A novel concept to include uncertainties in the evaluation of stereotactic body radiation therapy after 4D dose accumulation using deformable image registration.
Autor: | Azcona JD; Service of Radiation Physics and Radiation Protection, Clínica Universidad de Navarra, Avda. Pío XII, 31008, Pamplona, Navarra, Spain., Huesa-Berral C; Service of Radiation Physics and Radiation Protection, Clínica Universidad de Navarra, Avda. Pío XII, 31008, Pamplona, Navarra, Spain.; Department of Physics and Applied Mathematics, School of Sciences, Universidad de Navarra. C/ Irunlarrea, 31008, Pamplona, Navarra, Spain., Moreno-Jiménez M; Service of Radiation Oncology, Clínica Universidad de Navarra, Avda. Pío XII, 31008, Pamplona, Navarra, Spain., Barbés B; Service of Radiation Physics and Radiation Protection, Clínica Universidad de Navarra, Avda. Pío XII, 31008, Pamplona, Navarra, Spain., Aristu JJ; Service of Radiation Oncology, Clínica Universidad de Navarra, Avda. Pío XII, 31008, Pamplona, Navarra, Spain., Burguete J; Department of Physics and Applied Mathematics, School of Sciences, Universidad de Navarra. C/ Irunlarrea, 31008, Pamplona, Navarra, Spain. |
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Jazyk: | angličtina |
Zdroj: | Medical physics [Med Phys] 2019 Oct; Vol. 46 (10), pp. 4346-4355. Date of Electronic Publication: 2019 Sep 06. |
DOI: | 10.1002/mp.13759 |
Abstrakt: | Purpose: To use four-dimensional (4D) dose accumulation based on deformable image registration (DIR) to assess dosimetric uncertainty in lung stereotactic body radiation therapy (SBRT) treatment planning. A novel concept, the Evaluation Target Volume (ETV), was introduced to achieve this goal. Methods: The internal target volume (ITV) approach was used for treatment planning for 11 patients receiving lung SBRT. Retrospectively, 4D dose calculation was done in Pinnacle v9.10. Total dose was accumulated in the reference phase using DIR with MIM. DIR was validated using landmarks introduced by an expert radiation oncologist. The 4D and three-dimensional (3D) dose distributions were compared within the gross tumor volume (GTV) and the planning target volume (PTV) using the D Results: The target registration error (TRE) per spatial component was below 0.5 ± 2.1mm for all our patients. For five patients, dose degradation above 2% (>4% in 2 patients) was found in the PTV after 4D accumulation and attributed to anatomical variations due to breathing. Comparison of D Conclusions: A workflow for 4D dose accumulation based on DIR has been devised. Dose degradation was attributed to respiratory motion. To overcome limitations in the PTV for the purposes of evaluating DIR-based 4D accumulated dose distributions, a new concept, the ETV, was proposed. This concept appears to facilitate more reliable dose evaluation and a better understanding of dosimetric uncertainties due to motion and deformation. (© 2019 American Association of Physicists in Medicine.) |
Databáze: | MEDLINE |
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