Articles producció científica> Ciències Mèdiques Bàsiques

Automatic planning of the lower extremities for total marrow irradiation using volumetric modulated arc therapy

  • Dades identificatives

    Identificador: imarina:9334306
    Autors:
    Lambri, NDei, DHernandez, VCastiglioni, IClerici, ECrespi, LDe Philippis, CLoiacono, DNavarria, PReggiori, GRusconi, RTomatis, SBramanti, SScorsetti, MMancosu, P
    Resum:
    Purpose Total marrow (and lymphoid) irradiation (TMI-TMLI) is limited by the couch travel range of modern linacs, which forces the treatment delivery to be split into two plans with opposite orientations: a head-first supine upper-body plan, and a feet-first supine lower extremities plan. A specific field junction is thus needed to obtain adequate target coverage in the overlap region of the two plans. In this study, an automatic procedure was developed for field junction creation and lower extremities plan optimization. Methods Ten patients treated with TMI-TMLI at our institution were selected retrospectively. The planning of the lower extremities was performed automatically. Target volume parameters (CTV_J-V-98% > 98%) at the junction region and several dose statistics (D-98%, D-mean, and D-2%) were compared between automatic and manual plans. The modulation complexity score (MCS) was used to assess plan complexity. Results The automatic procedure required 60-90 min, depending on the case. All automatic plans achieved clinically acceptable dosimetric results (CTV_J-V-98% > 98%), with significant differences found at the junction region, where D-mean and D-2% increased on average by 2.4% (p < 0.03) and 3.0% (p < 0.02), respectively. Similar plan complexity was observed (median MCS = 0.12). Since March 2022, the automatic procedure has been introduced in our clinic, reducing the TMI-TMLI simulation-to-delivery schedule by 2 days. Conclusion The developed procedure allowed treatment planning of TMI-TMLI to be streamlined, increasing efficiency and standardization, preventing human errors, while maintaining the dosimetric plan quality and complexity of manual plans. Automated strategies can simplify the future adoption and clinical implementation of TMI-TMLI treatments i
  • Altres:

    Autor segons l'article: Lambri, N; Dei, D; Hernandez, V; Castiglioni, I; Clerici, E; Crespi, L; De Philippis, C; Loiacono, D; Navarria, P; Reggiori, G; Rusconi, R; Tomatis, S; Bramanti, S; Scorsetti, M; Mancosu, P
    Departament: Ciències Mèdiques Bàsiques
    Autor/s de la URV: Hernandez Masgrau, Victor
    Paraules clau: Vmat Total-body irradiation Tmi Retrospective studies Randomized-trial Radiotherapy, intensity-modulated Radiotherapy planning, computer-assisted Radiotherapy dosage Radiotherapy Organs at risk Lower extremity Leukemia Humans Helical tomotherapy Guided total-marrow Field junction Feasibility Busulfan Bone marrow Automation
    Resum: Purpose Total marrow (and lymphoid) irradiation (TMI-TMLI) is limited by the couch travel range of modern linacs, which forces the treatment delivery to be split into two plans with opposite orientations: a head-first supine upper-body plan, and a feet-first supine lower extremities plan. A specific field junction is thus needed to obtain adequate target coverage in the overlap region of the two plans. In this study, an automatic procedure was developed for field junction creation and lower extremities plan optimization. Methods Ten patients treated with TMI-TMLI at our institution were selected retrospectively. The planning of the lower extremities was performed automatically. Target volume parameters (CTV_J-V-98% > 98%) at the junction region and several dose statistics (D-98%, D-mean, and D-2%) were compared between automatic and manual plans. The modulation complexity score (MCS) was used to assess plan complexity. Results The automatic procedure required 60-90 min, depending on the case. All automatic plans achieved clinically acceptable dosimetric results (CTV_J-V-98% > 98%), with significant differences found at the junction region, where D-mean and D-2% increased on average by 2.4% (p < 0.03) and 3.0% (p < 0.02), respectively. Similar plan complexity was observed (median MCS = 0.12). Since March 2022, the automatic procedure has been introduced in our clinic, reducing the TMI-TMLI simulation-to-delivery schedule by 2 days. Conclusion The developed procedure allowed treatment planning of TMI-TMLI to be streamlined, increasing efficiency and standardization, preventing human errors, while maintaining the dosimetric plan quality and complexity of manual plans. Automated strategies can simplify the future adoption and clinical implementation of TMI-TMLI treatments in new centers.
    Àrees temàtiques: Radiology, nuclear medicine and imaging Radiology, nuclear medicine & medical imaging Oncology General medicine
    Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
    Adreça de correu electrònic de l'autor: victor.hernandez@urv.cat
    Identificador de l'autor: 0000-0003-3770-8486
    Data d'alta del registre: 2024-08-03
    Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
    Enllaç font original: https://link.springer.com/article/10.1007/s00066-022-02014-0
    URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referència a l'article segons font original: Strahlentherapie Und Onkologie. 199 (4): 412-419
    Referència de l'ítem segons les normes APA: Lambri, N; Dei, D; Hernandez, V; Castiglioni, I; Clerici, E; Crespi, L; De Philippis, C; Loiacono, D; Navarria, P; Reggiori, G; Rusconi, R; Tomatis, S (2023). Automatic planning of the lower extremities for total marrow irradiation using volumetric modulated arc therapy. Strahlentherapie Und Onkologie, 199(4), 412-419. DOI: 10.1007/s00066-022-02014-0
    DOI de l'article: 10.1007/s00066-022-02014-0
    Entitat: Universitat Rovira i Virgili
    Any de publicació de la revista: 2023
    Tipus de publicació: Journal Publications
  • Paraules clau:

    Oncology,Radiology, Nuclear Medicine & Medical Imaging,Radiology, Nuclear Medicine and Imaging
    Vmat
    Total-body irradiation
    Tmi
    Retrospective studies
    Randomized-trial
    Radiotherapy, intensity-modulated
    Radiotherapy planning, computer-assisted
    Radiotherapy dosage
    Radiotherapy
    Organs at risk
    Lower extremity
    Leukemia
    Humans
    Helical tomotherapy
    Guided total-marrow
    Field junction
    Feasibility
    Busulfan
    Bone marrow
    Automation
    Radiology, nuclear medicine and imaging
    Radiology, nuclear medicine & medical imaging
    Oncology
    General medicine
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