Patient specific evaluation of breathing motion induced interplay effects

Varasteh, Mohammad; Ali, Asmaa; Esteve, Sergio; Jeevanandam, Prakash; Göpfert, Fabian; Irvine, Denise M.; Hounsell, Alan R.; McGarry, Conor K.

doi:10.1016/j.ejmp.2022.11.005

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…The increase in the NBs during irradiation has been associated with lower dose discrepancies 17 . The work presented in this manuscript agrees with that reported, with NBs >20 showing a gamma-passing rate exceeding the 90% tolerance level (10% dose threshold) and NBs > 25 (50% dose threshold) 32 . The simulations started with 5 NBs to simulate unrealistic breathing scenarios and were increased in steps of 5 up to 50 NBs to simulate an extremely short breathing period, which might occur due to a local irregularity during patient breathing.…”

Section: Discussionsupporting

confidence: 91%

“…With the aid of in-house software, the static measurements were convolved with a sinusoidal breathing pattern with different range-of-motion amplitudes 32 . Finally, the plan verification software Verisoft V6·2 (PTW-Freiburg, Germany) was used for dose comparison.…”

Section: Methodsmentioning

confidence: 99%

“…This work considered the same methodology of dose measurements detailed in a previous piece of work 32 . The static dose distribution and measured dose distribution (MDD) in a virtually moving phantom with the beam starting at end-inhalation of 0% and end-exhalation of 50% were obtained through the following steps: All plans were re-calculated and delivered using the OCT4D phantom on the couch without motion to acquire the static dose distribution. Via in-house software, the phantom position (off-axis information) and the superior-inferior (SI) breathing motion were utilised to generate the time-dependent translation files with the Extensible Markup Language (XML) format.…”

Section: Methodsmentioning

confidence: 99%

Section: Dose Measurements and Evaluationmentioning

confidence: 99%

“…The estimation of the interplay effect presented in this study applies the same simulation-based approach presented in a previous piece of work 32 . The benefit of this validated simulation method is a better pre-treatment understanding of the interplay characteristics for different motion amplitudes and NBs by acquiring a single static dose measurement.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the interplay effect in lung stereotactic ablative radiation therapy based on both breathing motion and plan characteristics

Ali,

Greenwood,

Varasteh

et al. 2023

J Radiother Pract

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Introduction: Stereotactic ablative radiotherapy (SABR) is susceptible to challenges for tumours affected by intrafraction organ motion. This study aims to investigate the effect of breathing characteristics and plan complexity on the interplay effect. Methods: A patient-specific interplay effect evaluation was performed using in-house software with an alpha version of the treatment planning verification software Verisoft (PTW-Freiburg, Germany) on VMAT plans. The OCTAVIUS 4D phantom was used to acquire the static dose distribution, and the simulation approach was utilised to generate the moving dose distribution. The influence of plan complexity, PTV size, number of breaths, and motion amplitudes on the interplay effect were examined. The dose distribution of two extreme phases—end-inhale and end-exhale—was considered using the gamma criteria of 2%/2 mm for the interplay effect evaluation. Results: A strong correlation was found between the motion amplitude (p < 0.001) and the NBs (p < 0.001) with the gamma-passing rate. No correlation was found between the gamma-passing rate and the PTV size or plan complexity. Conclusion: The simulation tool allowed the analysis of a large number of breathing traces, demonstrating how free-breathing patients, suspected of high interplay, could be selected for other motion management solutions. The simulated cases showed strong interplay effects for long breathing periods with extended motion amplitudes in a small group of patients.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Dose Measurements and Evaluationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of the interplay effect in lung stereotactic ablative radiation therapy based on both breathing motion and plan characteristics

Ali,

Greenwood,

Varasteh

et al. 2023

J Radiother Pract

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Dose prescription for stereotactic body radiotherapy: general and organ-specific consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery

Brunner,

Boda-Heggemann,

Bürgy

et al. 2024

Strahlenther Onkol

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Purpose and objective To develop expert consensus statements on multiparametric dose prescriptions for stereotactic body radiotherapy (SBRT) aligning with ICRU report 91. These statements serve as a foundational step towards harmonizing current SBRT practices and refining dose prescription and documentation requirements for clinical trial designs. Materials and methods Based on the results of a literature review by the working group, a two-tier Delphi consensus process was conducted among 24 physicians and physics experts from three European countries. The degree of consensus was predefined for overarching (OA) and organ-specific (OS) statements (≥ 80%, 60–79%, < 60% for high, intermediate, and poor consensus, respectively). Post-first round statements were refined in a live discussion for the second round of the Delphi process. Results Experts consented on a total of 14 OA and 17 OS statements regarding SBRT of primary and secondary lung, liver, pancreatic, adrenal, and kidney tumors regarding dose prescription, target coverage, and organ at risk dose limitations. Degree of consent was ≥ 80% in 79% and 41% of OA and OS statements, respectively, with higher consensus for lung compared to the upper abdomen. In round 2, the degree of consent was ≥ 80 to 100% for OA and 88% in OS statements. No consensus was reached for dose escalation to liver metastases after chemotherapy (47%) or single-fraction SBRT for kidney primaries (13%). In round 2, no statement had 60–79% consensus. Conclusion In 29 of 31 statements a high consensus was achieved after a two-tier Delphi process and one statement (kidney) was clearly refused. The Delphi process was able to achieve a high degree of consensus for SBRT dose prescription. In summary, clear recommendations for both OA and OS could be defined. This contributes significantly to harmonization of SBRT practice and facilitates dose prescription and reporting in clinical trials investigating SBRT.

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High-speed low-noise optical respiratory monitoring for spot scanning proton therapy

et al. 2023

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Patient specific evaluation of breathing motion induced interplay effects

Cited by 5 publications

References 34 publications

Analysis of the interplay effect in lung stereotactic ablative radiation therapy based on both breathing motion and plan characteristics

Analysis of the interplay effect in lung stereotactic ablative radiation therapy based on both breathing motion and plan characteristics

Dose prescription for stereotactic body radiotherapy: general and organ-specific consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery

High-speed low-noise optical respiratory monitoring for spot scanning proton therapy

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