TY - JOUR
T1 - Role of deformable image registration for delivered dose accumulation of adaptive external beam radiation therapy and brachytherapy in cervical cancer
AU - van Heerden, Laura E.
AU - Visser, Jorrit
AU - Koedooder, Kees
AU - Rasch, Coen R. N.
AU - Pieters, Bradley R.
AU - Bel, Arjan
PY - 2018
Y1 - 2018
N2 - Purpose: Deformable image registration (DIR) can be used to accumulate the absorbed dose distribution of daily image-guided adaptive external beam radiation treatment (EBRT) and brachytherapy (BT). Since dose-volume parameter addition assumes a uniform delivered EBRT dose around the planned BT boost, the added value of DIR over direct addition was investigated for dose accumulation in bladder and rectum. Material and methods: For 10 patients (EBRT 46/46.2 GyEQD2, EBRT + BT: D90 85-90 GyEQD2, in equivalent dose in 2 Gy fractions), the actually delivered dose from adaptive volumetric-modulated arc therapy (VMAT)/intensity-modulated radiotherapy (IMRT) EBRT was calculated using the daily anatomy from the cone-beam computed tomography (CBCT) scans acquired prior to irradiation. The CBCT of the first EBRT fraction and the BT planning MRI were registered using DIR. The cumulative dose to the 2 cm3 with the highest dose (D2cm3) from EBRT and BT to the bladder and rectum was calculated and compared to direct addition assuming a uniform EBRT dose (UD). Results: Differences (DIR-UD) in the total EBRT + BT dose ranged between –0.2-3.9 GyEQD2 (bladder) and –1.0-3.7 GyEQD2 (rectum). The total EBRT + BT dose calculated with DIR was at most 104% of the dose calculated with the UD method. Conclusions: Differences between UD and DIR were small (< 3.9 GyEQD2). The dose delivered with adaptive VMAT/IMRT EBRT to bladder and rectum near the planned BT boost can be considered uniform for the evaluation of bladder/rectum D2cm3.
AB - Purpose: Deformable image registration (DIR) can be used to accumulate the absorbed dose distribution of daily image-guided adaptive external beam radiation treatment (EBRT) and brachytherapy (BT). Since dose-volume parameter addition assumes a uniform delivered EBRT dose around the planned BT boost, the added value of DIR over direct addition was investigated for dose accumulation in bladder and rectum. Material and methods: For 10 patients (EBRT 46/46.2 GyEQD2, EBRT + BT: D90 85-90 GyEQD2, in equivalent dose in 2 Gy fractions), the actually delivered dose from adaptive volumetric-modulated arc therapy (VMAT)/intensity-modulated radiotherapy (IMRT) EBRT was calculated using the daily anatomy from the cone-beam computed tomography (CBCT) scans acquired prior to irradiation. The CBCT of the first EBRT fraction and the BT planning MRI were registered using DIR. The cumulative dose to the 2 cm3 with the highest dose (D2cm3) from EBRT and BT to the bladder and rectum was calculated and compared to direct addition assuming a uniform EBRT dose (UD). Results: Differences (DIR-UD) in the total EBRT + BT dose ranged between –0.2-3.9 GyEQD2 (bladder) and –1.0-3.7 GyEQD2 (rectum). The total EBRT + BT dose calculated with DIR was at most 104% of the dose calculated with the UD method. Conclusions: Differences between UD and DIR were small (< 3.9 GyEQD2). The dose delivered with adaptive VMAT/IMRT EBRT to bladder and rectum near the planned BT boost can be considered uniform for the evaluation of bladder/rectum D2cm3.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85060081398&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30662477
U2 - https://doi.org/10.5114/jcb.2018.79840
DO - https://doi.org/10.5114/jcb.2018.79840
M3 - Article
C2 - 30662477
SN - 1689-832X
VL - 10
SP - 542
EP - 550
JO - Journal of contemporary brachytherapy
JF - Journal of contemporary brachytherapy
IS - 6
ER -