“Dose of the day” based on cone beam computed tomography and deformable image registration for lung cancer radiotherapy

Yuan, Zhigang; Rong, Yi; Benedict, Stanley H; Daly, Megan E.; Qiu, Jianfeng; Yamamoto, Tokihiro

doi:10.1002/acm2.12793

Cited by 18 publications

(22 citation statements)

References 34 publications

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“…The spinal cord of both H&N and thoracic body site and the parotid gland showed the largest deviations amongst all OAR dose parameters for both the H&N and thoracic region, having dose difference values of up to 14.5%. Comparably large dose deviations were also obtained by a DIR-based CBCT correction approach with − 5.55% ± 14.3% for the thoracic spinal cord [48]. For the H&N body site, absolute mean dose differences for the parotid gland and the spinal cord were reported as 0.05-0.07 Gy and 0.42 Gy [35] which compares to our results by a factor of approximately 0.5.…”

Section: Discussionsupporting

confidence: 48%

Evaluation of a cycle-generative adversarial network-based cone-beam CT to synthetic CT conversion algorithm for adaptive radiation therapy

et al. 2020

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Image-guided radiation therapy could benefit from implementing adaptive radiation therapy (ART) techniques. A cycle-generative adversarial network (cycle-GAN)-based cone-beam computed tomography (CBCT)-to-synthetic CT (sCT) conversion algorithm was evaluated regarding image quality, image segmentation and dosimetric accuracy for head and neck (H&N), thoracic and pelvic body regions. Methods: Using a cycle-GAN, three body site-specific models were priorly trained with independent paired CT and CBCT datasets of a kV imaging system (XVI, Elekta). sCT were generated based on first-fraction CBCT for 15 patients of each body region. Mean errors (ME) and mean absolute errors (MAE) were analyzed for the sCT. On the sCT, manually delineated structures were compared to deformed structures from the planning CT (pCT) and evaluated with standard segmentation metrics. Treatment plans were recalculated on sCT. A comparison of clinically relevant dose-volume parameters (D 98 , D 50 and D 2 of the target volume) and 3D-gamma (3%/3mm) analysis were performed. Results: The mean ME and MAE were 1.4, 29.6, 5.4 Hounsfield units (HU) and 77.2, 94.2, 41.8 HU for H&N, thoracic and pelvic region, respectively. Dice similarity coefficients varied between 66.7 ± 8.3% (seminal vesicles) and 94.9 ± 2.0% (lungs). Maximum mean surface distances were 6.3 mm (heart), followed by 3.5 mm (brainstem). The mean dosimetric differences of the target volumes did not exceed 1.7%. Mean 3D gamma pass rates greater than 97.8% were achieved in all cases. Conclusions: The presented method generates sCT images with a quality close to pCT and yielded clinically acceptable dosimetric deviations. Thus, an important prerequisite towards clinical implementation of CBCTbased ART is fulfilled.

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Section: Discussionsupporting

confidence: 48%

Evaluation of a cycle-generative adversarial network-based cone-beam CT to synthetic CT conversion algorithm for adaptive radiation therapy

et al. 2020

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“…Improved computer methods such as deformable registration of planning CTs to create virtual CTs matching up-to-date CB-CTs ( 19 , 70 ) are also promising. Further advances in image reconstruction and procession, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, frequent adaptation of the target volume and hence the treatment plan might be applied to limit toxicity by reducing dose to adjacent critical structures. In previous studies, however, adaptation was usually performed only once or twice during the course of radiotherapy (15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Cone-Beam-CT Guided Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer Enables Quality Assurance and Superior Sparing of Healthy Lung

