Virtual bronchoscopy-guided lung SAbR: dosimetric implications of using AAA versus Acuros XB to calculate dose in airways
| Autor: | Esther Vicente, Kun-Chang Yu, Arezoo Modiri, Robert Timmerman, Yulong Yan, P. Kinkopf, Pranshu Mohindra, Amit Sawant |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Lung
medicine.diagnostic_test Dose calculation business.industry Radiotherapy Planning Computer-Assisted medicine.medical_treatment Planning target volume Radiotherapy Dosage respiratory system SABR volatility model Article Radiation therapy Acuros xb medicine.anatomical_structure Bronchoscopy medicine Humans Radiotherapy Intensity-Modulated Airway Nuclear medicine business Algorithms General Nursing |
| Zdroj: | Biomed Phys Eng Express |
| ISSN: | 2057-1976 |
| DOI: | 10.1088/2057-1976/ac240c |
| Popis: | In previous works, we showed that incorporating individual airways as organs-at-risk (OARs) in the treatment of lung stereotactic ablative radiotherapy (SAbR) patients potentially mitigates post-SAbR radiation injury. However, the performance of common clinical dose calculation algorithms in airways has not been thoroughly studied. Airways are of particular concern because their small size and the density differences they create have the potential to hinder dose calculation accuracy. To address this gap in knowledge, here we investigate dosimetric accuracy in airways of two commonly used dose calculation algorithms, the anisotropic analytical algorithm (AAA) and Acuros-XB (AXB), recreating clinical treatment plans on a cohort of four SAbR patients. A virtual bronchoscopy software was used to delineate 856 airways on a high-resolution breath-hold CT (BHCT) image acquired for each patient. The planning target volumes (PTVs) and standard thoracic OARs were contoured on an average CT (AVG) image over the breathing cycle. Conformal and intensity-modulated radiation therapy plans were recreated on the BHCT image and on the AVG image, for a total of four plan types per patient. Dose calculations were performed using AAA and AXB, and the differences in maximum and mean dose in each structure were calculated. The median differences in maximum dose among all airways were ≤0.3Gy in magnitude for all four plan types. With airways grouped by dose-to-structure or diameter, median dose differences were still ≤0.5Gy in magnitude, with no clear dependence on airway size. These results, along with our previous airway radiosensitivity works, suggest that dose differences between AAA and AXB correspond to an airway collapse variation ≤0.7% in magnitude. This variation in airway injury risk can be considered as not clinically relevant, and the use of either AAA or AXB is therefore appropriate when including patient airways as individual OARs so as to reduce risk of radiation-induced lung toxicity. |
| Databáze: | OpenAIRE |
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