Automated planning of stereotactic spine re-irradiation using cumulative dose limits

Autor: Sebastian Meyer, Lei Zhang, Yilin Liu, Li Cheng Kuo, Yu-Chi Hu, Yoshiya Yamada, Masoud Zarepisheh, Pengpeng Zhang, Laura Cerviño
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Physics and Imaging in Radiation Oncology, Vol 29, Iss , Pp 100547- (2024)
Druh dokumentu: article
ISSN: 2405-6316
DOI: 10.1016/j.phro.2024.100547
Popis: Background and Purpose: The lack of dedicated tools in commercial planning systems currently restricts efficient review and planning for re-irradiation. The aim of this study was to develop an automated re-irradiation planning framework based on cumulative doses. Materials and Methods: We performed a retrospective study of 14 patients who received spine SBRT re-irradiation near a previously irradiated treatment site. A fully-automated workflow, DART (Dose Accumulation-based Re-irradiation Tool), was implemented within Eclipse by leveraging a combination of a dose accumulation script and a proprietary automated optimization algorithm. First, we converted the prior treatment dose into equivalent dose in 2 Gy fractions (EQD2) and mapped it to the current anatomy, utilizing deformable image registration. Subsequently, the intersection of EQD2 isodose lines with relevant organs at risk defines a series of optimization structures. During plan optimization, the residual allowable dose at a specified tissue tolerance was treated as a hard constraint. Results: All DART plans met institutional physical and cumulative constraints and passed plan checks by qualified medical physicists. DART demonstrated significant improvements in target coverage over clinical plans, with an average increase in PTV D99% and V100% of 2.3 Gy [range −0.3–7.7 Gy] and 3.4 % [range −0.4 %−7.6 %] (p 105 %) outside the PTV was reduced by up to 7 cm3. The homogeneity index for DART plans was improved by 19 % (p
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