PMID- 37348607
OWN - NLM
STAT- MEDLINE
DCOM- 20230821
LR  - 20230821
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 186
DP  - 2023 Sep
TI  - Comparing adaptation strategies in MRI-guided online adaptive radiotherapy for 
      prostate cancer: Implications for treatment margins.
PG  - 109761
LID - S0167-8140(23)00299-2 [pii]
LID - 10.1016/j.radonc.2023.109761 [doi]
AB  - PURPOSE: To quantify the difference in accuracy of adapt-to-position (ATP), 
      adapt-to-rotation (ATR) and adapt-to-shape (ATS) workflows used in MRI-guided 
      online adaptive radiotherapy for prostate carcinoma (PCa) by evaluating the 
      margins required to accommodate intra-fraction motion of the clinical target 
      volumes for prostate (CTVpros), prostate including seminal vesicles 
      (CTVpros + sv) and gross tumor volume (GTV). MATERIALS AND METHODS: Clinical 
      delineations of the CTVpros, CTVpros + sv and GTV of 24 patients with 
      intermediate- and high-risk PCa, treated using ATS on a 1.5 T MR-Linac, were used 
      for analysis. Delineations were available pre- and during beam-on. To simulate 
      ATP and ATR workflows, we automatically generated the structures associated with 
      these workflows using rigid transformations from the planning-MRI to the daily 
      online MRIs. Clinical GTVs were analyzed as ATR GTVs and only ATP GTVs were 
      simulated. Planning target volumes (PTVs) were generated with isotropic margins 
      ranging 0.0-5.0 mm. The volumetric overlap was calculated between these PTVs and 
      their corresponding clinical delineation on the MRI acquired during beam-on and 
      averaged over all treatment fractions. RESULTS: The PTV margin required to 
      cover > 95% of the CTVpros was equal (2.5 mm) for all workflows. For the 
      CTVpros + sv, this margin increased to 5.0, 4.0 and 3.5 mm in the ATP, ATR and 
      ATS workflow, respectively. GTV coverage improved from ATP to ATR for margins up 
      to 4.0 mm. CONCLUSION: ATP, ATR and ATS workflows ensure equal coverage of the 
      CTVpros for the current clinical margins. For the CTVpros + sv, ATS showed 
      optimal performance. GTV coverage improves by additional adaptations to prostate 
      rotations.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier B.V. All rights reserved.
FAU - Dassen, Mathijs G
AU  - Dassen MG
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, 
      the Netherlands. Electronic address: t.dassen@nki.nl.
FAU - Janssen, Tomas
AU  - Janssen T
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, 
      the Netherlands.
FAU - Kusters, Martijn
AU  - Kusters M
AD  - Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, 
      the Netherlands.
FAU - Pos, Floris
AU  - Pos F
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, 
      the Netherlands.
FAU - Kerkmeijer, Linda G W
AU  - Kerkmeijer LGW
AD  - Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, 
      the Netherlands.
FAU - van der Heide, Uulke A
AU  - van der Heide UA
AD  - Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, 
      the Netherlands.
FAU - van der Bijl, Erik
AU  - van der Bijl E
AD  - Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, 
      the Netherlands. Electronic address: erik.vanderbijl@radboudumc.nl.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230620
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
RN  - 8L70Q75FXE (Adenosine Triphosphate)
SB  - IM
MH  - Male
MH  - Humans
MH  - *Radiotherapy Planning, Computer-Assisted
MH  - *Prostatic Neoplasms/diagnostic imaging/radiotherapy/pathology
MH  - Prostate/pathology
MH  - Magnetic Resonance Imaging
MH  - Adenosine Triphosphate
MH  - Radiotherapy Dosage
OTO - NOTNLM
OT  - Intra-fraction motion
OT  - MRI-guided
OT  - Margins
OT  - Online adaptive radiotherapy
OT  - Prostate cancer
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/06/23 01:10
MHDA- 2023/08/21 06:43
CRDT- 2023/06/22 19:13
PHST- 2023/01/11 00:00 [received]
PHST- 2023/05/26 00:00 [revised]
PHST- 2023/06/15 00:00 [accepted]
PHST- 2023/08/21 06:43 [medline]
PHST- 2023/06/23 01:10 [pubmed]
PHST- 2023/06/22 19:13 [entrez]
AID - S0167-8140(23)00299-2 [pii]
AID - 10.1016/j.radonc.2023.109761 [doi]
PST - ppublish
SO  - Radiother Oncol. 2023 Sep;186:109761. doi: 10.1016/j.radonc.2023.109761. Epub 
      2023 Jun 20.