Dosimetric impact of Acuros XB on cervix radiotherapy using RapidArc technique: a dosimetric study

Aim: We aimed to evaluate the dosimetric influence of Acuros XB (AXB) dose-to-medium (D m ) and dose-to-water (D w ) reporting mode on carcinoma cervix using intensity-modulated radiation therapy (IMRT) and RapidArc (RA) technique. Materials and Methods: A cohort of thirty patients cared for carcinoma cervix was retrospectively selected for the study. Plans were computed using analytical anisotropic algorithm (AAA), AXB-D m , and AXB-D w algorithms for dosimetric comparison. A paired t -test and Pitman–Morgan dispersion test were executed to appraise the difference in mean values and the inter-patient variability of the differences. Results: The dose–volume parameters were higher for AXB-D w in contrast to AAA for IMRT and RA plans, excluding D 98% , minimum dose to planning target volume (PTV) and rectum mean dose (RA). There was no systematic trend observed in dose–volume parameters for PTV and organs at risk (OARs) between AXB-D m and AXB-D w for IMRT and RA plans. The dose–volume parameters for target were higher for AXB-D m in comparison to AAA in IMRT and RA plans, except D 98% and minimum dose to PTV. Analysis envisaged less inter-patient variability while switching from AAA to AXB-D m in comparison to those switching from AAA to AXB-D w . Conclusions: The present study reveals the important difference between AAA, AXB-D m , and AXB-D w computations for cervix carcinoma using IMRT and RA techniques. The inter-patient variability and systematic difference in dose–volume parameters computed using AAA, AXB-D m , and AXB-D w algorithms present the possible impact on the dose prescription to PTV and their relative constraints to OARs for IMRT and RA techniques. This may help in the decision-making in clinic while switching from AAA to AXB (D m or D w ) algorithm for cervix carcinoma using IMRT and RA techniques.

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“…Kumar et al . [ 21 ] also detailed the use of AXB on cervix carcinoma using RA technique compared to AAA.…”

Section: Discussionsmentioning

confidence: 99%

Dosimetric Influence of Acuros XB Dose-to-Medium and Dose-to-Water Reporting Modes on Carcinoma Cervix Using Intensity-Modulated Radiation Therapy and Volumetric RapidArc Technique

Kumar¹,

Bhushan²,

Kishore³

et al. 2022

Journal of Medical Physics

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“…This study planned to evaluate two standard treatment planning techniques, i.e., IMRT and VMAT, with different optimization methods. [ 17 18 ] In the first method, there was not any restriction on entry or exit of the radiation beam. The method was a standard method used for plan optimization of pelvis patient.…”

Section: Introductionmentioning

confidence: 99%

To Study the Impact of Different Optimization Methods on Intensity-Modulated Radiotherapy and Volumetric-Modulated Arc Therapy Plans for Hip Prosthesis Patients

Singh

Tripathi

Singh

et al. 2022

Journal of Medical Physics

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Purpose: To study the impact of different optimization methods in dealing with metallic hip implant using intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques. Materials and Methods: A cohort of 16 patients having metallic implants was selected for the study. Three sets of IMRT and VMAT plans were generated. Set 1 IMRT (IM_Base), VMAT (VM_Base) without any restrictions on beam entry and exit, set 2 (IM_ENT and VM_ENT) optimizer restricts the beam entry and set 3 (IM_EXT+ENT), neither entry nor exit doses were allowed toward the metallic implant. Results: There was no significant difference in target (D 95% ) and organ-at-risk doses between IM_Base and IM_ENT. There were significant ( P = 0.002) improvements in planning target volume (PTV) V 95% and homogeneity from IM_EXT+ENT to IM_ENT. There was no significant difference in plan quality between VM_Base and VM_ENT. There were significant ( P = 0.005) improvements in PTV, V 95%, homogeneity from VM_EXT+ENT to VM_ENT. V 40Gy , V 30Gy for bladder, rectum, bowel, and bowel maximum dose decreases significantly ( P < 0.005) in IM_ENT compared to IM_EXT+ENT, but not significant for VMAT plans. Similarly, there was a significant decrease in dose spill outside target ( P < 0.05) comparing 40%, 50%, 60%, and 70% dose spills for IM_ENT compared to IM_EXT+ENT, but variations among VMAT plans are insignificant. VMAT plans were always superior to IMRT plans for the same optimization methods. Conclusion: The best approach is to plan hip prosthesis cases with blocked entry of radiation beam for IMRT and VMAT. The VMAT plans had more volumetric coverage, fewer hotspots, and lesser heterogeneity.

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Dosimetric Comparison between Varian Halcyon Analytical Anisotropic Algorithm and Acuros XB Algorithm for Planning of RapidArc Radiotherapy of Cervical Carcinoma

Mbewe

Shiba

2021

Progress in Medical Physics

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Purpose: The Halcyon radiotherapy platform at Groote Schuur Hospital was delivered with a factory-configured analytical anisotropic algorithm (AAA) beam model for dose calculation. In a recent system upgrade, the Acuros XB (AXB) algorithm was installed. Both algorithms adopt fundamentally different approaches to dose calculation. This study aimed to compare the dose distributions of cervical carcinoma RapidArc plans calculated using both algorithms.Methods: A total of 15 plans previously calculated using the AAA were retrieved and recalculated using the AXB algorithm. Comparisons were performed using the planning target volume (PTV) maximum (max) and minimum (min) doses, D95%, D98%, D50%, D2%, homogeneity index (HI), and conformity index (CI). The mean and max doses and D2% were compared for the bladder, bowel, and femoral heads.Results: The AAA calculated slightly higher targets, D98%, D95%, D50%, and CI, than the AXB algorithm (44.49 Gy vs. 44.32 Gy, P=0.129; 44.87 Gy vs. 44.70 Gy, P=0.089; 46.00 Gy vs. 45.98 Gy, P=0.154; and 0.51 vs. 0.50, P=0.200, respectively). For target min dose, D2%, max dose, and HI, the AAA scored lower than the AXB algorithm (41.24 Gy vs. 41.30 Gy, P=0.902; 47.34 Gy vs. 47.75 Gy, P<0.001; 48.62 Gy vs. 50.14 Gy, P<0.001; and 0.06 vs. 0.07, P=0.002, respectively). For bladder, bowel, and left and right femurs, the AAA calculated higher mean and max doses.Conclusions: Statistically significant differences were observed for PTV D2%, max dose, HI, and bowel max dose (P>0.05).

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Dosimetric impact of Acuros XB on cervix radiotherapy using RapidArc technique: a dosimetric study

Cited by 4 publications

References 21 publications

Dosimetric Influence of Acuros XB Dose-to-Medium and Dose-to-Water Reporting Modes on Carcinoma Cervix Using Intensity-Modulated Radiation Therapy and Volumetric RapidArc Technique

Dosimetric Influence of Acuros XB Dose-to-Medium and Dose-to-Water Reporting Modes on Carcinoma Cervix Using Intensity-Modulated Radiation Therapy and Volumetric RapidArc Technique

To Study the Impact of Different Optimization Methods on Intensity-Modulated Radiotherapy and Volumetric-Modulated Arc Therapy Plans for Hip Prosthesis Patients

Dosimetric Comparison between Varian Halcyon Analytical Anisotropic Algorithm and Acuros XB Algorithm for Planning of RapidArc Radiotherapy of Cervical Carcinoma

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