PMID- 37488951
OWN - NLM
STAT- MEDLINE
DCOM- 20230927
LR  - 20230927
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 62
IP  - 8
DP  - 2023 Aug
TI  - CBCT-based deformable dose accumulation of external beam radiotherapy in cervical 
      cancer.
PG  - 923-931
LID - 10.1080/0284186X.2023.2238543 [doi]
AB  - Background: Delivered radiotherapy doses do not exactly match those planned for a 
      course of treatment, largely due to inter-fraction changes in anatomy. In this 
      study, accumulated delivered dose was calculated for a sample of cervical cancer 
      patients, by deformably registering daily cone beam computed tomography (CBCT) 
      images to the planning computed tomography (CT) scan. Planned and accumulated 
      doses were compared for the clinical target volume (CTV), bladder, and 
      rectum.Material and Methods: For 10 patients receiving 45 Gy in 25 fractions of 
      external beam radiotherapy, daily dose distributions were calculated on CBCT. 
      These images were deformed onto the planning CT and the dose was accumulated 
      using Velocity 4.1 (Varian Medical Systems, Palo Alto, USA). The quality of 
      deformable image registration was evaluated visually and by calculating Dice 
      similarity coefficients and mean distance to agreement.Results: V95%>99% was 
      achieved for the primary CTV in 9/10 patients for the planned dose distribution 
      and 7/10 patients for the accumulated dose distribution. Primary CTV coverage by 
      95% of the prescription dose was reduced in one patient, due to an increase in 
      anterior-posterior separation. Comparison of planned and accumulated dose volume 
      histograms (DVHs) for the bladder and rectum found agreement within 5% at low and 
      intermediate doses, but differences exceeded 20% at higher doses. Direct addition 
      of CBCT DVHs was seen to be a poor estimate for the accumulated DVH at higher 
      doses.Conclusion: Computation of delivered radiotherapy dose that accounts for 
      inter-fraction anatomical changes is important for establishing dose-effect 
      relationships. Updating delivered dose distributions after each fraction would 
      support informed clinical decision making on any potential treatment 
      interventions.
FAU - Fischer, Andrea M
AU  - Fischer AM
AD  - Mount Vernon Cancer Centre, Northwood, UK.
FAU - Hague, Thomas
AU  - Hague T
AD  - Mount Vernon Cancer Centre, Northwood, UK.
FAU - Hoskin, Peter J
AU  - Hoskin PJ
AD  - Mount Vernon Cancer Centre, Northwood, UK.
AD  - Division of Cancer Sciences, Faculty of Biology Medicine and Health, University 
      of Manchester, Manchester, UK.
LA  - eng
PT  - Journal Article
DEP - 20230724
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
SB  - IM
MH  - Female
MH  - Humans
MH  - *Uterine Cervical Neoplasms/diagnostic imaging/radiotherapy
MH  - Radiotherapy Dosage
MH  - *Spiral Cone-Beam Computed Tomography
MH  - Cone-Beam Computed Tomography/methods
MH  - Tomography, X-Ray Computed
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Radiotherapy, Intensity-Modulated/methods
OTO - NOTNLM
OT  - Deformable image registration
OT  - cervical cancer
OT  - dose accumulation
OT  - external beam radiotherapy
EDAT- 2023/07/25 06:43
MHDA- 2023/09/27 06:42
CRDT- 2023/07/25 02:16
PHST- 2023/09/27 06:42 [medline]
PHST- 2023/07/25 06:43 [pubmed]
PHST- 2023/07/25 02:16 [entrez]
AID - 10.1080/0284186X.2023.2238543 [doi]
PST - ppublish
SO  - Acta Oncol. 2023 Aug;62(8):923-931. doi: 10.1080/0284186X.2023.2238543. Epub 2023 
      Jul 24.