First experimental evaluation of multi-target multileaf collimator tracking during volumetric modulated arc therapy for locally advanced prostate cancer

Autor: Linda J. Bell, Per Rugaard Poulsen, John Kipritidis, Stephanie Roderick, Paul J. Keall, Y Ge, Doan Nguyen, Emily A. Hewson, Andrew Dipuglia, Ricky O'Brien, Jeremy T. Booth, Thomas Eade
Rok vydání: 2021
Předmět:
Male
Real-time adaptive radiotherapy
Computer science
0299 Other Physical Sciences
1112 Oncology and Carcinogenesis
0299 Other Physical Sciences
Tracking (particle physics)
Imaging phantom
Standard deviation
030218 nuclear medicine & medical imaging
Locally advanced prostate cancer
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Prostate
medicine
Humans
Radiology
Nuclear Medicine and imaging
Oncology & Carcinogenesis
Lymph node
Phantoms
Imaging
business.industry
Radiotherapy Planning
Computer-Assisted
Prostatic Neoplasms
Radiotherapy Dosage
Tracking system
Hematology
medicine.disease
Multileaf collimator
medicine.anatomical_structure
Oncology
Multi-target tracking
030220 oncology & carcinogenesis
Radiotherapy
Intensity-Modulated
MLC tracking
Particle Accelerators
Nuclear medicine
business
Zdroj: Radiotherapy & Oncology
Hewson, E A, Dipuglia, A, Kipritidis, J, Ge, Y, O'Brien, R, Roderick, S, Bell, L, Poulsen, P R, Eade, T, Booth, J T, Keall, P J & Nguyen, D T 2021, ' First experimental evaluation of multi-target multileaf collimator tracking during volumetric modulated arc therapy for locally advanced prostate cancer ', Radiotherapy and Oncology, vol. 160, pp. 212-220 . https://doi.org/10.1016/j.radonc.2021.05.001
ISSN: 0167-8140
DOI: 10.1016/j.radonc.2021.05.001
Popis: Purpose Locally advanced and oligometastatic cancer patients require radiotherapy treatment to multiple independently moving targets. There is no existing commercial solution that can simultaneously track and treat multiple targets. This study experimentally implemented and evaluated a real-time multi-target tracking system for locally advanced prostate cancer. Methods Real-time multi-target MLC tracking was integrated with 3D x-ray image guidance on a standard linac. Three locally advanced prostate cancer treatment plans were delivered to a static lymph node phantom and dynamic prostate phantom that reproduced three prostate trajectories. Treatments were delivered using multi-target MLC tracking, single-target MLC tracking, and no tracking. Doses were measured using Gafchromic film placed in the dynamic and static phantoms. Dosimetric error was quantified by the 2%/2 mm gamma failure rate. Geometric error was evaluated as the misalignment between target and aperture positions. The multi-target tracking system latency was measured. Results The mean (range) gamma failure rates for the prostate and lymph nodes, were 18.6% (5.2%, 28.5%) and 7.5% (1.1%, 13.7%) with multi-target tracking, 7.9% (0.7%, 15.4%) and 37.8% (18.0%, 57.9%) with single-target tracking, and 38.1% (0.6%, 75.3%) and 37.2% (29%, 45.3%) without tracking. Multi-target tracking had the lowest geometric error with means and standard deviations within 0.2 ± 1.5 for the prostate and 0.0 ± 0.3 mm for the lymph nodes. The latency was 730 ± 20 ms. Conclusion This study presented the first experimental implementation of multi-target tracking to independently track prostate and lymph node displacement during VMAT. Multi-target tracking reduced dosimetric and geometric errors compared to single-target tracking and no tracking.
Databáze: OpenAIRE
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