Dosimetric effect of intrafraction tumor motion in phase gated lung stereotactic body radiotherapy

Zhao, Bo; Yang, Yong; Li, Tianfang; Li, Xiang; Heron, Dwight E.; Huq, M. Saiful

doi:10.1118/1.4757916

Cited by 29 publications

(32 citation statements)

References 31 publications

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“…Margins tend to be larger in the superior–inferior direction where respiration‐induced motion is more dominant relative to motion in the axial plane . When gating is used for treatment, margins can generally be reduced and some groups have thus defined the PTV as CTV + 5 mm . A margin expansion of a few millimeters is necessary to account for residual tumor motion and setup uncertainty .…”

Section: Treatment Planning and Physicsmentioning

confidence: 99%

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

et al. 2017

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The efficacy of stereotactic body radiotherapy (SBRT) has been well demonstrated. However, it presents unique challenges for accurate planning and delivery especially in the lungs and upper abdomen where respiratory motion can be significantly confounding accurate targeting and avoidance of normal tissues. In this paper we review the current literature on SBRT for lung and upper abdominal tumors with particular emphasis on addressing respiratory motion and its affects. We provide recommendations on strategies to manage motion for different, patient specific situations. Some of the recommendations will potentially be adopted to guide clinical trial protocols.

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Section: Treatment Planning and Physicsmentioning

confidence: 99%

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

et al. 2017

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“…Clinically, dose reconstruction with target motion has been investigated with respect to patients with lung (7, 8), prostate (9–13), and liver (14) tumors. Concerning treatment of the prostate, the basic finding from those studies is that its motion during radiation therapy is unpredictable (15), suggesting that the interplay effect needs to be fully accounted for to achieve accurate dose reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Dosimetric Impact of Real-Time Prostate Motion During Volumetric Modulated Arc Therapy

Azcona¹,

Li²,

Chen³

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Purpose To develop a method for dose reconstruction by incorporating the interplay effect between aperture modulation and target motion, and to assess the dosimetric impact of real-time prostate motion during volumetric modulated arc therapy (VMAT). Methods and Materials Clinical VMAT plans were delivered with the TrueBeam linac for 8 patients with prostate cancer. The real-time target motion during dose delivery was determined based on the 2-dimensional fiducial localization using an onboard electronic portal imaging device. The target shift in each image was correlated with the control point with the same gantry angle in the VMAT plan. An in-house–developed Monte Carlo simulation tool was used to calculate the 3-dimensional dose distribution for each control point individually, taking into account the corresponding real-time target motion (assuming a nondeform-able target with no rotation). The delivered target dose was then estimated by accumulating the dose from all control points in the plan. On the basis of this information, dose-volume histograms and 3-dimensional dose distributions were calculated to assess their degradation from the planned dose caused by target motion. Thirty-two prostate motion trajectories were analyzed. Results The minimum dose to 0.03 cm3 of the gross tumor volume (D0.03cc) was only slightly degraded after taking motion into account, with a minimum value of 94.1% of the planned dose among all patients and fractions. However, the gross tumor volume receiving prescription dose (V100%) could be largely affected by motion, dropping below 60% in 1 trajectory. We did not observe a correlation between motion magnitude and dose degradation. Conclusions Prostate motion degrades the delivered dose to the target in an unpredictable way, although its effect is reduced over multiple fractions, and for most patients the degradation is small. Patients with greater prostate motion or those treated with stereotactic body radiation therapy would benefit from real-time prostate tracking to reduce the margin.

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“…Intra-fractional motion is a movement during treatment due to respiratory motion, irregular motion, and physiological migration of organ. In prostate IMRT, changes in bladder and rectum filling volume cause the prostate intra-fractional motion [1] [2].…”

Section: Introductionmentioning

confidence: 99%

Markerless Respiratory Motion Tracking Using Single Depth Camera

Kumagai¹,

Uemura²,

Ishibashi³

et al. 2016

OJMI

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The aim of this study is to propose a novel system that has an ability to detect intra-fractional motion during radiotherapy treatment in real-time using three-dimensional surface taken by a depth camera, Microsoft Kinect v1. Our approach introduces three new aspects for three-dimensional surface tracking in radiotherapy treatment. The first aspect is a new algorithm for noise reduction of depth values. Ueda's algorithm was implemented and enabling a fast least square regression of depth values. The second aspect is an application for detection of patient's motion at multiple points in thracoabdominal regions. The third aspect is an estimation of three-dimensional surface from multiple depth values. For evaluation of noise reduction by Ueda's algorithm, two respiratory patterns are measured by the Kinect as well as a laser range meter. The resulting cross correlation coefficients between the laser range meter and the Kinect were 0.982 for abdominal respiration and 0.995 for breath holding. Moreover, the mean cross correlation coefficients between the signals of our system and the signals of Anzai with respect to participant's respiratory motion were 0.90 for thoracic respiration and 0.93 for abdominal respiration, respectively. These results proved that the performance of the developed system was comparable to existing motion monitoring devices. Reconstruction of three-dimensional surface also enabled us to detect the irregular motion and breathing arrest by comparing the averaged depth with predefined threshold values.

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Dosimetric effect of intrafraction tumor motion in phase gated lung stereotactic body radiotherapy

Abstract: The dose deviation in PTV and CTV due to target motion is not always negligible in gated SBRT. Although CTVs are covered sufficiently with prescribed dose in most cases, some are on the verge of underdose due to large tumor excursion caused by factors such as baseline shift.

Cited by 29 publications

References 31 publications

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

Assessing the Dosimetric Impact of Real-Time Prostate Motion During Volumetric Modulated Arc Therapy

Markerless Respiratory Motion Tracking Using Single Depth Camera

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