Evaluation of deformed image-based dose calculations for adaptive radiotherapy of nasopharyngeal carcinoma
The ultimate goal of adaptive radiotherapy (ART) is to deliver truly customized radiation treatments. Currently, the quality of cone-beam computed tomography (CBCT) images is still inferior to that of conventional CT images in contour delineations and dose calculations for replanning purposes. This...
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| Veröffentlicht in: | Medical dosimetry : official journal of the American Association of Medical Dosimetrists 2017, Vol.42 (4), p.273-281 |
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| creator | Poon, Miranda Holborn, Catherine Cheng, Ka Fai Fung, Winky Wing Ki Chiu, George |
| description | The ultimate goal of adaptive radiotherapy (ART) is to deliver truly customized radiation treatments. Currently, the quality of cone-beam computed tomography (CBCT) images is still inferior to that of conventional CT images in contour delineations and dose calculations for replanning purposes. This retrospective study aims to evaluate the dosimetric accuracy of using deformed conventional CT images for dose calculations, in the hope of inferring the feasibility of ART using planning CT (PCT) images that deformed to up-to-date CBCT images for patients with nasopharyngeal carcinoma (NPC). Thirty consecutive patients with NPC who had undergone 1 replan in their radiotherapy treatments were selected. The pretreatment PCT images were deformed to match the mid-treatment PCT images by deformable image registration. The same volumetric modulated arc therapy plan was then calculated on the deformed PCT images. The resulting dose distributions and dose volume histograms of the tumors and organs at risk (OARs) were compared with the original plan. Five dose levels, D98%, D95%, D50%, D5%, and D2%, were recorded for 9 NPC targets. Four dose levels, Dmax, D10%, D50%, and Dmean, were recorded for 15 OARs. The greatest percentage difference in observed dose for D98%, D95%, D50%, D5%, and D2% of the targets were 1.71%, 1.55%, 0.64%, 0.97%, and 1.13%, respectively. The greatest percentage difference in observed dose for Dmax, D10%, D50%, and Dmean of the OARs were -26.51% (left optic nerve), -17.06% (left optic nerve), 56.70% (spinal cord), and 18.97% (spinal cord), respectively. In addition, 29 of 45 (64%) dosimetric end points of the targets showed statistically significant dose differences (p |
| doi_str_mv | 10.1016/j.meddos.2017.06.001 |
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Currently, the quality of cone-beam computed tomography (CBCT) images is still inferior to that of conventional CT images in contour delineations and dose calculations for replanning purposes. This retrospective study aims to evaluate the dosimetric accuracy of using deformed conventional CT images for dose calculations, in the hope of inferring the feasibility of ART using planning CT (PCT) images that deformed to up-to-date CBCT images for patients with nasopharyngeal carcinoma (NPC). Thirty consecutive patients with NPC who had undergone 1 replan in their radiotherapy treatments were selected. The pretreatment PCT images were deformed to match the mid-treatment PCT images by deformable image registration. The same volumetric modulated arc therapy plan was then calculated on the deformed PCT images. The resulting dose distributions and dose volume histograms of the tumors and organs at risk (OARs) were compared with the original plan. Five dose levels, D98%, D95%, D50%, D5%, and D2%, were recorded for 9 NPC targets. Four dose levels, Dmax, D10%, D50%, and Dmean, were recorded for 15 OARs. The greatest percentage difference in observed dose for D98%, D95%, D50%, D5%, and D2% of the targets were 1.71%, 1.55%, 0.64%, 0.97%, and 1.13%, respectively. The greatest percentage difference in observed dose for Dmax, D10%, D50%, and Dmean of the OARs were -26.51% (left optic nerve), -17.06% (left optic nerve), 56.70% (spinal cord), and 18.97% (spinal cord), respectively. In addition, 29 of 45 (64%) dosimetric end points of the targets showed statistically significant dose differences (p < 0.05) between the original plan and the plan calculated