Volumetric-modulated arc therapy for oropharyngeal carcinoma: A dosimetric and delivery efficiency comparison with static-field IMRT

Dai, Xiang; Zhao, Yingchao; Liang, Zhiwen; Dassarath, Meera; Wang, Lu; Jin, L; Chen, Lili; Dong, Jianghu; Price, Robert A.; Ma, Charlie

doi:10.1016/j.ejmp.2014.09.003

Cited by 18 publications

(24 citation statements)

References 20 publications

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“…The use of one-arc VMAT may shorten the delivery time further; however, in our preliminary evaluation, we found that the dose distribution of one-arc VMAT was inferior to that of twoarc VMAT. This finding was consistent with that of Dai et al 28 who found the dosimetric benefit of two-arc VMAT over one arc for the treatment of head and neck cancer. Therefore, we used two-arc VMAT for this study.…”

Section: Discussionsupporting

confidence: 92%

Plan quality and delivery time comparisons between volumetric modulated arc therapy and intensity modulated radiation therapy for scalp angiosarcoma: A planning study

Kai

Toya

Saitô

et al. 2017

J of Medical Radiation Sci

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IntroductionDue to its spherical surface, scalp angiosarcoma requires careful consideration for radiation therapy planning and dose delivery. Herein, we investigated whether volumetric modulated arc therapy (VMAT) is superior to intensity modulated radiation therapy (IMRT) in terms of the plan quality and delivery time.MethodsThree different coplanar treatment plans were created for four patients, comprising a two‐arc VMAT plan as well as 5‐field and 9‐field IMRT plans with 6 MV beams. The X‐ray Voxel Monte Carlo algorithm was employed for dose calculation. A radiation therapy dose of 60 Gy was prescribed to the planning target volume (PTV) in 30 fractions. The homogeneity indexes (HIs) and conformity indexes (CIs) of the PTV, organs at risk (OARs) doses and delivery times were calculated and compared.ResultsFor the VMAT, 5‐field and 9‐field IMRT plans, the mean HIs were 0.14, 0.16 and 0.15; CIs100% were 0.63, 0.61 and 0.64; CIs98% were 0.72, 0.66 and 0.70 and CIs95% were 0.74, 0.67 and 0.71 respectively. All mean dose parameters of the VMAT and 9‐field IMRT plans for the brain were equal to or lower than those of the 5‐field IMRT plan. For the 5‐field IMRT plan, the dose constraints for the left lens were not satisfied in two patients. The mean delivery times were 3.3, 11.1 and 14.7 min for the VMAT, 5‐field and 9‐field IMRT plans respectively.ConclusionThe VMAT plan quality is comparable to that of 9‐field IMRT, with a reduced delivery time. Therefore, VMAT represents a valuable, sophisticated irradiation technique for treating scalp angiosarcoma.

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Section: Discussionsupporting

confidence: 92%

Plan quality and delivery time comparisons between volumetric modulated arc therapy and intensity modulated radiation therapy for scalp angiosarcoma: A planning study

Kai

Toya

Saitô

et al. 2017

J of Medical Radiation Sci

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“…Most previous dosimetric studies reported that VMAT plans provide no worse OAR sparing than SS‐IMRT . Only a few studies demonstrated significantly better OAR sparing in treating OPSCC with VMAT compared to SS‐IMRT.…”

Section: Discussionmentioning

confidence: 99%

“…The results from this study were highlighted in red or pink. Note that different definitions of D max were used for brainstem and spinal cord among the publications (Bertelsen et al, Doornaert et al, Holt et al, and Pursley et al: D max ; Franzese et al and Vanetti et al: D 2% ; Scorsetti et al: D 1% ; Johnston et al: D 1cc ; Clemente et al, Dai et al, and Huang et al: D 0.1cc ). Abbreviations: Cord, spinal cord; OC, oral cavity; PC, pharyngeal constrictors; PG, parotid gland; C/I/L/RPG = contralateral/ipsilateral/left/right parotid gland; SMG, submandibular gland; C/I/L/RSMG, contralateral/ipsilateral/left/right submandibular gland [Color figure can be viewed at wileyonlinelibrary.com]…”

Section: Discussionmentioning

confidence: 99%

Correlation between plan quality improvements and reduced acute dysphagia and xerostomia in the definitive treatment of oropharyngeal squamous cell carcinoma

et al. 2019

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Background To evaluate plan quality using volumetric‐modulated arc therapy (VMAT) and step‐and‐shoot intensity‐modulated radiation therapy (SS‐IMRT) techniques and for patients treated for oropharyngeal squamous cell carcinoma (OPSCC). Methods Treatment plans for patients treated definitively for stages I‐IVb, OPSCC between December 2009 and August 2015 were retrospectively reviewed. Dosimetric endpoints of involved organs‐at‐risk (OARs) were retrieved from clinical plans. Common Terminology Criteria for Adverse Events scores of acute toxicities were compared. Results Two‐hundred twenty‐two patients were identified with 134 and 88 receiving SS‐IMRT and VMAT with median follow‐up time of 23.0 and 7.9 months, respectively. The dosimetric endpoints of the OARs were significantly improved in VMAT cohort, which translated into significantly lower rates of grade 2 or higher acute dysphagia and xerostomia. Conclusion Improvements in stages I‐IVb, oropharyngeal cancer plan quality are associated with reduced grade ≥ 2 acute dysphagia and xerostomia.

