Feasibility and dosimetric evaluation of single- and multi-isocentre stereotactic body radiation therapy for multiple liver metastases

Tang, Chunbo; Gong, Changfei; Liu, Biaoshui; Guo, Hongjian; Dai, Zhongyang; Yuan, Jian; Wang, Xiaoping; Zhang, Yun

doi:10.3389/fonc.2023.1144784

Cited by 3 publications

(3 citation statements)

References 50 publications

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“…For RapidPlan-based automatic planning, firstly, 20 m-FSMP and 20 m-FSSP were randomly selected from 35 manual plans to train the specific r-FSMP and r-FSSP models, respectively. The main clinical workflow of RapidPlan modeling and training steps was adopted according to the literature (Tang et al 2023). RapidPlan is consisted of three main optimization components: a model building and training engine, an automatic constraint prediction module, and new optimization objectives.…”

Section: Treatment Planningmentioning

confidence: 99%

Dosimetric evaluation of different planning strategies for hypofractionated whole-breast irradiation technique

Tang,

Liu,

Yuan

et al. 2024

Phys. Med. Biol.

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Purpose: The dose hotspot areas in hypofractionated whole-breast irradiation greatly increase the risk of acute skin toxicity because of the anatomical peculiarities of the breast. In this study, we presented several novel planning strategies that integrate multiple sub-planning target volumes (sub-PTVs), field secondary placement, and RapidPlan models for right-sided hypofractionated whole-breast irradiation. Methods: A total of 35 cases of whole-breast irradiation with a dose of 42.5Gy for PTVs using tangential intensity-modulated radiotherapy(IMRT) were selected. Both PTVs were planned for simultaneous treatment using the original manual multiple sub-PTV plan (OMMP) and the original manual single-PTV plan (OMSP). The manual field secondary placement multiple sub-PTV plan (m-FSMP) with multiple objects on the original PTV and the manual field secondary placement single-objective plan (m-FSSP) were initially planned, which were distribution-based of V105(volume receiving 105% of the prescription dose). In addition, two RapidPlan-based plans were developed, including the RapidPlan-based multiple sub-PTVs plan (r-FSMP) and the RapidPlan-based single-PTV plan (r-FSSP). Dosimetric parameters of the plans were compared, and V105 was evaluated using multivariate analysis to determine how it was related to the volume of PTV and the interval of lateral beam angles (ILBA).Results: The lowest mean V105 (5.64±6.5%) of PTV was observed in m-FSMP compared to other manual plans. Upon validation, r-FSSP demonstrated superior dosimetric quality for OAR compared to the two other manual planning methods, except for V5(the volume of ipsilateral lung receiving 5 Gy) of the ipsilateral lung. While r-FSMP showed no significant difference (p=0.06) compared to r-FSSP, it achieved the lowest V105 value (4.3±4.5%), albeit with a slight increase in the dose to some OARs.Conclusions: m-FSMP and r-FSMP can substantially enhance the homogeneity index (HI) and reduce V105, thereby minimizing the risk of acute skin toxicities, even though there may be a slight dose compromise for certain OARs.

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Section: Treatment Planningmentioning

confidence: 99%

Dosimetric evaluation of different planning strategies for hypofractionated whole-breast irradiation technique

Tang,

Liu,

Yuan

et al. 2024

Phys. Med. Biol.

Self Cite

View full text Add to dashboard Cite

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“…It also has greater utility and cost‐effectiveness. 3 , 4 , 5 However, irradiation of multi‐lesion with single‐isocenter brings several problems when multi‐leaf collimator (MLC) delivery is concerned. In the present study, we focused on two issues that would increase unnecessary exposure to surrounding normal structures.…”

Section: Introductionmentioning

confidence: 99%

“…It also has greater utility and cost-effectiveness. [3][4][5] However, irradiation of multilesion with single-isocenter brings several problems when multi-leaf collimator (MLC) delivery is concerned.…”

Section: Introductionmentioning

confidence: 99%

Optimization of collimator angle combined island blocking with parked gap achieves superior normal tissue sparing in SBRT planning of multiple liver lesions

