{"title":"Enhancing targeted doses: Low-energy photon lipiodol-enhanced radiotherapy (LEPERT) for liver cancer patients.","authors":"Daisuke Kawahara","doi":"10.1002/acm2.14578","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study proposes a novel approach, \"Low-energy photon Lipiodol-Enhanced Radiotherapy\" (LEPERT), for patients with liver cancer. Moreover, we evaluate the dose difference of the conventional treatment planning with 10 MV X-ray beam (MV-plan) and LEPERT.</p><p><strong>Methods: </strong>The computed tomography (CT) was modeled with the Monte Carlo simulation. For LEPERT, 120 kV X-ray beams collimated with CT were irradiated on a virtual tumor filled with Lipiodol at 10-50 mg/mL, which was inserted into a whole-body phantom. A prescribed dose of 40 Gy/4fr was irradiated to achieve D<sub>95%</sub> of the target. The doses to the target and organs at risk (OARs), such as the bone, normal liver, spinal cord, and kidneys, were evaluated by comparison with conventional radiotherapy with a 10 MV VMAT plan (MV-plan).</p><p><strong>Results: </strong>Differences in the effective energy and off-axis ratio between the measurements and simulations were within 2 keV and 3%, respectively. The D<sub>2%</sub> of tumors exceeded 130% of the prescribed dose at 50 mg. The difference in the D<sub>98%</sub> of the tumor between LEPERT and MV-plan was within 0.7 Gy. The V<sub>5Gy</sub> of the normal liver (>40 mg/mL) was lower for LEPERT than for MV-plan. The V<sub>20Gy</sub> of the normal liver (>10 mg/mL) for LEPERT was over 80% lower than that for MV-plan. Dose constraints for the OARs were satisfied.</p><p><strong>Conclusion: </strong>The LEPERT can selectively enhanced only the tumor region with sparing the OAR dose. It could be a novel and effective treatment technique in the point that the treatment machine is a general CT device.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e14578"},"PeriodicalIF":2.0000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Applied Clinical Medical Physics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/acm2.14578","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This study proposes a novel approach, "Low-energy photon Lipiodol-Enhanced Radiotherapy" (LEPERT), for patients with liver cancer. Moreover, we evaluate the dose difference of the conventional treatment planning with 10 MV X-ray beam (MV-plan) and LEPERT.
Methods: The computed tomography (CT) was modeled with the Monte Carlo simulation. For LEPERT, 120 kV X-ray beams collimated with CT were irradiated on a virtual tumor filled with Lipiodol at 10-50 mg/mL, which was inserted into a whole-body phantom. A prescribed dose of 40 Gy/4fr was irradiated to achieve D95% of the target. The doses to the target and organs at risk (OARs), such as the bone, normal liver, spinal cord, and kidneys, were evaluated by comparison with conventional radiotherapy with a 10 MV VMAT plan (MV-plan).
Results: Differences in the effective energy and off-axis ratio between the measurements and simulations were within 2 keV and 3%, respectively. The D2% of tumors exceeded 130% of the prescribed dose at 50 mg. The difference in the D98% of the tumor between LEPERT and MV-plan was within 0.7 Gy. The V5Gy of the normal liver (>40 mg/mL) was lower for LEPERT than for MV-plan. The V20Gy of the normal liver (>10 mg/mL) for LEPERT was over 80% lower than that for MV-plan. Dose constraints for the OARs were satisfied.
Conclusion: The LEPERT can selectively enhanced only the tumor region with sparing the OAR dose. It could be a novel and effective treatment technique in the point that the treatment machine is a general CT device.
期刊介绍:
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