dimensional CRT plans. The rectal NTCPs were increased 3.5 to 4.1 times when the prescribed total dose was changed from 70 Gy to 78 Gy and the dose delivery and the image guided radiation therapy techniques remained unchanged. PTV margin reduction was shown to reduce the value of rectal NTCP significantly. Overall, implementing the IMRT technique alone could reduce the NTCP values only by 2.1% to 7.3% from those of 3-dimensional CRT. The introduction of both IMRT and PTV margin reduction was found to be necessary for rectal NTCP to remain <5% in the dose escalation from 70 to 78 Gy. CONCLUSIONS The complementary relationship between the introduction of IMRT and PTV margin reduction was proven. We found that both approaches need to be implemented to safely deliver a curative dose in dose-escalating prostate radiation therapy.
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Affiliation(s)
- Satoru Utsunomiya
- Department of Radiological Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan.
| | - Jun Yamamoto
- School of Medicine, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Mayu Oishi
- School of Medicine, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Aruha Satsuma
- School of Medicine, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Motoki Kaidu
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Eisuke Abe
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Atsushi Ohta
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Hidefumi Aoyama
- Department of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Nakano T, Saito H, Tanaka K, Shioi M, Oshikane T, Maruyama K, Ohta A, Kaidu M, Abe E, Aoyama H. Risk Factors for Early Cognitive Deterioration after Whole-Brain Radiation Therapy for Brain Metastasis. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Takahashi H, Tanabe S, Saito H, Ohta A, Nakano T, Sasamoto R, Utsunomiya S, Abe E, Tanaka K, Kushima N, Maruyama K, Shioi M, Kaidu M, Aoyama H. Decision Criteria for the Selection Between 3DCRT and VMAT in High-Grade Gliomas Based on the Normal Tissue Complication Probability of Normal Brain. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.861] [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: 11/27/2022]
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Kaidu M, Tanaka K, Nakano T, Maruyama K, Saito H, Shioi M, Utsunomiya S, Tanabe S, Takahashi H, Ohta A, Abe E, Sasamoto R, Aoyama H. Salvage High-Dose-Rate Brachytherapy for Locally Recurrent Prostatic Cancer after Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1187] [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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Ohta A, Kaidu M, Tanabe S, Utsunomiya S, Sasamoto R, Maruyama K, Tanaka K, Saito H, Nakano T, Shioi M, Takahashi H, Kushima N, Abe E, Aoyama H. Respiratory gating and multifield technique radiotherapy for esophageal cancer. Jpn J Radiol 2017; 35:95-100. [DOI: 10.1007/s11604-016-0606-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/08/2016] [Indexed: 12/25/2022]
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Liu J, Sasamoto R, Kaidu M, Ayukawa F, Yamana N, Tanaka K, Kawaguchi G, Ohta A, Maruyama K, Abe E, Saitou H, Nakano T, Aoyama H. High-Dose-Rate Brachytherapy in Which 2 Fractions Were Administered Within a Single Day Combined With External Beam Radiation Therapy for Prostate Cancer: Four-year Experience and Outcomes. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1262] [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: 11/15/2022]
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Kaidu M, Toyabe SI, Oda JI, Okamoto K, Ozaki T, Shiina M, Sasai K, Akazawa K. Development and evaluation of a teleradiology and videoconferencing system. J Telemed Telecare 2016; 10:214-8. [PMID: 15273031 DOI: 10.1258/1357633041424430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We developed a teleradiology system linking a general hospital on Sado Island to tertiary care hospitals in Niigata City. The island is 40 km from Niigata City on the mainland and has only one diagnostic radiologist (for 72,000 islanders). Fibre optic cables between Sado Island and Niigata City were used for transmission. The introduction of the teleradiology system facilitated diagnostic and therapeutic consultation with specialists in Niigata City. The performance of the system was evaluated (on a scale of 0–6, with higher scores indicating better performance) by five diagnostic radiologists, who rated 32 features of the system twice, once in April 2002 and once in September 2003. The performance ratings improved from 1.38 to 2.86. While many of the initial problems with the software had been resolved, many still remained.
