PMID- 36538287
OWN - NLM
STAT- MEDLINE
DCOM- 20221222
LR  - 20230213
IS  - 1361-6560 (Electronic)
IS  - 0031-9155 (Linking)
VI  - 68
IP  - 1
DP  - 2022 Dec 20
TI  - Detailed dosimetric evaluation of inter-fraction and respiratory motion in lung 
      stereotactic body radiation therapy based on daily 4D cone beam CT images.
LID - 10.1088/1361-6560/aca94d [doi]
AB  - Objective. Periodic respiratory motion and inter-fraction variations are sources 
      of geometric uncertainty in stereotactic body radiation therapy (SBRT) of 
      pulmonary lesions. This study extensively evaluates and validates the separate 
      and combined dosimetric effect of both factors using 4D-CT and daily 4D-cone beam 
      CT (CBCT) dose accumulation scenarios.Approach. A first cohort of twenty early 
      stage or metastatic disease lung cancer patients were retrospectively selected to 
      evaluate each scenario. The planned-dose (3D(Ref)) was optimized on a 3D 
      mid-position CT. To estimate the dosimetric impact of respiratory motion 
      (4D(Ref)), inter-fractional variations (3D(Acc)) and the combined effect of both 
      factors (4D(Acc)), three dose accumulation scenarios based on 4D-CT, daily 
      mid-cone beam CT (CBCT) position and 4D-CBCT were implemented via CT-CT/CT-CBCT 
      deformable image registration (DIR) techniques. Each scenario was compared to 
      3D(Ref.)A separate cohort of ten lung SBRT patients was selected to validate DIR 
      techniques. The distance discordance metric (DDM) was implemented per voxel and 
      per patient for tumor and organs at risk (OARs), and the dosimetric impact for 
      CT-CBCT DIR geometric errors was calculated.Main results.Median and interquartile 
      range (IQR) of the dose difference per voxel were 0.05/2.69 Gy and -0.12/2.68 Gy 
      for3DAcc-3DRefand4DAcc-3DRef.For4DRef-3DRefthe IQR was considerably smaller 
      -0.15/0.78 Gy. These findings were confirmed by dose volume histogram parameters 
      calculated in tumor and OARs. For CT-CT/CT-CBCT DIR validation, DDM (95th 
      percentile) was highest for heart (6.26 mm)/spinal cord (8.00 mm), and below 3 mm 
      for tumor and the rest of OARs. The dosimetric impact of CT-CBCT DIR errors was 
      below 2 Gy for tumor and OARs.Significance. The dosimetric impact of 
      inter-fraction variations were shown to dominate those of periodic respiration in 
      SBRT for pulmonary lesions. Therefore, treatment evaluation and dose-effect 
      studies would benefit more from dose accumulation focusing on day-to-day changes 
      then those that focus on respiratory motion.
CI  - (c) 2022 Institute of Physics and Engineering in Medicine.
FAU - Huesa-Berral, Carlos
AU  - Huesa-Berral C
AUID- ORCID: 0000-0003-2290-0176
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 
      121, 1066 CX Amsterdam, The Netherlands.
AD  - Physics and Applied Mathematics, School of Science, University of Navarra, 
      E-31008 Pamplona, Navarra, Spain.
AD  - Service of Radiation Physics and Radiation Protection, University of Navarra 
      Clinic, E-31008 Pamplona, Navarra, Spain.
FAU - Juan-Cruz, Celia
AU  - Juan-Cruz C
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 
      121, 1066 CX Amsterdam, The Netherlands.
FAU - van Kranen, Simon
AU  - van Kranen S
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 
      121, 1066 CX Amsterdam, The Netherlands.
FAU - Rossi, Maddalena
AU  - Rossi M
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 
      121, 1066 CX Amsterdam, The Netherlands.
FAU - Belderbos, Jose
AU  - Belderbos J
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 
      121, 1066 CX Amsterdam, The Netherlands.
FAU - Diego Azcona, Juan
AU  - Diego Azcona J
AUID- ORCID: 0000-0001-7242-4169
AD  - Service of Radiation Physics and Radiation Protection, University of Navarra 
      Clinic, E-31008 Pamplona, Navarra, Spain.
FAU - Burguete, Javier
AU  - Burguete J
AD  - Physics and Applied Mathematics, School of Science, University of Navarra, 
      E-31008 Pamplona, Navarra, Spain.
FAU - Sonke, Jan-Jakob
AU  - Sonke JJ
AUID- ORCID: 0000-0001-5155-5274
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 
      121, 1066 CX Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221220
PL  - England
TA  - Phys Med Biol
JT  - Physics in medicine and biology
JID - 0401220
SB  - IM
MH  - Humans
MH  - *Radiosurgery/methods
MH  - Radiotherapy Dosage
MH  - Retrospective Studies
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Lung Neoplasms/diagnostic imaging/radiotherapy/pathology
MH  - Lung/pathology
MH  - Four-Dimensional Computed Tomography/methods
MH  - Cone-Beam Computed Tomography/methods
OTO - NOTNLM
OT  - 4D-CBCT
OT  - daily dose calculation
OT  - deformable image registration
OT  - inter-fractional anatomical variations
OT  - respiratory motion
EDAT- 2022/12/21 06:00
MHDA- 2022/12/23 06:00
CRDT- 2022/12/20 11:22
PHST- 2022/07/26 00:00 [received]
PHST- 2022/12/06 00:00 [accepted]
PHST- 2022/12/20 11:22 [entrez]
PHST- 2022/12/21 06:00 [pubmed]
PHST- 2022/12/23 06:00 [medline]
AID - 10.1088/1361-6560/aca94d [doi]
PST - epublish
SO  - Phys Med Biol. 2022 Dec 20;68(1). doi: 10.1088/1361-6560/aca94d.