Articles producció científica> Ciències Mèdiques Bàsiques

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

  • Identification data

    Identifier: imarina:9334306
    Authors:
    Lambri, NDei, DHernandez, VCastiglioni, IClerici, ECrespi, LDe Philippis, CLoiacono, DNavarria, PReggiori, GRusconi, RTomatis, SBramanti, SScorsetti, MMancosu, P
    Abstract:
    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
  • Others:

    Author, as appears in the 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
    Department: Ciències Mèdiques Bàsiques
    URV's Author/s: Hernandez Masgrau, Victor
    Keywords: 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
    Abstract: 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.
    Thematic Areas: Radiology, nuclear medicine and imaging Radiology, nuclear medicine & medical imaging Oncology General medicine
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: victor.hernandez@urv.cat
    Author identifier: 0000-0003-3770-8486
    Record's date: 2024-08-03
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://link.springer.com/article/10.1007/s00066-022-02014-0
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Strahlentherapie Und Onkologie. 199 (4): 412-419
    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
    Article's DOI: 10.1007/s00066-022-02014-0
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2023
    Publication Type: Journal Publications
  • Keywords:

    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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