在线自适应磁共振引导放疗的可变形剂量累积的多机构比较

IF 3.4 Q2 ONCOLOGY
Martina Murr , Uffe Bernchou , Edyta Bubula-Rehm , Mark Ruschin , Parisa Sadeghi , Peter Voet , Jeff D Winter , Jinzhong Yang , Eyesha Younus , Cornel Zachiu , Yao Zhao , Hualiang Zhong , Daniela Thorwarth
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引用次数: 0

摘要

背景和目的应用不同的可变形剂量累积(DDA)解决方案使得在线自适应磁共振引导放射治疗(OA-MRgRT)后的机构比较具有挑战性。这项多机构研究的目的是分析 OA-MRgRT 中 DDA 实施的准确性和一致性。材料和方法 分析了一个用生物力学模型变形的金标准(GS)病例和五个临床病例,包括前列腺癌(2x)、宫颈癌、肝癌和淋巴结核癌,均采用 OA-MRgRT 治疗。六个中心使用机构实施方案进行了 DDA。通过类内相关系数(ICC)和临床剂量测定标准(CDC)分析,使用轮廓指标狄斯相似系数(DSC)、表面-DSC、豪斯多夫距离(HD95%)和累积剂量-体积直方图(DVHs)比较了可变形图像配准(DIR)和 DDA 结果。临床病例的 DIR 导致高达 81.3% 的等值线的 DSC > 0.8,表面-DSC 值的变化取决于实施情况。肝脏病例中十二指肠的最大 HD95%=73.3 mm。虽然除两个轮廓外,所有轮廓在 DDA 后的 DVH ICC > 0.90,但在临床病例中观察到了相关的绝对 CDC 差异:前列腺 I/II 显示膀胱 V28Gy 的差异最大(10.2/7.6%),而直肠 D2cm3 (2.8 Gy)、十二指肠 Dmax (7.1 Gy) 和直肠 D0.5cm3 (4.6 Gy) 的宫颈、肝脏和淋巴结的差异最大。总体而言,不同的 DIR 和 DDA 实施之间的一致性很高,但也观察到了依赖于病例和算法的差异,这可能会导致与临床相关的结果。需要进行更大规模的研究,以确定未来的 DDA 指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A multi-institutional comparison of retrospective deformable dose accumulation for online adaptive magnetic resonance-guided radiotherapy

Background and Purpose

Application of different deformable dose accumulation (DDA) solutions makes institutional comparisons after online-adaptive magnetic resonance-guided radiotherapy (OA-MRgRT) challenging. The aim of this multi-institutional study was to analyze accuracy and agreement of DDA-implementations in OA-MRgRT.

Material and Methods

One gold standard (GS) case deformed with a biomechanical-model and five clinical cases consisting of prostate (2x), cervix, liver, and lymph node cancer, treated with OA-MRgRT, were analyzed. Six centers conducted DDA using institutional implementations. Deformable image registration (DIR) and DDA results were compared using the contour metrics Dice Similarity Coefficient (DSC), surface-DSC, Hausdorff-distance (HD95%), and accumulated dose-volume histograms (DVHs) analyzed via intraclass correlation coefficient (ICC) and clinical dosimetric criteria (CDC).

Results

For the GS, median DDA errors ranged from 0.0 to 2.8 Gy across contours and implementations. DIR of clinical cases resulted in DSC > 0.8 for up to 81.3% of contours and a variability of surface-DSC values depending on the implementation. Maximum HD95%=73.3 mm was found for duodenum in the liver case. Although DVH ICC > 0.90 was found after DDA for all but two contours, relevant absolute CDC differences were observed in clinical cases: Prostate I/II showed maximum differences in bladder V28Gy (10.2/7.6%), while for cervix, liver, and lymph node the highest differences were found for rectum D2cm3 (2.8 Gy), duodenum Dmax (7.1 Gy), and rectum D0.5cm3 (4.6 Gy).

Conclusion

Overall, high agreement was found between the different DIR and DDA implementations. Case- and algorithm-dependent differences were observed, leading to potentially clinically relevant results. Larger studies are needed to define future DDA-guidelines.

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来源期刊
Physics and Imaging in Radiation Oncology
Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation
CiteScore
5.30
自引率
18.90%
发文量
93
审稿时长
6 weeks
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