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Affiliation(s)
- Motoki Kaidu
- Department of Diagnostic Imaging and Internal Medicine, Sado General Hospital, Sado Island, Japan
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Liu J, Kaidu M, Sasamoto R, Ayukawa F, Yamana N, Sato H, Tanaka K, Kawaguchi G, Ohta A, Maruyama K, Abe E, Kasahara T, Nishiyama T, Tomita Y, Aoyama H. Two-fraction high-dose-rate brachytherapy within a single day combined with external beam radiotherapy for prostate cancer: single institution experience and outcomes. J Radiat Res 2016; 57:280-287. [PMID: 26983988 PMCID: PMC4915542 DOI: 10.1093/jrr/rrw003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/27/2015] [Accepted: 01/07/2016] [Indexed: 06/05/2023]
Abstract
We investigated the outcomes of treatment for patients with localized prostate cancer (PCa) treated with 3D conformal radiation therapy (3D-CRT) followed by two-fraction high-dose-rate brachytherapy within a single day (2-fr.-HDR-BT/day) at a single institution. A total of 156 consecutive Asian males (median age, 67 years) were enrolled. To compare our findings with those of other studies, we analyzed our results using the D'Amico classification, assigning the patients to low- ( N =: 5; 3.2%), intermediate- ( N =: 36; 23.1%) and high-risk ( N =: 115; 73.7%) groups (Stage T3 PCa patients were classified as high-risk). One patient in the D'Amico low-risk group (20%), 13 intermediate-risk patients (36.1%) and 99 high-risk patients (86.1%) underwent androgen deprivation therapy. We administered a prescription dose of 39 Gy in 13 fractions of 3D-CRT combined with 18 Gy of HDR-BT in two 9-Gy fractions delivered within a single day. We did not distinguish between risk groups in determining the prescription dose. The median follow-up period was 38 months. Of the 156 patients, one died from primary disease and five died from other diseases. The 3-year overall survival (OS) rates were 100%, 100% and 93.7%, and the 3-year 'biochemical no evidence of disease (bNED)' rates were 100%, 100% and 96.9% for the D'Amico low-, intermediate- and high-risk groups, respectively. No patient developed ≥ Grade 3 early toxicity. The Grade 3 late genitourinary toxicity rate was 2.6%, and no ≥ Grade 3 late gastrointestinal toxicity occurred. The efficacy and safety of this study were satisfactory, and longer-term follow-up is necessary.
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Affiliation(s)
- Junyang Liu
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Ryuta Sasamoto
- School of Health Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Fumio Ayukawa
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Nobuko Yamana
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Hiraku Sato
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Kensuke Tanaka
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Gen Kawaguchi
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Katsuya Maruyama
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Takashi Kasahara
- Urology Department, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Tsutomu Nishiyama
- Urology Department, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Yoshihiko Tomita
- Urology Department, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
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Ohta A, Tanabe S, Utsunomiya S, Tanaka K, Sato H, Maruyama K, Kawaguchi G, Kaidu M, Sasamoto R, Aoyama H. Respiratory Gating Intermittent Radiation for Esophageal Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tanaka K, Kanemoto A, Ohta A, Sato H, Kawaguchi G, Kaidu M, Ayukawa F, Abe E, Matsumoto Y, Sugita T, Aoyama H. Assessment of Verbal Learning and Memory After Whole-Brain Radiation Therapy With Different Dose Fractionation Using the Hopkins Verbal Learning Test: The Revised Japanese Version. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.803] [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: 11/27/2022]
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Sato H, Abe E, Utsunomiya S, Kaidu M, Yamana N, Tanaka K, Ohta A, Obinata M, Liu J, Kawaguchi G, Maruyama K, Ayukawa F, Aoyama H. Superiority of a soft tissue-based setup using cone-beam computed tomography over a bony structure-based setup in intensity-modulated radiotherapy for prostate cancer. J Appl Clin Med Phys 2015; 16:239–245. [PMID: 26699304 PMCID: PMC5690178 DOI: 10.1120/jacmp.v16i5.5448] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 05/13/2015] [Accepted: 04/13/2015] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to test the superiority of a soft tissue‐based setup using cone‐beam computed tomography (CBCT) to a bony structure‐based setup using the ExacTrac system in intensity‐modulated radiotherapy (IMRT) for prostate cancer. We studied 20 patients with localized prostate cancer who received IMRT between November 2010 and February 2012. After the initial setup, the pelvic bony structure‐based setup and ExacTrac system were applied. After that, CBCT