Retrospective assessment of HDR brachytherapy dose calculation methods in locally advanced cervical cancer patients: AcurosBV vs. AAPM TG43 formalism.

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2024-10-09 DOI:10.1002/acm2.14549

Billie Ann Radcliffe, Yongbok Kim, Julie Raffi, Diandra N Ayala-Peacock, Sarah J Stephens, Junzo Chino, Sheridan Meltsner, Oana Craciunescu

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引用次数: 0

Abstract

Purpose: This retrospective analysis was completed to investigate the use of a model-based dose calculation algorithm (MBDCA) AcurosBV, for use in HDR BT treatments for locally advanced cervical cancer treated with tandem and ovoid applicators with interstitial needles.

Methods: A cohort of 32 patients receiving post-EBRT HDR brachytherapy boost with a prescription dose of 5.5 Gy × 5 fractions to the high-risk clinical target volume (CTV_HR) were selected for this study. For standard TG43 dose calculation, applicators were manually digitized on the planning images, while for AcurosBV calculations, solid renderings of Titanium Fletcher Suite Delclos (FSD) applicators included in BrachyVision were matched to those used clinically and Ti needles were manually digitized. The dose was recalculated using Varian's AcurosBV 13.5 and dose-to-medium-in-medium (D_m,m) was reported. EQD2 values for targets and organs at risk were compared between dose calculation formalisms. D_90% and D_98% values were reported for the high and intermediate-risk CTVs, and $D_{2 c m^{3}}$ values were reported for OARs including bladder, rectum, sigmoid, bowel, and vagina. Due to variability within the patient cohort, the dosimetric impact of AcurosBV was investigated corresponding to planning image modality (CT vs. CBCT), presence of Ti needles, and contrast within vaginal balloons used to stabilize implants. AcurosBV showed lower dosimetric values for all plans compared to TG43.

Results: The average ± standard deviation of dosimetric reduction in D_90% was 4.33 ± 0.09% for CTV_HR and 4.12 ± 0.09% for CTV_IR. The reduction to OARs $D_{2 c m^{3}}$ was: 4.99 ± 0.15% for bladder, 7.87 ± 0.16% for rectum, 5.79 ± 0.17% for sigmoid, 6.91 ± 0.14% for bowel, and 4.55 ± 0.14% for vagina.

Conclusions: AcurosBV should be utilized for HDR BT GYN cases, treated with tandem and ovoid applicators, with high degrees of heterogeneity and calculated in tandem with TG43.

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局部晚期宫颈癌患者 HDR 近距离放射治疗剂量计算方法的回顾性评估：AcurosBV 与 AAPM TG43 形式化对比。

目的：本回顾性分析旨在研究基于模型的剂量计算算法（MBDCA）AcurosBV在使用带间隙针的串联和卵形涂抹器治疗局部晚期宫颈癌的HDR近距离放射治疗中的应用：本研究选取了 32 例接受 EBRT 后 HDR 近距离放射治疗的患者，对高风险临床靶体积 (CTVHR) 的处方剂量为 5.5 Gy × 5 次分次。在计算标准 TG43 剂量时，应用者在计划图像上手动数字化，而在计算 AcurosBV 时，BrachyVision 中包含的钛 Fletcher Suite Delclos (FSD) 应用者的实体渲染与临床使用的应用者相匹配，并手动数字化钛针。使用瓦里安的 AcurosBV 13.5 重新计算剂量，并报告剂量-中间-中间 (Dm,m)。对不同剂量计算形式的目标和危险器官的 EQD2 值进行了比较。报告了高危和中危 CTV 的 D90% 和 D98% 值，报告了包括膀胱、直肠、乙状结肠、肠道和阴道在内的 OAR 的 D 2 c m 3 ${mathrm{2\D}}_{{\mathrm{2\c}}{{mathrm{m}}^{\mathrm{3}}$ 值。由于患者队列中存在变异，研究人员根据规划图像模式（CT 与 CBCT）、Ti 针的存在以及用于稳定植入物的阴道球囊内的对比度，对 AcurosBV 的剂量影响进行了调查。与 TG43 相比，AcurosBV 在所有计划中都显示出较低的剂量值：结果：CTVHR 和 CTVIR 的 D90% 剂量降低平均值（± 标准偏差）分别为 4.33 ± 0.09% 和 4.12 ± 0.09%。D 2 c m 3 ${\mathrm{ D}}_{{mathrm{2\c}}{{\mathrm{m}}^{mathrm{3}}$ 的 OARs 减少率为： CTVHR 为 4.99 ± 0.15%，CTVIR 为 4.12 ± 0.09%：膀胱为 4.99 ± 0.15%，直肠为 7.87 ± 0.16%，乙状结肠为 5.79 ± 0.17%，肠道为 6.91 ± 0.14%，阴道为 4.55 ± 0.14%：AcurosBV 应用于 HDR BT 妇科病例，使用串联和卵圆形涂抹器进行治疗，具有高度异质性，并与 TG43 一起计算。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic