Is model-based dose calculation based on cone-beam computed tomography suitable for adaptive treatment planning in brachytherapy?

IF 2.7 3区 医学 Q3 ONCOLOGY
Strahlentherapie und Onkologie Pub Date : 2025-01-01 Epub Date: 2024-11-27 DOI:10.1007/s00066-024-02318-3
Andre Karius, Maya Shariff, Sabrina Schaller, Michael Lotter, Vratislav Strnad, Niklas Lackner, Rainer Fietkau, Christoph Bert, Ricarda Merten, Claudia Schweizer
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Abstract

Background and purpose: Model-based dose calculation considering tissue compositions is increasingly being investigated in brachytherapy. The aim of this study was to assess the suitability of modern cone-beam computed tomography (CBCT) imaging compared to conventional computed tomography (CT) scans for this purpose.

Materials and methods: By means of a phantom study, we evaluated the CT numbers and electron densities measured using a modern CBCT device as well as a conventional CT scanner for various materials. Based on this, we compared dose calculations (using the TG-43 formalism as well as model-based collapsed cone calculations assuming uniform materials [ACEuniform] and considering CT numbers [ACECT#]) on planning CTs and control CBCTs for patients with cervical and breast cancer as well as phantom-simulated skin cancer cases. Assessing dosimetric deviations between the planning CTs and control CBCTs acquired during the treatment course served to estimate interfractional implant variations.

Results: The comparison of ACEuniform-ACECT# deviations between planning CTs and control CBCTs revealed no statistically significant difference for almost all examined dose parameters. Dosimetric deviations between model-based dose calculations and TG-43 were partly significant but of small magnitude (< 10 cGy per fraction). Interfractional dosimetric variations were substantially larger than the dosimetric differences found between the various dose calculation procedures.

Conclusion: Model-based dose calculation based on modern CBCT imaging was suitable. However, the found differences between these calculations and the TG-43 formalism should be investigated in dose-outcome analyses. The observed interfractional dosimetric variations revealed the importance of performing treatment quality assurance.

基于锥束计算机断层扫描的模型剂量计算是否适合近距离放射治疗中的自适应治疗规划?
背景和目的:在近距离放射治疗中,越来越多地研究基于模型的剂量计算(考虑组织成分)。本研究的目的是评估现代锥束计算机断层扫描(CBCT)成像与传统计算机断层扫描(CT)相比是否适用于这一目的:通过模型研究,我们评估了使用现代 CBCT 设备和传统 CT 扫描仪测量的各种材料的 CT 数量和电子密度。在此基础上,我们比较了规划 CT 和对照 CBCT 对宫颈癌和乳腺癌患者以及模型模拟皮肤癌病例的剂量计算(使用 TG-43 公式以及基于模型的塌缩锥计算,假设材料均匀[ACEuniform]并考虑 CT 数[ACECT#])。评估治疗过程中获得的计划 CT 和对照 CBCT 之间的剂量测定偏差有助于估算点阵间植入物的变化:结果:对计划 CT 和对照 CBCT 之间的 ACEuniform-ACECT# 偏差进行比较后发现,几乎所有检查的剂量参数都没有明显的统计学差异。基于模型的剂量计算与 TG-43 之间的剂量偏差有部分显著性,但幅度较小(结论:基于现代 CBCT 的模型剂量计算与 TG-43 之间的剂量偏差有部分显著性,但幅度较小):基于现代 CBCT 成像的模型剂量计算是合适的。然而,这些计算与 TG-43 形式之间的差异应在剂量结果分析中加以研究。观察到的部分间剂量学差异揭示了进行治疗质量保证的重要性。
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
CiteScore
5.70
自引率
12.90%
发文量
141
审稿时长
3-8 weeks
期刊介绍: Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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