on deformed images. Forty-nine of 60 (82%) dosimetric end points of the OARs also showed statistically significant dose differences (p < 0.05). Dose calculations using deformed PCT images could result in significant dose uncertainties in target volumes and OARs. Larger dose deviations were found in OARs in comparison with target volumes. The spinal cord and optic nerve showed the greatest percentage dose differences and the clinical significance has yet to be determined. Deformable registration error was believed to be the problem causing the dose deviations. Owing to unknown clinical significanceof dose deviation results obtained from this study, a conventional CT scan is still required for replanning in patients with NPC who are experiencing significant anatomical changes during the course of radiation treatment.</description><identifier>ISSN: 0958-3947</identifier><identifier>EISSN: 1873-4022</identifier><identifier>DOI: 10.1016/j.meddos.2017.06.001</identifier><identifier>PMID: 28781156</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adaptive radiotherapy ; Carcinoma - diagnostic imaging ; Carcinoma - radiotherapy ; CARCINOMAS ; COMPUTERIZED TOMOGRAPHY ; Cone-Beam Computed Tomography ; Deformable image registration ; Dose calculation ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms - diagnostic imaging ; Nasopharyngeal Neoplasms - radiotherapy ; NERVES ; ORGANS ; Organs at Risk ; PLANNING ; RADIATION DOSE DISTRIBUTIONS ; RADIATION DOSES ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; SPINAL CORD ; Treatment planning</subject><ispartof>Medical dosimetry : official journal of the American Association of Medical Dosimetrists, 2017, Vol.42 (4), p.273-281</ispartof><rights>2017 American Association of Medical Dosimetrists</rights><rights>Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-f80b716d3230c57a376f9d1915e55ac7fabed388b1ea5d9b7edcac05cb5526423</citedby><cites>FETCH-LOGICAL-c390t-f80b716d3230c57a376f9d1915e55ac7fabed388b1ea5d9b7edcac05cb5526423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0958394717300572$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28781156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22824165$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Poon, Miranda</creatorcontrib><creatorcontrib>Holborn, Catherine</creatorcontrib><creatorcontrib>Cheng, Ka Fai</creatorcontrib><creatorcontrib>Fung, Winky Wing Ki</creatorcontrib><creatorcontrib>Chiu, George</creatorcontrib><title>Evaluation of deformed image-based dose calculations for adaptive radiotherapy of nasopharyngeal carcinoma</title><title>Medical dosimetry : official journal of the American Association of Medical Dosimetrists</title><addtitle>Med Dosim</addtitle><description>The ultimate goal of adaptive radiotherapy (ART) is to deliver truly customized radiation treatments. Currently, the quality of cone-beam computed tomography (CBCT) images is still inferior to that of conventional CT images in contour delineations and dose calculations for replanning purposes. This retrospective study aims to evaluate the dosimetric accuracy of using deformed conventional CT images for dose calculations, in the hope of inferring the feasibility of ART using planning CT (PCT) images that deformed to up-to-date CBCT images for patients with nasopharyngeal carcinoma (NPC). Thirty consecutive patients with NPC who had undergone 1 replan in their radiotherapy treatments were selected. The pretreatment PCT images were deformed to match the mid-treatment PCT images by deformable image registration. The same volumetric modulated arc therapy plan was then calculated on the deformed PCT images. The resulting dose distributions and dose volume histograms of the tumors and organs at risk (OARs) were compared with the original plan. Five dose levels, D98%, D95%, D50%, D5%, and D2%, were recorded for 9 NPC targets. Four dose levels, Dmax, D10%, D50%, and Dmean, were recorded for 15 OARs. The greatest percentage difference in observed dose for D98%, D95%, D50%, D5%, and D2% of the targets were 1.71%, 1.55%, 0.64%, 0.97%, and 1.13%, respectively. The greatest percentage difference in observed dose for Dmax, D10%, D50%, and Dmean of the OARs were -26.51% (left