Autor segons l'article: May, Lauren; Hardcastle, Nicholas; Hernandez, Victor; Saez, Jordi; Rosenfeld, Anatoly; Poder, Joel
Departament: Ciències Mèdiques Bàsiques
Autor/s de la URV: Hernandez Masgrau, Victor
Paraules clau: Radiotherapy, intensity-modulated; Radiotherapy planning, computer-assisted; Radiotherapy dosage; Radiotherapy; Radiosurgery; Radiometry; Quality; Plan robustness; Plan complexity; Organs at risk; Mlc; Metrics; Linear accelerator-based radiotherapy; Intra-cranial stereotactic radiosurgery; Imr; Humans; Delivery errors; Delivery error; Complexity; Brain neoplasms; Accuracy
Resum: Background: The use of modulated techniques for intra-cranial stereotactic radiosurgery (SRS) results in highly modulated fields with small apertures, which may be susceptible to uncertainties in the delivery device.Purpose: This study aimed to quantify the impact of simulated delivery errors on treatment plan dosimetry and how this is affected by treatment planning system (TPS), plan geometry, delivery technique, and plan complexity. A beam modelling error was also included as context to the dose uncertainties due to treatment delivery errors.Methods: Delivery errors were assessed for multiple-target brain SRS plans obtained through the Trans-Tasman Radiation Oncology Group (TROG) international treatment planning challenge (2018). The challenge dataset consisted of five intra-cranial targets, each with a prescription of 20 Gy. Of the final dataset of 54 plans, 51 were created using the volumetric modulated arc therapy (VMAT) technique and three used intensity modulated arc therapy (IMRT). Thirty-five plans were from the Varian Eclipse TPS, 17 from Elekta Monaco TPS, and one plan each from RayStation and Philips Pinnacle TPS. The errors introduced included: monitor unit calibration errors, multi-leaf collimator (MLC) bank offset, single MLC leaf offset, couch rotations, and collimator rotations. Dosimetric leaf gap (DLG) error was also included as a beam modelling error. Dose to targets was assessed via dose covering 98% of planning target volume (PTV) (D98%), dose covering 2% of PTV (D2%), and dose covering 99% of gross tumor volume (GTV) (D99%). Dose to organs at risk (OARs) was assessed using the volume of normal brain receiving 12 Gy (V12Gy), mean dose to normal brain, and maximum dose covering 0.03cc brainstem (D0.03cc). Plan complexity was also assessed via edge metric, modulation complexity score (MCS), mean MLC gap, mean MLC speed, and plan modulation (PM).Results: PTV D98% showed high robustness on average to most errors with the exception of a bank shift of 1.0 mm and large rotational errors >= 1.0 degrees for either the couch or collimator. However, in some cases, errors close to or within generally accepted machine tolerances resulted in clinically relevant impacts. The greatest impact upon normal brain V12Gy, mean dose to normal brain, and D0.03cc brainstem was found for DLG error in alignment with other recent studies. All delivery errors had on average a minimal impact across these parameters. Comparing plans from the Monaco TPS and the Eclipse TPS, showed a lesser increase to V12Gy, mean dose to normal brain, and D0.03cc brainstem for Monaco plans (p < 0.01) when DLG error was simulated. Monaco plans also correlated to lower plan complexity. Using Spearman's correlation coefficient (r) a strong negative correlation (r
Àrees temàtiques: Radiology, nuclear medicine and imaging; Radiology, nuclear medicine & medical imaging; Medicine (miscellaneous); Medicina ii; Medicina i; Interdisciplinar; General medicine; Engenharias iv; Engenharias ii; Ciências biológicas iii; Ciências biológicas ii; Ciências biológicas i; Ciência da computação; Biotecnología; Biophysics; Astronomia / física; Antropologia / arqueologia
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
Data d'alta del registre: 2025-03-03
Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
Enllaç font original: https://aapm.onlinelibrary.wiley.com/doi/full/10.1002/mp.16907
Referència a l'article segons font original: Medical Physics. 51 (2): 910-921
Referència de l'ítem segons les normes APA: May, Lauren; Hardcastle, Nicholas; Hernandez, Victor; Saez, Jordi; Rosenfeld, Anatoly; Poder, Joel (2024). Multi-institutional investigation into the robustness of intra-cranial multi-target stereotactic radiosurgery plans to delivery errors. Medical Physics, 51(2), 910-921. DOI: 10.1002/mp.16907
URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
DOI de l'article: 10.1002/mp.16907
Entitat: Universitat Rovira i Virgili
Any de publicació de la revista: 2024
Tipus de publicació: Journal Publications
Repositori URV