Adaptive plan selection vs. re-optimisation in radiotherapy for bladder cancer: A dose accumulation comparison

Vestergaard, A.; Muren, L.P.; Søndergaard, Jimmi; Elstrøm, U.V.; Høyer, Morten; Petersen, Jørgen B. B.

doi:10.1016/j.radonc.2013.08.045

Cited by 71 publications

(77 citation statements)

References 30 publications

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“…More accurate dose estimations could be performed if registration error was known and accounted for as demonstrated in our previous work 29. Typical plan adaptation strategies revolve around re‐planning on the CBCT study using DIR to propagate contours and evaluate dose 30, 31, 32. Two publications by Veiga et al have evaluated the process of using DIR to CBCT studies for determining daily dose23 and accumulated dose with different DIR algorithms,28 but in both cases dose computations are needed for each fraction.…”

Section: Discussionmentioning

confidence: 99%

Online daily assessment of dose change in head and neck radiotherapy without dose‐recalculation

Vickress

Battista

Barnett

et al. 2018

J Applied Clin Med Phys

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BackgroundHead and neck cancers are commonly treated with radiation therapy, but due to possible volume changes, plan adaptation may be required during the course of treatment. Currently, plan adaptations consume significant clinical resources. Existing methods to evaluate the need for plan adaptation requires deformable image registration (DIR) to a new CT simulation or daily cone beam CT (CBCT) images and the recalculation of the dose distribution. In this study, we explore a tool to assist the decision for plan adaptation using a CBCT without re‐computation of dose, allowing for rapid online assessment.MethodsThis study involved 18 head and neck cancer patients treated with CBCT image guidance who had their treatment plan modified based on a new CT simulation (ReCT). Dose changes were estimated using different methods and compared to the current gold standard of using DIR between the planning CT scan (PCT) and ReCT with recomputed dose. The first and second methods used DIR between the PCT and daily CBCT with the planned dose or recalculated dose from the ReCT respectively, with the dose transferred to the CBCT using rigid registration. The necessity of plan adaptation was assessed by the change in dose to 95% of the planning target volume (D95) and mean dose to the parotids.ResultsThe treatment plans were adapted clinically for all 18 patients but only 7 actually needed an adaptation yielding 11 unnecessary adaptations. Applying a method using the daily CBCT with the planned dose distribution would have yielded only four unnecessary adaptations and no missed adaptations: a significant improvement from that done clinically.ConclusionUsing the DIR between the planning CT and daily CBCT can flag cases for plan adaptation before every fraction while not requiring a new re‐planning CT scan and dose recalculation.

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Section: Discussionmentioning

confidence: 99%

Online daily assessment of dose change in head and neck radiotherapy without dose‐recalculation

Vickress

Battista

Barnett

et al. 2018

J Applied Clin Med Phys

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“…This presents promising outcomes for the use of Lipiodol for boost and partial bladder treatment delivery. Online adaptive radiotherapy acts in the interest of varying bladder sizes between fractions and has been deemed a viable method of treatment delivery in many studies [21,[27][28][29][30]. Lipiodol and fiducial markers can both work well with adaptive planning, by providing enhanced visualization of the target as well as improved registration, which are fundamental to a successful online adaptive protocol.…”

Section: Discussionmentioning

confidence: 99%

A review of the use of fiducial markers for image-guided bladder radiotherapy

Nolan

Forde

2015

Acta Oncologica

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Background: Enhancing target visualization and reducing set-up errors in image-guided radiotherapy (IGRT) are issues faced when trying to implement more conformal and partial bladder techniques. This review examines the evidence available pertaining to the clinical use of Lipiodol and gold fiducials for IGRT for bladder cancer. Material and methods: Nine published articles relating to the feasibility of using Lipiodol injections or gold fiducial markers in IGRT for bladder patients were recruited from a database search strategy. Set-up errors were evaluated in addition to the stability and visibility of each on verification imaging. Adverse reactions from the insertion of each method were also assessed. Results: Both Lipiodol and gold fiducials have the potential to remain stable and visible in the bladder, however, fading, washout and seed loss was also reported. Set-up errors can be reduced by using Lipiodol or fiducial registration when compared to other registration techniques. Adverse reactions reported were minimal for each. Conclusion: Current evidence suggests that Lipiodol injections and gold fiducial markers present as promising and highly accurate methods of overcoming interfraction bladder motion in IGRT.

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“…In addition to one in silico implementation of online compensation [58], these were the only studies where feedback from delivered dose triggered adaptations. Contributing to differences in applied strategies and workflows could be the additional manual contouring, which was a pre-requisite in over 70% of the simulated ART workflows [22,59,60,[62][63][64][65][66][68][69][70]72,74,78,79,[81][82][83]85,86,88,89,91,93,[95][96][97][98][100][101][102][103][104][105][106][107]. To reduce the need of manual contours, the segmentation could be propagated using deformable image registration.…”

Section: Discussionmentioning

confidence: 99%

Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

et al. 2016

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Adaptive plan selection vs. re-optimisation in radiotherapy for bladder cancer: A dose accumulation comparison

Cited by 71 publications

References 30 publications

Online daily assessment of dose change in head and neck radiotherapy without dose‐recalculation

Online daily assessment of dose change in head and neck radiotherapy without dose‐recalculation

A review of the use of fiducial markers for image-guided bladder radiotherapy

Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

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