Respiratory motion-management in stereotactic body radiation therapy for lung cancer - A dosimetric comparison in an anthropomorphic lung phantom (LuCa).
- Ehrbar S Department of Radiation Oncology, University Hospital Zurich (USZ), Switzerland; University of Zurich, Switzerland. Electronic address: stefanie.ehrbar@usz.ch.
- Perrin R Center for Proton Therapy, Paul Scherrer Institute (PSI), Switzerland.
- Peroni M Center for Proton Therapy, Paul Scherrer Institute (PSI), Switzerland.
- Bernatowicz K Center for Proton Therapy, Paul Scherrer Institute (PSI), Switzerland.
- Parkel T Innovative Design, Centre Suisse d'Electronique et de Microtechnique (CSEM) S. A., Switzerland.
- Pytko I Department of Radiation Oncology, University Hospital Zurich (USZ), Switzerland; University of Zurich, Switzerland.
- Klöck S Department of Radiation Oncology, University Hospital Zurich (USZ), Switzerland; University of Zurich, Switzerland.
- Guckenberger M Department of Radiation Oncology, University Hospital Zurich (USZ), Switzerland; University of Zurich, Switzerland.
- Tanadini-Lang S Department of Radiation Oncology, University Hospital Zurich (USZ), Switzerland; University of Zurich, Switzerland.
- Weber DC University of Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Switzerland.
- Lomax A Center for Proton Therapy, Paul Scherrer Institute (PSI), Switzerland; Swiss Federal Institute of Technology in Zurich (ETHZ), Switzerland.
- 2016-11-08
Published in:
- Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - 2016
Couch tracking
Lung phantom
Radiotherapy
Respiratory motion management
Stereotactic body radiation therapy
Anthropometry
Four-Dimensional Computed Tomography
Humans
Lung Neoplasms
Movement
Organ Sparing Treatments
Organs at Risk
Phantoms, Imaging
Radiometry
Radiosurgery
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Respiration
English
BACKGROUND AND PURPOSE
The objective of this study was to compare the latest respiratory motion-management strategies, namely the internal-target-volume (ITV) concept, the mid-ventilation (MidV) principle, respiratory gating and dynamic couch tracking.
MATERIALS AND METHODS
An anthropomorphic, deformable and dynamic lung phantom was used for the dosimetric validation of these techniques. Stereotactic treatments were adapted to match the techniques and five distinct respiration patterns, and delivered to the phantom while radiographic film measurements were taken inside the tumor. To report on tumor coverage, these dose distributions were used to calculate mean doses (Dmean), changes in homogeneity indices (ΔH2-98), gamma agreement, and areas covered by the planned minimum dose (A>Dmin).
RESULTS
All techniques achieved good tumor coverage (A>Dmin>99.0%) and minor changes in Dmean (±3.2%). Gating and tracking strategies showed superior results in gamma agreement and ΔH2-98 compared to ITV and MidV concepts, which seem to be more influenced by the interplay and the gradient effect. For lung, heart and spinal cord, significant dose differences between the four techniques were found (p<0.05), with lowest doses for gating and tracking strategies.
CONCLUSION
Active motion-management techniques, such as gating or tracking, showed superior tumor dose coverage and better organ dose sparing than the passive techniques based on tumor margins.
The objective of this study was to compare the latest respiratory motion-management strategies, namely the internal-target-volume (ITV) concept, the mid-ventilation (MidV) principle, respiratory gating and dynamic couch tracking.
MATERIALS AND METHODS
An anthropomorphic, deformable and dynamic lung phantom was used for the dosimetric validation of these techniques. Stereotactic treatments were adapted to match the techniques and five distinct respiration patterns, and delivered to the phantom while radiographic film measurements were taken inside the tumor. To report on tumor coverage, these dose distributions were used to calculate mean doses (Dmean), changes in homogeneity indices (ΔH2-98), gamma agreement, and areas covered by the planned minimum dose (A>Dmin).
RESULTS
All techniques achieved good tumor coverage (A>Dmin>99.0%) and minor changes in Dmean (±3.2%). Gating and tracking strategies showed superior results in gamma agreement and ΔH2-98 compared to ITV and MidV concepts, which seem to be more influenced by the interplay and the gradient effect. For lung, heart and spinal cord, significant dose differences between the four techniques were found (p<0.05), with lowest doses for gating and tracking strategies.
CONCLUSION
Active motion-management techniques, such as gating or tracking, showed superior tumor dose coverage and better organ dose sparing than the passive techniques based on tumor margins.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.radonc.2016.10.011
- PMID 27817945
- Persistent URL
- https://folia.unifr.ch/global/documents/181232
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