Posterior kV-CBCT scanning of the head and neck region minimizes doses to critical organs with sustained image quality

Khamfongkhruea, Chirasak; Utapom, Kitsana; Munsing, Siwapon; Suttiprapha, Sittipong; Tannanonta, Chirapha; Yabsantia, Sumalee

doi:10.1016/j.ejmp.2015.03.016

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…In the scanning direction, both MRCPs were irradiated from the posterior region. Considering critical organs, it seems more satisfactory for clinical practice as it causes a lower imaging dose to be delivered to the patient [20]. Furthermore, a half scan decreases the exposure time to the radiation dose from the kV CBCT imaging system.…”

Section: Discussionmentioning

confidence: 99%

Dose estimation for cone-beam computed tomography in image-guided radiation therapy using mesh-type reference computational phantoms and assuming head and neck cancer

Cumur¹,

Hamada²

2022

J. Radiol. Prot.

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This study aimed to estimate the additional dose the cone-beam computed tomography (CBCT) system integrated into the Varian TrueBeam linear accelerator delivers to a patient with head and neck cancer using mesh-type International Commission on Radiological Protection (ICRP) Reference Computational Phantoms. In the first part, for use as a benchmark for the accuracy of the Monte Carlo geometry of CBCT, Particle and Heavy Ion Transport code System (PHITS) calculations were confirmed against measured lateral and depth dose profiles using a CT dose profiler (CTDP). After obtaining good agreement, organ dose calculations were performed by PHITS using mesh-type reference computational phantom (MRCP) and irradiating the neck region; the effective dose was calculated utilising absorbed organ doses and tissue weighting factors for male and female MRCP. Substantially, it has been found that the effective doses for male and female MRCP are 0.81 and 1.06 mSv, respectively. As this study aimed to assess the imaging dose from the CBCT system used in image-guided radiation therapy (IGRT), it is required to take into account this dose in terms of both the target organ and surrounding tissues. Although the absorbed organ dose values and effective dose values obtained for both MRCP males and females were small, attention should be paid to the additional dose resulting from CBCT. This study can create awareness on the importance of doses arising from imaging techniques, especially CBCT.

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Section: Discussionmentioning

confidence: 99%

Dose estimation for cone-beam computed tomography in image-guided radiation therapy using mesh-type reference computational phantoms and assuming head and neck cancer

Cumur¹,

Hamada²

2022

J. Radiol. Prot.

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“…Incorporating MV imaging dose into the treatment plan and avoiding daily MVCBCT imaging is advised to reduce excess dose [124]. Other dose limiting recommendations include: use of a posterior CBCT acquisition angle (90-290 degrees) to reduce eye dose [125], utilising topogram feature to move field of view caudally [126] and using the lowest numbers of monitor units possible to acquire MV images [124].…”

Section: Imaging Dosementioning

confidence: 99%

A review of Image Guided Radiation Therapy in head and neck cancer from 2009–2019 – Best Practice Recommendations for RTTs in the Clinic

Kearney

Coffey

Leong

2020

Technical Innovations & Patient Support in Radiation Oncolo

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Radiation therapy (RT) is beneficial in Head and Neck Cancer (HNC) in both the definitive and adjuvant setting. Highly complex and conformal planning techniques are becoming standard practice in delivering increased doses in HNC. A sharp falloff in dose outside the high dose area is characteristic of highly complex techniques and geometric uncertainties must be minimised to prevent under dosage of the target volume and possible over dosage of surrounding critical structures. CTV-PTV margins are employed to account for geometric uncertainties such as set up errors and both interfraction and intrafraction motion. Robust immobilisation and Image Guided Radiation Therapy (IGRT) is also essential in this group of patients to minimise discrepancies in patient position during the treatment course. IGRT has evolved with increased 2-Dimensional (2D) and 3-Dimensional (3D) IGRT modalities available for geometric verification. 2D and 3D IGRT modalities are both beneficial in geometric verification while 3D imaging is a valuable tool in assessing volumetric changes that may have dosimetric consequences for this group of patients. IGRT if executed effectively and efficiently provides clinicians with confidence to reduce CTV-PTV margins thus limiting treatment related toxicities in patients. Accumulated exposure dose from IGRT vary considerably and may be incorporated into the treatment plan to avoid excess dose. However, there are considerable variations in the application of IGRT in RT practice. This paper aims to summarise the advances in IGRT in HNC treatment and provide clinics with recommendations for an IGRT strategy for HNC in the clinic.

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Effect of diagnostic cone-beam computed tomography protocols on image quality, patient dose, and lesion detection

et al. 2016

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Posterior kV-CBCT scanning of the head and neck region minimizes doses to critical organs with sustained image quality

Cited by 5 publications

References 19 publications

Dose estimation for cone-beam computed tomography in image-guided radiation therapy using mesh-type reference computational phantoms and assuming head and neck cancer

Dose estimation for cone-beam computed tomography in image-guided radiation therapy using mesh-type reference computational phantoms and assuming head and neck cancer

A review of Image Guided Radiation Therapy in head and neck cancer from 2009–2019 – Best Practice Recommendations for RTTs in the Clinic

Effect of diagnostic cone-beam computed tomography protocols on image quality, patient dose, and lesion detection

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