and a soft tissue‐based setup were used. A shift in the isocenter between the ExacTrac‐based and CBCT‐based setup was recorded in the anterior–posterior (AP), superior–inferior (SI), and left–right (LR) axes. The shift was considered an interfractional prostate shift. Post‐treatment CBCT was also taken once a week to measure the intrafractional prostate shift, based on the coordinates of the isocenter between pre‐ and post‐treatment CBCT. The planning target volume (PTV) margins were determined using van Herk's method. We measured the elapsed time required for soft tissue matching and the entire treatment time using CBCT. The means±standard deviation(SD) of the inter‐ and intrafractional shifts were 0.9±2.8 mm and −0.3±1.4 mm in the AP, 0.9±2.2 mm and −0.1±1.2 mm in the SI, and 0.1±0.7 mm and −0.1±0.7 mm in the LR directions. The PTV margins in the cases of bony structure‐based and soft tissue‐based setups were 7.3 mm and 2.7 mm in the AP, 5.8 mm and 2.3 mm in the SI, and 1.9 mm and 1.2 mm in the LR directions. Even though the median elapsed time using CBCT was expanded in 5.9 min, the PTV margins were significantly reduced. We found the calculated PTV margins in the soft tissue‐based setup using CBCT were small, and this arrangement was superior to the bony structure‐based setup in prostate IMRT. PACS numbers: 87.19.ru, 87.55.T‐
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Affiliation(s)
- Hiraku Sato
- Niigata University Graduate School of Medical and Dental Sciences.
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Moriyama M, Matsumoto Y, Zhou Q, Yamana K, Ikeda Y, Ayukawa F, Abe E, Sato S, Takano K, Kaidu M, Aoyama H, Saijo Y. A case of pancreatic neuroendocrine tumors. Int Cancer Conf J 2015; 5:1-4. [PMID: 31149413 DOI: 10.1007/s13691-015-0230-x] [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] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 06/20/2015] [Indexed: 11/30/2022] Open
Abstract
Pancreatic neuroendocrine tumors (pNETs) are an uncommon malignancy arising from the neuroendocrine cells of pancreas. Most cases of pNETs present with metastatic disease, but there are few reports in the literature describing pNETs metastasis to the lung and mediastinal lymph nodes [1]. Moreover, although a multimodal treatment including surgical resection and chemotherapy is acceptable for management of pNETs, advanced pNETs still remain a difficult therapeutic challenge [2, 3]. Radiotherapy or combined chemoradiotherapy has not been standard in the treatment of pNETs. An 80-year-old female was admitted to our hospital with cough and anorexia. She had been diagnosed and resected pNETs 8 years ago. Mass shadow was pointed out with chest X-ray, and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed. Pathological examination revealed neuroendocrine tumors, so the lung mass was considered as metastasis of pNETs. Then, we discussed her treatment at Cancer Board, and radiotherapy was chosen. We hope this case suggests that radiotherapy will be one of the treatment options for metastatic pNETs.
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Affiliation(s)
- Masato Moriyama
- 1Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
| | - Yoshifumi Matsumoto
- 1Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
| | - Qiliang Zhou
- 1Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
| | - Kanako Yamana
- 2Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yohei Ikeda
- 2Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Fumio Ayukawa
- 2Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Eisuke Abe
- 2Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Seijiro Sato
- 3Department of Thoracic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kabuto Takano
- 4Department of Digestive Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Motoki Kaidu
- 2Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hidefumi Aoyama
- 2Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yasuo Saijo
- 1Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
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Kawaguchi G, Obinata M, Sasamoto R, Tanaka K, Sato H, Kanemoto A, Ayukawa F, Abe E, Kaidu M, Aoyama H. A New Choice of Treatments for Invasive Superficial Esophageal Squamous Cell Carcinoma: Investigation of Efficacy of Prophylactic Chemoradiation Therapy After Endoscopic Submucosal Dissection. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.752] [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: 10/26/2022]
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Kaidu M, Oyamatu M, Sato K, Saitou A, Yamamoto S, Yoshimura N, Sasai K. Diagnostic limitations of 10 mm thickness single-slice computed tomography for patients with suspected appendicitis. ACTA ACUST UNITED AC 2008; 26:63-9. [DOI: 10.1007/s11604-007-0196-5] [Citation(s) in RCA: 3] [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] [Received: 02/05/2007] [Accepted: 10/03/2007] [Indexed: 12/24/2022]
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