optic nerve), -17.06% (left optic nerve), 56.70% (spinal cord), and 18.97% (spinal cord), respectively. In addition, 29 of 45 (64%) dosimetric end points of the targets showed statistically significant dose differences (p < 0.05) between the original plan and the plan calculated on deformed images. Forty-nine of 60 (82%) dosimetric end points of the OARs also showed statistically significant dose differences (p < 0.05). Dose calculations using deformed PCT images could result in significant dose uncertainties in target volumes and OARs. Larger dose deviations were found in OARs in comparison with target volumes. The spinal cord and optic nerve showed the greatest percentage dose differences and the clinical significance has yet to be determined. Deformable registration error was believed to be the problem causing the dose deviations. Owing to unknown clinical significanceof dose deviation results obtained from this study, a conventional CT scan is still required for replanning in patients with NPC who are experiencing significant anatomical changes during the course of radiation treatment.</description><subject>Adaptive radiotherapy</subject><subject>Carcinoma - diagnostic imaging</subject><subject>Carcinoma - radiotherapy</subject><subject>CARCINOMAS</subject><subject>COMPUTERIZED TOMOGRAPHY</subject><subject>Cone-Beam Computed Tomography</subject><subject>Deformable image registration</subject><subject>Dose calculation</subject><subject>Humans</subject><subject>Nasopharyngeal Carcinoma</subject><subject>Nasopharyngeal Neoplasms - diagnostic imaging</subject><subject>Nasopharyngeal Neoplasms - radiotherapy</subject><subject>NERVES</subject><subject>ORGANS</subject><subject>Organs at Risk</subject><subject>PLANNING</subject><subject>RADIATION DOSE DISTRIBUTIONS</subject><subject>RADIATION DOSES</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted</subject><subject>SPINAL CORD</subject><subject>Treatment planning</subject><issn>0958-3947</issn><issn>1873-4022</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9r3DAQxUVoaDZpv0Eohl56saM_lmRfCiWkTSHQS3sWY2mc1eK1XMle2G8fuU577EkD-r03w3uE3DJaMcrU3aE6onMhVZwyXVFVUcouyI41WpQ15fwN2dFWNqVoa31FrlM6UEplTcVbcsUb3TAm1Y4cHk4wLDD7MBahLxz2IWbfwh_hGcsOUp7zEiwsDHYZ_oCpyFABDqbZn7CI4HyY9xhhOq8eI6Qw7SGex2eEIQuj9WM4wjty2cOQ8P3re0N-fX34ef9YPv349v3-y1NpRUvnsm9op5lyggtqpQahVd861jKJUoLVPXToRNN0DEG6ttPoLFgqbSclVzUXN-Tj5hvS7E2yfka7t2Ec0c6G84bXTMlMfdqoKYbfC6bZHH2yOAwwYliSYS1Xrc45qYzWG2pjSClib6aY84lnw6hZuzAHs3Vh1i4MVSZ3kWUfXjcsXf7-J_obfgY-bwDmNE4e43osjhadj-utLvj_b3gB1nKePA</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Poon, Miranda</creator><creator>Holborn, Catherine</creator><creator>Cheng, Ka Fai</creator><creator>Fung, Winky Wing Ki</creator><creator>Chiu, George</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>2017</creationdate><title>Evaluation of deformed image-based dose calculations for adaptive radiotherapy of nasopharyngeal carcinoma</title><author>Poon, Miranda ; Holborn, Catherine ; Cheng, Ka Fai ; Fung, Winky Wing Ki ; Chiu, George</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-f80b716d3230c57a376f9d1915e55ac7fabed388b1ea5d9b7edcac05cb5526423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adaptive radiotherapy</topic><topic>Carcinoma - diagnostic imaging</topic><topic>Carcinoma - radiotherapy</topic><topic>CARCINOMAS</topic><topic>COMPUTERIZED TOMOGRAPHY</topic><topic>Cone-Beam Computed Tomography</topic><topic>Deformable image registration</topic><topic>Dose calculation</topic><topic>Humans</topic><topic>Nasopharyngeal Carcinoma</topic><topic>Nasopharyngeal Neoplasms - diagnostic imaging</topic><topic>Nasopharyngeal Neoplasms - radiotherapy</topic><topic>NERVES</topic><topic>ORGANS</topic><topic>Organs at Risk</topic><topic>PLANNING</topic><topic>RADIATION DOSE DISTRIBUTIONS</topic><topic>RADIATION DOSES</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted</topic><topic>SPINAL CORD</topic><topic>Treatment planning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poon, Miranda</creatorcontrib><creatorcontrib>Holborn, Catherine</creatorcontrib><creatorcontrib>Cheng, Ka Fai</creatorcontrib><creatorcontrib>Fung, Winky Wing Ki</creatorcontrib><creatorcontrib>Chiu, George</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Medical