Comparison of manual and inverse optimisation techniques in high dose rate intracavitary brachytherapy of cervical cancer: A dosimetric study

Kannan, Rajan; Gururajachar, Janaki Manur; Ponni, Arul; Koushik, Kirthi; Kumar, Mohan; Alva, Ram Charith; Harjani, Ritika; Murthy, Arvind

doi:10.1016/j.rpor.2015.05.003

Cited by 14 publications

(15 citation statements)

References 13 publications

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“…Nevertheless, a biological correlation between HR-CTV hotspots and local control for cervical cancer is unknown. In our study, we could achieve median HR-CTV hotspots of greater than 62% (V 150 ) and 39% (V 200 ) by volume-based planning and were comparable to the data reported by other studies [ 51 , 52 ].…”

Section: Discussionsupporting

confidence: 90%

Dosimetric evaluation of Point A and volume-based high-dose-rate plans: a single institution study on adaptive brachytherapy planning for cervical cancer

Paul

Nalichowski

Abrams

et al. 2018

jcb

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PurposeExternal beam radiation therapy (EBRT) and brachytherapy (BT) with concurrent cisplatin is the standard of care for locally advanced cervical cancer. The applicability of image-guided adaptive volume-based high-dose-rate (HDR) intracavitary brachytherapy planning is an active area of investigation. In this study, we examined whether volume-based HDR-BT (HDRVOL) plans leads to more conformal plans compared to Point A (HDRPointA)-based plans.Material and methodsTwo hundred and forty HDRPointA plans from 48 cervical cancer patients treated with chemoradiotherapy were retrospectively collected. Point A plans were renormalized with respect to the high-risk clinical target volume (HR-CTV) for the HDRVOL plans. The doses to organs at risk (OAR; rectum, sigmoid, and bladder), and HR-CTV and the conformal index were compared between HDRPointA and HDRVOL plans.ResultsHDRVOL plans resulted in a 6-12% reduction in the total dose (EBRT + HDR-BT) to 0.1 cc, 1.0 cc, and 2.0 cc of the OAR as well as an 8-37% reduction in the dose to 2 cc of OAR per HDR-BT fraction compared to HDRPointA plans. Differences in the conformal indexes between the two groups of plans showed an 18-31% relative increase per HDR-BT fraction for HDRVOL plans. The D90 of the HR-CTV was reduced by 11% by HDRVOL planning and had a median dose of 86 Gy.ConclusionsOur study reports the relative improvement in OAR doses per HDR-BT fraction by HDRVOL planning compared to HDRPointA planning and demonstrates the dosimetric advantages of volume-based HDR-BT planning in creating more conformal plans.

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Section: Discussionsupporting

confidence: 90%

Dosimetric evaluation of Point A and volume-based high-dose-rate plans: a single institution study on adaptive brachytherapy planning for cervical cancer

Paul

Nalichowski

Abrams

et al. 2018

jcb

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“…With the advantage in target coverage and normal tissue sparing, inverse optimization techniques have been gradually replacing manual optimization for high-dose-rate (HDR) BT, particularly for prostate BT. For cervix BT, inverse planning algorithms, especially the IPSA algorithm, have been implemented by several institutions and positive results have been published [3][4][5][6][7][8][9][10]. Recent clinical results further veri ed the use of IPSA in the clinics [33,34].…”

Section: Discussionmentioning

confidence: 99%

“…The principle of an inverse planning optimization algorithm is to search for the minimum value of an aggregate objective function based on a set of prede ned dose objectives. Compared with forward planning, inverse planning has advantages including less planning time, better reproducibility, higher target coverage and lower dose to OARs [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Two Inverse Planning Algorithms for Cervical Cancer Brachytherapy

