Statistical breathing curve sampling to quantify interplay effects of moving lung tumors in a 4D Monte Carlo dose calculation framework

Münchow, A. Von; Straub, K.; Losert, Christoph; Shpani, Roel; Hofmaier, Jan; Freislederer, P.; Heinz, C.; Thieke, Christian; Söhn, Matthias; Alber, M.; Floca, Ralf; Belka, Claus; Parodi, Katia; Reiner, M. J.; Kamp, Florian

doi:10.1016/j.ejmp.2022.07.006

Cited by 6 publications

(2 citation statements)

References 37 publications

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“…More work is still needed to develop robust simulation methods that consider clinics, devices and patient differences in quantifying the interplay effect. Tools that are simulation-based without the requirement of measurement are emerging 40 and it is acknowledged that these solutions could further streamline the process of patient-specific determination of interplay effect. These solutions will help ensure that dose errors are minimised by finding alternative motion management and treatment options where there is the potential for dosimetric errors to compromise the treatment goals.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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show abstract

“…Ultimately, with fast time-resolved synthetic 4D-CT generation methods, dose calculation, and optimization algorithms, the partially delivered dose could be reconstructed and accumulated in real-time during the treatment fraction itself, and the treatment plan could be continuously adapted based on this information (Kontaxis et al 2015, Menten et al 2017. Further applications of such time-resolved synthetic 4D-CTs include gating window optimization (Oh et al 2019), 4D and robust treatment plan optimization and analysis (Heath et al 2009, Meschini et al 2022, and the investigation of interplay effects (Rao et al 2012, von Münchow et al 2022. Furthermore, the dose reconstructed over the whole treatment course could serve as input for clinical dose-response modeling in the post-treatment phase (van Herk et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Continuous time-resolved estimated synthetic 4D-CTs for dose reconstruction of lung tumor treatments at a 0.35 T MR-linac

Rabe,

Paganelli,

Schmitz

et al. 2023

Phys. Med. Biol.

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Objective. To experimentally validate a method to create continuous time-resolved estimated synthetic 4D-computed tomography datasets (tresCTs) based on orthogonal cine MRI data for lung cancer treatments at a magnetic resonance imaging (MRI)-guided linear accelerator (MR-linac).Approach. A breathing porcine lung phantom was scanned at a CT scanner and 0.35 T MR-linac. Orthogonal cine MRI series (sagittal/coronal orientation) at 7.3 Hz, intersecting tumor-mimicking gelatin nodules, were deformably registered to mid-exhale 3D-CT and 3D-MRI datasets. The time-resolved deformation vector fields were extrapolated to 3D and applied to a reference synthetic 3D-CT image (sCTref), while accounting for breathing phase-dependent lung density variations, to create 82s-long tresCTs at 3.65 Hz. Ten tresCTs were created for ten tracked nodules with different motion patterns in two lungs. For each dataset, a treatment plan was created on the mid-exhale phase of a measured ground truth (GT) respiratory-correlated 4D-CT dataset with the tracked nodule as gross tumor volume (GTV). Each plan was recalculated on the GT 4D-CT, randomly sampled tresCT, and static sCTref images. Dose distributions for corresponding breathing phases were compared in gamma (2%/2mm) and dose-volume histogram (DVH) parameter analyses.Main results. The mean gamma pass rate between all tresCT and GT 4D-CT dose distributions was 98.6%. The mean absolute relative deviations of the tresCT with respect to GT DVH parameters were 1.9%, 1.0%, and 1.4% for the GTV D 98%, D 50%, and D 2%, respectively, 1.0% for the remaining nodules D 50%, and 1.5% for the lung V 20 Gy. The gamma pass rate for the tresCTs was significantly larger (p<0.01), and the GTV D 50% deviations with respect to the GT were significantly smaller (p<0.01) than for the sCTref.Significance. The results suggest that tresCTs could be valuable for time-resolved reconstruction and intrafractional accumulation of the dose to the GTV for lung cancer patients treated at MR-linacs in the future.

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

et al. 2023

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Statistical breathing curve sampling to quantify interplay effects of moving lung tumors in a 4D Monte Carlo dose calculation framework

Cited by 6 publications

References 37 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

Continuous time-resolved estimated synthetic 4D-CTs for dose reconstruction of lung tumor treatments at a 0.35 T MR-linac

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

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