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“…VMAT provides dose distributions that are comparable or superior to those of conventional intensity modulated radiation therapy, with a shorter treatment time. [1][2][3] The VMAT technique is especially beneficial for patients with head and neck cancer because in most cases the tumor is adjacent to critical organs. In these complex regions, a smaller margin size is desirable to minimize radiation-related toxicities.…”

Section: Introductionmentioning

confidence: 99%

Deep learning‐based virtual noncontrast CT for volumetric modulated arc therapy planning: Comparison with a dual‐energy CT‐based approach

Koike¹,

Ohira²,

Akino

et al. 2019

Medical Physics

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Purpose The aim of this study was to develop a deep learning (DL) method for generating virtual noncontrast (VNC) computed tomography (CT) images from contrast‐enhanced (CE) CT images (VNCDL) and to evaluate its performance in dose calculations for head and neck radiotherapy in comparison with VNC images derived from a dual‐energy CT (DECT) scanner (VNCDECT). Methods This retrospective study included data for 61 patients who underwent head and neck radiotherapy. All planning CT images were obtained with a single‐source DECT scanner (80 and 140 kVp) with rapid kVp switching. The DL‐based method used a pair of virtual monochromatic images (VMIs) at 70 keV with and without contrast materials. VMIs without contrast materials were used as reference true noncontrast (TNC) images. Deformable image registration was used between the TNC and CE images. We used the data of 45 patients, chosen randomly, for training (7922 paired images), and data from the other 16 patients as test data. We generated the VNCDL images with a densely connected convolutional network. As the VNCDECT images, we used VMIs with the iodine signal suppressed, reconstructed from the CE images of the 16 test patients. The CT numbers of the tumor, common carotid artery, internal jugular vein, muscle, fat, bone marrow, cortical bone, and mandible of each VNC image were compared with those of the TNC image. The dose of the reference TNC plan was recalculated using the CE, VNCDL, and VNCDECT images. Difference maps of the dose distributions and dose–volume histograms were evaluated. Results The mean prediction time for the VNCDL images was 3.4 s per patient, and the mean number of slices was 204. The absolute differences in CT numbers of the VNCDL images were significantly smaller than those of the VNCDECT images for the bone marrow (8.0 ± 6.5 vs 175.1 ± 40.9 HU; P < 0.001) and mandible (20.3 ± 19.3 vs 106.2 ± 80.5 HU; P = 0.002). The DL‐based model provided the dose distribution most similar to that of the TNC plan. With the VNCDECT plans, dose errors >1.0% were observed in bone regions. The dose–volume histogram analysis showed that the VNCDL plans yielded the smallest errors for the primary target, although dose differences were <1.0% for all the approaches. For the maximum dose to the mandible, the mean ± SD errors for the CE, VNCDL, and VNCDECT plans were –0.13% ± 0.23% (range: −0.46% to 0.31%; P = 0.037), –0.01% ± 0.22% (range: −0.40% to 0.36%; P = 1.0), and 0.53% ± 0.47% (range: −0.21% to 1.41%; P < 0.001), respectively. Conclusions In this study, we developed a method based on DL that can rapidly generate VNC images from CE images without a DECT scanner. Compared with the DECT approach, the DL‐based method improved the prediction accuracy of CT numbers in bone regions. Consequently, there was greater agreement between the VNCDL and TNC plan dose distributions than with the CE and VNCDECT plans, achieved by suppressing the contrast material signals while retaining the CT numbers of bone structures.

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Volumetric-modulated arc therapy for oropharyngeal carcinoma: A dosimetric and delivery efficiency comparison with static-field IMRT

Cited by 18 publications

References 20 publications

Plan quality and delivery time comparisons between volumetric modulated arc therapy and intensity modulated radiation therapy for scalp angiosarcoma: A planning study

Plan quality and delivery time comparisons between volumetric modulated arc therapy and intensity modulated radiation therapy for scalp angiosarcoma: A planning study

Correlation between plan quality improvements and reduced acute dysphagia and xerostomia in the definitive treatment of oropharyngeal squamous cell carcinoma

Deep learning‐based virtual noncontrast CT for volumetric modulated arc therapy planning: Comparison with a dual‐energy CT‐based approach

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