ArticleJournal of applied clinical medical physics2019
Evaluation of a simplified optimizer for MR-guided adaptive RT in case of pancreatic cancer.
Article in Journal of applied clinical medical physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- MRI-guided stereotactic body radiation therapy for very elderly patients with primary lung cancer: a retrospective analysis of safety and efficacy profiles.La Radiologia medica · 2025Article
- Delta Radiomics Analysis for Local Control Prediction in Pancreatic Cancer Patients Treated Using Magnetic Resonance Guided Radiotherapy.Diagnostics (Basel, Switzerland) · 2021Article
- Role of MRI-Based Functional Imaging in Improving the Therapeutic Index of Radiotherapy in Cancer Treatment.Frontiers in oncology · 2021Review
- A prospective trial of stereotactic body radiation therapy for unresectable pancreatic cancer testing ablative doses.Journal of gastrointestinal oncology · 2020Article
- Case Report: First in Human Online Adaptive MR Guided SBRT of Peritoneal Carcinomatosis Nodules: A New Therapeutic Approach for the Oligo-Metastatic Patient.Frontiers in oncology · 2020Article
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Authors and funding
13 authors.
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Abstract
purposeMagnetic resonance-guided adaptive radiotherapy (MRgART) is considered a promising resource for pancreatic cancer, as it allows to online modify the dose distribution according to daily anatomy. This study aims to compare the dosimetric performance of a simplified optimizer implemented on a MR-Linac treatment planning system (TPS) with those obtained using an advanced optimizer implemented on a conventional Linac.
methodsTwenty patients affected by locally advanced pancreatic cancer (LAPC) were considered. Gross tumor volume (GTV) and surrounding organ at risks (OARs) were contoured on the average 4DCT scan. Planning target volume was generated from GTV by adding an isotropic 3 mm margin and excluding overlap areas with OARs. Treatment plans were generated by using the simple optimizer for the MR-Linac in intensity-modulated radiation therapy (IMRT) and the advanced optimizer for conventional Linac in IMRT and volumetric modulated arc therapy (VMAT) technique. Prescription dose was 40 Gy in five fractions. The dosimetric comparison was performed on target coverage, dosimetric indicators, and low dose diffusion.
resultsThe simplified optimizer of MR-Linac generated clinically acceptable plans in 80% and optimal plans in 55% of cases. The number of clinically acceptable plans obtained using the advanced optimizer of the conventional Linac with IMRT was the same of MR-Linac, but the percentage of optimal plans was higher (65%). Using the VMAT technique, it is possible to obtain clinically acceptable plan in 95% and optimal plans in 90% of cases. The advanced optimizer combined with VMAT technique ensures higher target dose homogeneity and minor diffusion of low doses, but its actual optimization time is not suitable for MRgART.
conclusionSimplified optimization solutions implemented in the MR-Linac TPS allows to elaborate in most of cases treatment plans dosimetrically comparable with those obtained by using an advanced optimizer. A superior treatment plan quality is possible using the VMAT technique that could represent a breakthrough for the MRgART if the modern advancements will lead to shorter optimization times.
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