PO-1078: CBCT guided adaptive radiotherapy for cervix cancer: Uncertainty of the choice of the plan of the day

Gobeli, M.; Rigaud, B.; Charra-Brunaud, C.; Renard, S.; Rauglaudre, Gaëtan De; Beneyton, V.; Racadot, S.; Peignaux, K.; Leseur, J.; Williaume, D.; Rannou, N.; Simon, A.; Lafond, C.; Jaksic, N.; Gnep, K.; Hervé, C.; Riet, F.-G.; Pougnet, I.; Crevoisier, R. de

doi:10.1016/s0167-8140(18)31388-4

Cited by 2 publications

(4 citation statements)

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“…In the current clinical practice, the treatment plan is selected visually, resulting in potentially high inter-observer variations (Gobeli et al 2018). The identification of the optimal treatment plan appears particularly difficult in the context of complex deformations and limited image quality.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, selecting the best plan as the one providing the best CTV coverage is the approach considered in the literature (Gobeli et al 2018. On the other hand, since the OARs were also segmented in the proposed process, considering the OARs in the PoD selection is technically possible.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the expert needs to visualize the full 3D volume to assess the coverage of the whole target by the available treatment plans. The PoD selection is therefore a time-consuming process which is submitted to interobserver variability, as demonstrated in (Gobeli et al 2018) where 26 operators manually selected PoD on 24 CBCT images. This study showed a high inter-observer variablility since the optimal PoD was chosen on average by 60% of users.…”

Section: Introductionmentioning

confidence: 99%

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Automatic segmentation for plan-of-the-day selection in CBCT-guided adaptive radiation therapy of cervical cancer

Zhang¹,

Lafond²,

Barateau³

et al. 2022

Phys. Med. Biol.

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Objective: Plan-of-the-day (PoD) adaptive radiation therapy (ART) is based on a library of treatment plans, among which, at each treatment fraction, the PoD is selected using daily images. However, this strategy is limited by PoD selection uncertainties. This work aimed to propose and evaluate a workflow to automatically and quantitatively identify the PoD for cervix cancer ART based on daily CBCT images. Approach: The quantification was based on the segmentation of the main structures of interest in the CBCT images (clinical target volume [CTV], rectum, bladder, and bowel bag) using a deep learning model. Then, the PoD was selected from the treatment plan library according to the geometrical coverage of the CTV. For the evaluation, the resulting PoD was compared to the one obtained considering reference CBCT delineations. Main results: In experiments on a database of 23 patients with 272 CBCT images, the proposed method reached a concordance of 98.9% between the reference PoD and the automatically identified PoD. Significance: The proposed automatic workflow automatically selected PoD for ART using deep-learning methods. The results showed the ability of the proposed process to identify the optimal PoD in a treatment plan library.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Automatic segmentation for plan-of-the-day selection in CBCT-guided adaptive radiation therapy of cervical cancer

Zhang¹,

Lafond²,

Barateau³

et al. 2022

Phys. Med. Biol.

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show abstract

“… 4 , 5 Each fraction, the radiation therapist (RTT) then selects the best‐suited radiation therapy plan. 6 However, the choice of the best‐suited plan is subject to a large interrater variability. 5 This approach is not commonly used as it requires additional planning CTs with different bladder filling and subsequent contouring and treatment plans.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an ultrasound bladder scanner in supine and standing position

Crop

Comte

Tinier

et al. 2021

J Applied Clin Med Phys

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This study examined the performance of a bladder volume measuring device, the BladderScan (BS) BVI9400. The use of the BS offers the possibility of assessing the bladder volume before positioning the patient and performing the daily image-guided radiotherapy procedure. Patients often cannot lie down before entering the treatment vault. Therefore, the BS was also assessed in a standing position. Methods: The repeatability precision was first evaluated, which is the variability of immediate repeated measures of the BS with same operator and subject. This was followed by the reproducibility precision of the BS in which the operator and subjects differ. Finally, the trueness was evaluated in terms of fixed and proportional bias of the results by applying weighted least-squares fitting. Note that 53 and 85 patient measurements were carried out in supine and standing position, respectively, each consisting of three repeated BS measurements. These were compared with the computed tomography (CT)-delineated bladder volume.Results: Repeatability was dependent on measurement value (heteroscedasticity) with σ repeatability (BS) = ±15 cm 3 ± 10%. However, the total agreement between BS and CT was low with the 95% limits of agreement (LOAs) exceeding ±200 cm 3 due to poor patient reproducibility and presence of fixed and proportional bias. Only in the best case of male patients in the supine position, three BS measurements, and correction for the fixed and proportional bias, 95% LOAs of [-147, +114] cm 3 were obtained between CT and BS. Conclusion:The agreement of the BVI9400 BS with CT was found to be too low for radiotherapy applications.

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PO-1078: CBCT guided adaptive radiotherapy for cervix cancer: Uncertainty of the choice of the plan of the day

Cited by 2 publications

References 0 publications

Automatic segmentation for plan-of-the-day selection in CBCT-guided adaptive radiation therapy of cervical cancer

Automatic segmentation for plan-of-the-day selection in CBCT-guided adaptive radiation therapy of cervical cancer

Evaluation of an ultrasound bladder scanner in supine and standing position

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