dosimetry : official journal of the American Association of Medical Dosimetrists</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poon, Miranda</au><au>Holborn, Catherine</au><au>Cheng, Ka Fai</au><au>Fung, Winky Wing Ki</au><au>Chiu, George</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of deformed image-based dose calculations for adaptive radiotherapy of nasopharyngeal carcinoma</atitle><jtitle>Medical dosimetry : official journal of the American Association of Medical Dosimetrists</jtitle><addtitle>Med Dosim</addtitle><date>2017</date><risdate>2017</risdate><volume>42</volume><issue>4</issue><spage>273</spage><epage>281</epage><pages>273-281</pages><issn>0958-3947</issn><eissn>1873-4022</eissn><abstract>The ultimate goal of adaptive radiotherapy (ART) is to deliver truly customized radiation treatments. Currently, the quality of cone-beam computed tomography (CBCT) images is still inferior to that of conventional CT images in contour delineations and dose calculations for replanning purposes. This retrospective study aims to evaluate the dosimetric accuracy of using deformed conventional CT images for dose calculations, in the hope of inferring the feasibility of ART using planning CT (PCT) images that deformed to up-to-date CBCT images for patients with nasopharyngeal carcinoma (NPC). Thirty consecutive patients with NPC who had undergone 1 replan in their radiotherapy treatments were selected. The pretreatment PCT images were deformed to match the mid-treatment PCT images by deformable image registration. The same volumetric modulated arc therapy plan was then calculated on the deformed PCT images. The resulting dose distributions and dose volume histograms of the tumors and organs at risk (OARs) were compared with the original plan. Five dose levels, D98%, D95%, D50%, D5%, and D2%, were recorded for 9 NPC targets. Four dose levels, Dmax, D10%, D50%, and Dmean, were recorded for 15 OARs. The greatest percentage difference in observed dose for D98%, D95%, D50%, D5%, and D2% of the targets were 1.71%, 1.55%, 0.64%, 0.97%, and 1.13%, respectively. The greatest percentage difference in observed dose for Dmax, D10%, D50%, and Dmean of the OARs were -26.51% (left optic nerve), -17.06% (left optic nerve), 56.70% (spinal cord), and 18.97% (spinal cord), respectively. In addition, 29 of 45 (64%) dosimetric end points of the targets showed statistically significant dose differences (p < 0.05) between the original plan and the plan calculated on deformed images. Forty-nine of 60 (82%) dosimetric end points of the OARs also showed statistically significant dose differences (p < 0.05). Dose calculations using deformed PCT images could result in significant dose uncertainties in target volumes and OARs. Larger dose deviations were found in OARs in comparison with target volumes. The spinal cord and optic nerve showed the greatest percentage dose differences and the clinical significance has yet to be determined. Deformable registration error was believed to be the problem causing the dose deviations. Owing to unknown clinical significanceof dose deviation results obtained from this study, a conventional CT scan is still required for replanning in patients with NPC who are experiencing significant anatomical changes during the course of radiation treatment.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28781156</pmid><doi>10.1016/j.meddos.2017.06.001</doi><tpages>9</tpages></addata></record> |
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| subjects | Adaptive radiotherapy Carcinoma - diagnostic imaging Carcinoma - radiotherapy CARCINOMAS COMPUTERIZED TOMOGRAPHY Cone-Beam Computed Tomography Deformable image registration Dose calculation Humans Nasopharyngeal Carcinoma Nasopharyngeal Neoplasms - diagnostic imaging Nasopharyngeal Neoplasms - radiotherapy NERVES ORGANS Organs at Risk PLANNING RADIATION DOSE DISTRIBUTIONS RADIATION DOSES RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted SPINAL CORD Treatment planning |
| title | Evaluation of deformed image-based dose calculations for adaptive radiotherapy of nasopharyngeal carcinoma |
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