et al. 2020

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PurposeTo evaluate the potential of cone-beam-CT (CB-CT) guided adaptive radiotherapy (ART) for locally advanced non-small cell lung cancer (NSCLC) for sparing of surrounding organs-at-risk (OAR).Materials and MethodsIn 10 patients with locally advanced NSCLC, daily CB-CT imaging was acquired during radio- (n = 4) or radiochemotherapy (n = 6) for simulation of ART. Patients were treated with conventionally fractionated intensity-modulated radiotherapy (IMRT) with total doses of 60–66 Gy (pPlan) (311 fraction CB-CTs). OAR were segmented on every daily CB-CT and the tumor volumes were modified weekly depending on tumor changes. Doses actually delivered were recalculated on daily images (dPlan), and voxel-wise dose accumulation was performed using a deformable registration algorithm. For simulation of ART, treatment plans were adapted using the new contours and re-optimized weekly (aPlan).ResultsCB-CT showed continuous tumor regression of 1.1 ± 0.4% per day, leading to a residual gross tumor volume (GTV) of 65.3 ± 13.4% after 6 weeks of radiotherapy (p = 0.005). Corresponding PTVs decreased to 83.7 ± 7.8% (p = 0.005). In the actually delivered plans (dPlan), both conformity (p = 0.005) and homogeneity (p = 0.059) indices were impaired compared to the initial plans (pPlan). This resulted in higher actual lung doses than planned: V20Gy was 34.6 ± 6.8% instead of 32.8 ± 4.9% (p = 0.066), mean lung dose was 19.0 ± 3.1 Gy instead of 17.9 ± 2.5 Gy (p = 0.013). The generalized equivalent uniform dose (gEUD) of the lung was 18.9 ± 3.1 Gy instead of 17.8 ± 2.5 Gy (p = 0.013), leading to an increased lung normal tissue complication probability (NTCP) of 15.2 ± 13.9% instead of 9.6 ± 7.3% (p = 0.017). Weekly plan adaptation enabled decreased lung V20Gy of 31.6 ± 6.2% (−3.0%, p = 0.007), decreased mean lung dose of 17.7 ± 2.9 Gy (−1.3 Gy, p = 0.005), and decreased lung gEUD of 17.6 ± 2.9 Gy (−1.3 Gy, p = 0.005). Thus, resulting lung NTCP was reduced to 10.0 ± 9.5% (−5.2%, p = 0.005). Target volume coverage represented by conformity and homogeneity indices could be improved by weekly plan adaptation (CI: p = 0.007, HI: p = 0.114) and reached levels of the initial plan (CI: p = 0.721, HI: p = 0.333).ConclusionIGRT with CB-CT detects continuous GTV and PTV changes. CB-CT-guided ART for locally advanced NSCLC is feasible and enables superior sparing of healthy lung at high levels of plan conformity.

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“…Interestingly, a recent study showed that higher tumor regression may be an adverse prognostic factor for CHRT, and a favorable prognostic factor for RT alone (38). Several studies have postulated the benefits of adaptive RT in locally advanced NSCLC (39)(40)(41). This approach is being investigated in the ongoing RTOG 1106 trial, results of which are expected shortly (42).…”

Section: Tumor Volume and Its Dynamicsmentioning

confidence: 99%

Concurrent chemoradiotherapy for stage III non-small-cell lung cancer: recent progress and future perspectives (a narrative review)

Łazar-Poniatowska

Bandura

Dziadziuszko

et al. 2021

Transl Lung Cancer Res

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“Dose of the day” based on cone beam computed tomography and deformable image registration for lung cancer radiotherapy

Cited by 18 publications

References 34 publications

Evaluation of a cycle-generative adversarial network-based cone-beam CT to synthetic CT conversion algorithm for adaptive radiation therapy

Evaluation of a cycle-generative adversarial network-based cone-beam CT to synthetic CT conversion algorithm for adaptive radiation therapy

Cone-Beam-CT Guided Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer Enables Quality Assurance and Superior Sparing of Healthy Lung

Concurrent chemoradiotherapy for stage III non-small-cell lung cancer: recent progress and future perspectives (a narrative review)

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