Application of an automated dose accumulation workflow in high-risk prostate cancer - validation and dose-volume analysis between planned and delivered dose

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

“…Splashes of low doses to the rectum, which increases due to the inclusion of PLNs irradiation has negligible impact on the risk of having Grade ≥ 1 GI toxicity as demonstrated in this study. Despite having a significantly higher percentage of rectal volume receiving 35 Gy in D A , which could be attributed to the occurrence of rectal distension at the superior portion of the rectum as previously reported [17] , [28] , it does not have a parallel impact on rectal toxicity. Similarly, results reported by Vargas et al [29] , on associating DV metrics with late Grade 2 GI toxicity concluded that relative volume of rectum irradiated to ≤ 40 Gy was not predictive for this toxicity endpoint.…”

“…Apart from the standard DV variables, mean doses obtained from the alternative DB-ROI method were used as additional dosimetric variables for model building. The details of the generation of these structures were reported previously [17] . Briefly, DB-ROI structures were created by performing a volumetric expansion based on steps of 5 mm (5–50 mm) from the surface of the prostate gland.…”

“…A customised dose accumulation workflow was developed using MIM (MIMVista® v6.9, MIM Software Inc., Cleveland OH, USA) [20] . Details of the workflow construction and validation of an intensity-based deformable image registration (DIR) algorithm used in MIM have been described in our recent publication [17] . Within this workflow, fractional doses obtained from patients’ daily CBCT images were accumulated onto the pCT to create the final D A .…”

Predictors for late genitourinary toxicity in men receiving radiotherapy for high-risk prostate cancer using planned and accumulated dose

“…DB-ROI structures were created using an automated process utilizing a customized workflow in MIM (MIMVista® v6.9, MIM Software Inc., Cleveland OH USA) [22] (refer to supplemental Fig. S1 ).…”

Predictive modelling for late rectal and urinary toxicities after prostate radiotherapy using planned and delivered dose

“…Two types of dosimetric data from each patient were analysed: D P and D A . For a given patient, the D P value obtained from the DVH of the patient's RT plan whereas the D A value was extracted from the DVH generated from the previously developed dose accumulation workflow (19,20). D A accounted for the patient's inter-fractional organ variations based on the daily acquired conebeam computed tomography images.…”