{"title":"评估前列腺癌每日自适应分次放疗后较高的蒙特卡洛统计不确定性对累积剂量的影响","authors":"Thyrza Z. Jagt, Tomas M. Janssen, Jan-Jakob Sonke","doi":"10.1016/j.phro.2024.100636","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and purpose</h3><p>Monte Carlo (MC) based dose calculations are widely used in radiotherapy with a low statistical uncertainty, being accurate but slow. Increasing the uncertainty accelerates the calculation, but reduces quality. In online adaptive planning, however, dose is recalculated every treatment fraction, potentially decreasing the cumulative calculation error. This study aimed to evaluate the effect of higher MC statistical uncertainty in the context of daily online plan adaptation.</p></div><div><h3>Materials and methods</h3><p>For twenty prostate cancer patients, daily plans were simulated for 5 fractions and three modes of variation: rigid whole body translations, local-rigid prostate translations and local-rigid prostate rotations. For each mode and fraction, adaptive plans were generated from a clinical reference plan using three MC uncertainty values: 1 % (standard), 2 % and 3 % per plan. Dose-volume criteria were evaluated for accumulated doses, checking plan acceptability and comparing higher uncertainty plans to the standard.</p></div><div><h3>Results</h3><p>Increasing the statistical uncertainty setting from 1 % to 2–3 % caused an accumulated median target D<sub>98</sub><sub>%</sub> reduction of 0.1 Gy, with interquartile ranges (IQRs) up to 0.12 Gy. Rectum V<sub>35Gy</sub> increased in median up to 0.16 cm<sup>3</sup> with IQRs up to 0.33 cm<sup>3</sup>. The bladder V<sub>28Gy</sub> and V<sub>32Gy</sub> showed median increases up to 0.24 %-point, with IQRs up to 0.54 %-point. Using 2 % uncertainty reduced calculation times by more than a minute for all modes of variation, with no further time gain when increasing to 3 %.</p></div><div><h3>Conclusion</h3><p>A 2–3 % MC statistical uncertainty was clinically feasible. Using a 2 % uncertainty setting reduced calculation times at the cost of limited relative dose-volume differences.</p></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405631624001064/pdfft?md5=a3af17f95df925315c54d13a6b199bae&pid=1-s2.0-S2405631624001064-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Evaluating the effect of higher Monte Carlo statistical uncertainties on accumulated doses after daily adaptive fractionated radiotherapy in prostate cancer\",\"authors\":\"Thyrza Z. Jagt, Tomas M. Janssen, Jan-Jakob Sonke\",\"doi\":\"10.1016/j.phro.2024.100636\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and purpose</h3><p>Monte Carlo (MC) based dose calculations are widely used in radiotherapy with a low statistical uncertainty, being accurate but slow. Increasing the uncertainty accelerates the calculation, but reduces quality. In online adaptive planning, however, dose is recalculated every treatment fraction, potentially decreasing the cumulative calculation error. This study aimed to evaluate the effect of higher MC statistical uncertainty in the context of daily online plan adaptation.</p></div><div><h3>Materials and methods</h3><p>For twenty prostate cancer patients, daily plans were simulated for 5 fractions and three modes of variation: rigid whole body translations, local-rigid prostate translations and local-rigid prostate rotations. For each mode and fraction, adaptive plans were generated from a clinical reference plan using three MC uncertainty values: 1 % (standard), 2 % and 3 % per plan. Dose-volume criteria were evaluated for accumulated doses, checking plan acceptability and comparing higher uncertainty plans to the standard.</p></div><div><h3>Results</h3><p>Increasing the statistical uncertainty setting from 1 % to 2–3 % caused an accumulated median target D<sub>98</sub><sub>%</sub> reduction of 0.1 Gy, with interquartile ranges (IQRs) up to 0.12 Gy. Rectum V<sub>35Gy</sub> increased in median up to 0.16 cm<sup>3</sup> with IQRs up to 0.33 cm<sup>3</sup>. The bladder V<sub>28Gy</sub> and V<sub>32Gy</sub> showed median increases up to 0.24 %-point, with IQRs up to 0.54 %-point. Using 2 % uncertainty reduced calculation times by more than a minute for all modes of variation, with no further time gain when increasing to 3 %.</p></div><div><h3>Conclusion</h3><p>A 2–3 % MC statistical uncertainty was clinically feasible. Using a 2 % uncertainty setting reduced calculation times at the cost of limited relative dose-volume differences.</p></div>\",\"PeriodicalId\":36850,\"journal\":{\"name\":\"Physics and Imaging in Radiation Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2405631624001064/pdfft?md5=a3af17f95df925315c54d13a6b199bae&pid=1-s2.0-S2405631624001064-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physics and Imaging in Radiation Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405631624001064\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physics and Imaging in Radiation Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405631624001064","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Evaluating the effect of higher Monte Carlo statistical uncertainties on accumulated doses after daily adaptive fractionated radiotherapy in prostate cancer
Background and purpose
Monte Carlo (MC) based dose calculations are widely used in radiotherapy with a low statistical uncertainty, being accurate but slow. Increasing the uncertainty accelerates the calculation, but reduces quality. In online adaptive planning, however, dose is recalculated every treatment fraction, potentially decreasing the cumulative calculation error. This study aimed to evaluate the effect of higher MC statistical uncertainty in the context of daily online plan adaptation.
Materials and methods
For twenty prostate cancer patients, daily plans were simulated for 5 fractions and three modes of variation: rigid whole body translations, local-rigid prostate translations and local-rigid prostate rotations. For each mode and fraction, adaptive plans were generated from a clinical reference plan using three MC uncertainty values: 1 % (standard), 2 % and 3 % per plan. Dose-volume criteria were evaluated for accumulated doses, checking plan acceptability and comparing higher uncertainty plans to the standard.
Results
Increasing the statistical uncertainty setting from 1 % to 2–3 % caused an accumulated median target D98% reduction of 0.1 Gy, with interquartile ranges (IQRs) up to 0.12 Gy. Rectum V35Gy increased in median up to 0.16 cm3 with IQRs up to 0.33 cm3. The bladder V28Gy and V32Gy showed median increases up to 0.24 %-point, with IQRs up to 0.54 %-point. Using 2 % uncertainty reduced calculation times by more than a minute for all modes of variation, with no further time gain when increasing to 3 %.
Conclusion
A 2–3 % MC statistical uncertainty was clinically feasible. Using a 2 % uncertainty setting reduced calculation times at the cost of limited relative dose-volume differences.