ArticleJournal of applied clinical medical physics2018
Online daily assessment of dose change in head and neck radiotherapy without dose-recalculation.
Article in Journal of applied clinical medical physics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Evaluating the Necessity of Adaptive RT and the Role of Deformable Image Registration in Lung Cancer with Different Pathologic Classifications.Diagnostics (Basel, Switzerland) · 2023Article
- Deterioration of Intended Target Volume Radiation Dose Due to Anatomical Changes in Patients with Head-and-Neck Cancer.Cancers · 2021Article
- Alert system for monitoring changes in patient anatomy during radiation therapy of head and neck cancer.Journal of applied clinical medical physics · 2021Article
- Adaptive radiotherapy for head and neck cancer.Cancers of the head & neck · 2020Review
- Adaptive radiotherapy for head and neck cancer reduces the requirement for rescans during treatment due to spinal cord dose.Radiation oncology (London, England) · 2019Article
- Comparison of Three Commercial Methods of Cone-Beam Computed Tomography-Based Dosimetric Analysis of Head-and-Neck Patients with Weight Loss.Journal of medical physicsArticle
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Authors and funding
4 authors.
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Abstract
backgroundHead and neck cancers are commonly treated with radiation therapy, but due to possible volume changes, plan adaptation may be required during the course of treatment. Currently, plan adaptations consume significant clinical resources. Existing methods to evaluate the need for plan adaptation requires deformable image registration (DIR) to a new CT simulation or daily cone beam CT (CBCT) images and the recalculation of the dose distribution. In this study, we explore a tool to assist the decision for plan adaptation using a CBCT without re-computation of dose, allowing for rapid online assessment.
methodsThis study involved 18 head and neck cancer patients treated with CBCT image guidance who had their treatment plan modified based on a new CT simulation (ReCT). Dose changes were estimated using different methods and compared to the current gold standard of using DIR between the planning CT scan (PCT) and ReCT with recomputed dose. The first and second methods used DIR between the PCT and daily CBCT with the planned dose or recalculated dose from the ReCT respectively, with the dose transferred to the CBCT using rigid registration. The necessity of plan adaptation was assessed by the change in dose to 95% of the planning target volume (D95) and mean dose to the parotids.
resultsThe treatment plans were adapted clinically for all 18 patients but only 7 actually needed an adaptation yielding 11 unnecessary adaptations. Applying a method using the daily CBCT with the planned dose distribution would have yielded only four unnecessary adaptations and no missed adaptations: a significant improvement from that done clinically.
conclusionUsing the DIR between the planning CT and daily CBCT can flag cases for plan adaptation before every fraction while not requiring a new re-planning CT scan and dose recalculation.
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