Zuo

et al. 2020

Preprint

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Purpose: To compare two methods, the hybrid inverse planning optimization (HIPO) algorithm and the inverse planning simulated annealing (IPSA) algorithm, for cervical cancer brachytherapy and provide suggestions for their usage.Material and methods: This study consisted of 24 cervical cancer patients treated with CT image-based high-dose-rate brachytherapy using various combinations of tandem/ovoid applicator and interstitial needles. For fixed catheter configurations, plans were retrospectively optimized with two methods: IPSA and HIPO. The dosimetric parameters with respect to target coverage, localization of high dose volume (LHDV), conformal index (COIN), and sparing of organs at risk (OARs) were evaluated. A plan assessment method which combines a graphical analysis and a scoring index was used to compare the quality of two plans for each case. The characteristics of dwell time distributions of the two plans were also analyzed.Results: Both IPSA and HIPO can produce clinically acceptable treatment plans. The rectum D2cc was slightly lower for HIPO as compared to IPSA (p=0.002). All other dosimetric parameters for targets and OARs were not significantly different between the two algorithms. The generated radar plots and scores intuitively presented the plan properties and enabled to reflect the clinical priorities for the treatment plans. Different characteristics were observed between the dwell time distributions generated by IPSA and HIPO. Conclusions: Despite significant difference in dwell time distributions, both the two algorithms could generate high-quality treatment plans. With the help of the plan assessment method, the clinical decision on the optimal plan can be made quickly and consistently for each patient.

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“…In BT, apart from prostate cancer, the integration of inverse planning into clinical routine has not been accomplished so far. In the literature, there are reports on the use of inverse planning for cervix cancer [7,8,9,10,11,12,13], vaginal irradiation [14,15], and head and neck brachytherapy [16,17]. For breast cancer, the available information is scarce.…”

Section: Purposementioning

confidence: 99%

Does inverse planning improve plan quality in interstitial high-dose-rate breast brachytherapy?

Major¹,

Fröhlich²,

Mészáros³

et al. 2020

jcb

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Purpose: To investigate the effect of input parameters for an inverse optimization algorithm, and dosimetrically evaluate and compare clinical treatment plans made by inverse and forward planning in high-dose-rate interstitial breast implants. Material and methods: By using a representative breast implant, input parameters responsible for target coverage and dose homogeneity were changed step-by-step, and their optimal values were determined. Then, effects of parameters on dosimetry of normal tissue and organs at risk were investigated. The role of dwell time modulation restriction was also studied. With optimal input parameters, treatment plans of forty-two patients were recalculated using an inverse optimization algorithm (HIPO). Then, a pair-wise comparison between forward and inverse plans was performed using dose-volume parameters. Results: To find a compromise between target coverage and dose homogeneity, we recommend using weight factors in the range of 70-90 for minimum dose, and in the range of 10-30 for maximum dose. Maximum dose value of 120% with a weight factor of 5 is recommended for normal tissue. Dose constraints for organs at risk did not play an important role, and the dwell time gradient restriction had only minor effect on target dosimetry. In clinical treatment plans, at identical target coverage, the inverse planning significantly increased the dose conformality (COIN, 0.75 vs. 0.69, p < 0.0001) and improved the homogeneity (DNR, 0.35 vs. 0.39, p = 0.0027), as compared to forward planning. All dosimetric parameters for non-target breast, ipsilateral lung, ribs, and heart were significantly better with inverse planning. The most exposed small volumes for skin were less in HIPO plans, but without statistical significance. Volume irradiated by 5% was 173.5 cm 3 in forward and 167.7 cm 3 in inverse plans (p = 0.0247). Conclusions: By using appropriate input parameters, inverse planning can provide dosimetrically superior dose distributions over forward planning in interstitial breast implants.

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Comparison of manual and inverse optimisation techniques in high dose rate intracavitary brachytherapy of cervical cancer: A dosimetric study

Abstract: The use of inverse planning in intracavitary brachytherapy of cervix has shown a significant improvement in the target volume coverage when compared with manual planning.

Cited by 14 publications

References 13 publications

Dosimetric evaluation of Point A and volume-based high-dose-rate plans: a single institution study on adaptive brachytherapy planning for cervical cancer

Dosimetric evaluation of Point A and volume-based high-dose-rate plans: a single institution study on adaptive brachytherapy planning for cervical cancer

Comparison of Two Inverse Planning Algorithms for Cervical Cancer Brachytherapy

Does inverse planning improve plan quality in interstitial high-dose-rate breast brachytherapy?

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