Abuduxiku,

Chen,

Zhang

et al. 2024

J Applied Clin Med Phys

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PurposeTo propose an efficient collimator angle optimization method by combining island blocking (IB) and parked gap (PG) problem to reduce the radiotherapy dose for normal tissue. The reduction will be done with single‐isocenter multi‐lesion volumetric modulated arc therapy (VMAT) for the stereotactic body radiation therapy (SBRT) of liver cancer.MethodsA novel collimator angle optimization algorithm was developed based on the two‐dimensional projection of targets on a beam's eye view (BEV) plane as a function of gantry and collimator angle. This optimization algorithm minimized the sum of the combined IB and PG (IB & PG) areas from all gantry angles for each arc. For comparison, two SBRT plans were respectively generated for each of the 20 retrospective liver cancer cases with multiple lesions. One plan was optimized using the IB & PG algorithm, and the other plan was optimized with a previously reported optimization algorithm that only considered the IB area. Plans were then evaluated and compared using typical dosimetric metrics.ResultsWith the comparable target coverage, IB & PG plans had significantly lower D500cc, D700cc, mean dose (Dmean), and V15 of normal liver tissues when compared to IB plans. The median percent reductions were 3.32% to 5.36%. The D1cc, D5cc, and Dmean for duodenum and small intestine in IB & PG plans were significantly reduced in a range from 7.60% up to 16.03%. Similarly, the median integral dose was reduced by 3.73%. Furthermore, the percentage of normal liver Dmean sparing when IB & PG plans compared to IB plans, was found to be positively correlated (ρ = 0.669, P = 0.001) with the inter‐target distance.ConclusionThe proposed IB & PG algorithm has been demonstrated to outperform the IB algorithm in almost all normal tissue sparing, and the magnitude of liver sparing was positively correlated with inter‐target distance.

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Dosimetric Effect of Target Position Accuracy on Single-Isocenter Multiple Liver Metastases SBRT

Zhang,

Niu,

Yuan

et al. 2024

Technol Cancer Res Treat

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Purpose: To evaluate the dosimetric effects of intrafraction baseline shifts combined with rotational errors on Four-dimensional computed tomography-guided stereotactic body radiotherapy for multiple liver metastases (MLMs). Methods: A total of 10 patients with MLM (2 or 3 lesions) were selected for this retrospective study. Baseline shift errors of 0.5, 1.0, and 2.0 mm; and rotational errors of 0.5°, 1°, and 1.5°, were simulated about all axes. All of the baseline shifts and rotation errors were simulated around the planned isocenter using a matrix transformation of 6° of freedom. The coverage degradation of baseline shifts and rotational errors were analyzed according to the dose to 95% of the planning target volume (D95) and the volume covered by 95% of the prescribed dose (V95), and related changes in gross tumor volume were also analyzed. Results: At the rotation error of 0.5° and the baseline offset of less than 0.5 mm, the D95 and V95 values of all targets were >95%. For rotational errors of 1.0° (combined with all baseline shift errors), 36.3% of targets had D95 and V95 values of <95%. Coverage worsened substantially when the baseline shift errors were increased to 1.0 mm. D95 and V95 values were >95% for about 77.3% of the targets. Only 11.4% of the D95 and V95 values were >95% when the baseline shift errors were increased to 2.0 mm. When the rotational error was increased to 1.5° and baseline shift errors increased to 1.0 mm, the D95 and V95 values were >95% in only 3 cases. Conclusions: The multivariate regression model analysis in this study showed that the coverage of the target decreased further with reduced target volume, increasing the baseline drift, the rotation error, and the distance to the target.

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Feasibility and dosimetric evaluation of single- and multi-isocentre stereotactic body radiation therapy for multiple liver metastases

Cited by 3 publications

References 50 publications

Dosimetric evaluation of different planning strategies for hypofractionated whole-breast irradiation technique

Dosimetric evaluation of different planning strategies for hypofractionated whole-breast irradiation technique

Optimization of collimator angle combined island blocking with parked gap achieves superior normal tissue sparing in SBRT planning of multiple liver lesions

Dosimetric Effect of Target Position Accuracy on Single-Isocenter Multiple Liver Metastases SBRT

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