Rectal volume variations and estimated rectal dose during 8 weeks of image-guided radical 3D conformal external beam radiotherapy for prostate cancer

Tøndel, Hanne; Solberg, Arne; Lydersen, Stian; Jensen, Christer André; Kaasa, Stein; Lund, Jo‐Åsmund

doi:10.1016/j.ctro.2019.02.003

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…Our observation agrees with the reported assessment for postprostatectomy patients that the daily variations of the rectum and bladder filling status are larger than the patients with intact prostate. 33,35,36 The composition with artifacts caused by severe air bubbles further challenges rectum segmentation 37 and also leads to high uncertainty in human contours used as training labels.…”

Section: Discussionmentioning

confidence: 99%

Ensemble learning and tensor regularization for cone‐beam computed tomography‐based pelvic organ segmentation

et al. 2022

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Purpose Cone‐beam computed tomography (CBCT) is a widely accessible low‐dose imaging approach compatible with on‐table patient anatomy observation for radiotherapy. However, its use in comprehensive anatomy monitoring is hindered by low contrast and low signal‐to‐noise ratio and a large presence of artifacts, resulting in difficulty in identifying organ and structure boundaries either manually or automatically. In this study, we propose and develop an ensemble deep‐learning model to segment post‐prostatectomy organs automatically. Methods We utilize the ensemble logic in various modules during the segmentation process to alleviate the impact of low image quality of CBCT. Specifically, (1) semantic attention was obtained from an ensemble 2.5D You‐only‐look‐once detector to consistently define regions of interest, (2) multiple view‐specific two‐stream 2.5D segmentation networks were developed, using auxiliary high‐quality CT data to aid CBCT segmentation, and (3) a novel tensor‐regularized ensemble scheme was proposed to aggregate the estimates from multiple views and regularize the spatial integrity of the final segmentation. Results A cross‐validation study achieved Dice similarity coefficient and mean surface distance of 0.779 ±$\pm$ 0.069 and 2.895 ±$\pm$ 1.496 mm for the rectum, and 0.915 ±$\pm$ 0.055 and 1.675 ±$\pm$ 1.311 mm for the bladder. Conclusions The proposed ensemble scheme manages to enhance the geometric integrity and robustness of the contours derived from CBCT with light network components. The tensor regularization approach generates organ results conforming to anatomy and physiology, without compromising typical quantitative performance in Dice similarity coefficient and mean surface distance, to support further clinical interpretation and decision making.

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Section: Discussionmentioning

confidence: 99%

Ensemble learning and tensor regularization for cone‐beam computed tomography‐based pelvic organ segmentation

et al. 2022

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“…The use of alternative DB-ROI structures that are closer to the prostate (5–10 mm) might be equivalent to the very high dose range (V70-75 Gy) in routine DV scenarios. Educating the importance of having an empty rectum, dietary interventions and the use of laxatives have been suggested to maintain the consistency of a small rectal volume [33] , thus minimising the risk of late GI toxicity.…”

Section: Discussionmentioning

confidence: 99%

Dose-volume analysis of planned versus accumulated dose as a predictor for late gastrointestinal toxicity in men receiving radiotherapy for high-risk prostate cancer

Ong

Knight

Panettieri

et al. 2022

Physics and Imaging in Radiation Oncology

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“…This can be simpler to reproduce and can reduce the volume overlapping with target if the rectum is an OAR. Variation in rectal filling is seen throughout the treatment course, with some evidence suggesting a trend towards a reduced volume [24,25]. To minimise variation, implementation of laxatives, enemas and dietary plans can be considered.…”

Section: Rectummentioning

confidence: 99%

Image-Guided Radiotherapy for Pelvic Cancers: A Review of Current Evidence and Clinical Utilisation

2020

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The meticulous selection and utilisation of image-guided radiotherapy treatment (IGRT) are essential for optimal radiotherapy treatment delivery when using highly conformal treatment techniques in pelvic radiotherapy. Pelvic IGRT has several general IGRT issues to consider (such as choice of match strategy, prioritisation between multiple treatment targets, and margin estimates) as well as issues specific to pelvic radiotherapy, in particular large interfraction organ variation. A range of interventions, including adaptive treatment strategies, have been developed to address these challenges. This review covers general considerations for clinical implementation of pelvic IGRT in routine practice and provides an overview of current knowledge regarding pelvic interfraction organ motion. Published IGRT evidence for each of the major tumour sites (gynaecological, prostate, bladder, rectal and anal cancer) is summarised, as are state-of-the-art adaptive approaches. General recommendations for implementation of an institutional pelvic IGRT strategy include• Ensuring consistency between treatment intent and IGRT approach utilised.• Ensuring minimum national and international IGRT guidance is followed whilst considering the benefit of daily volumetric IGRT. • Ensuring the appropriate Allied Health Professionals (namely Therapy Radiographers/RTTs) lead on undertaking IGRT. • Ensuring the IGRT workflow procedure is clear and includes an escalation process for difficult set-ups. • Ensuring a robust IGRT service is in place before implementing advanced adaptive approaches.

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Rectal volume variations and estimated rectal dose during 8 weeks of image-guided radical 3D conformal external beam radiotherapy for prostate cancer

Cited by 10 publications

References 30 publications

Ensemble learning and tensor regularization for cone‐beam computed tomography‐based pelvic organ segmentation

Ensemble learning and tensor regularization for cone‐beam computed tomography‐based pelvic organ segmentation

Dose-volume analysis of planned versus accumulated dose as a predictor for late gastrointestinal toxicity in men receiving radiotherapy for high-risk prostate cancer

Image-Guided Radiotherapy for Pelvic Cancers: A Review of Current Evidence and Clinical Utilisation

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Rectal volume variations and estimated rectal dose during 8 weeks of image-guided radical 3D conformal external beam radiotherapy for prostate cancer

Cited by 10 publications

References 30 publications

Ensemble learning and tensor regularization for cone‐beam computed tomography‐based pelvic organ segmentation

Ensemble learning and tensor regularization for cone‐beam computed tomography‐based pelvic organ segmentation

Dose-volume analysis of planned versus accumulated dose as a predictor for late gastrointestinal toxicity in men receiving radiotherapy for high-risk prostate cancer

Image-Guided Radiotherapy for Pelvic Cancers: A Review of Current Evidence and Clinical Utilisation

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Rectal volume variations and estimated rectal dose during 8 weeks of image-guided radical 3D conformal external beam radiotherapy for prostate cancer