Comparison of image-based three-dimensional treatment planning using AcurosTM BV and AAPM TG-43 algorithm for intracavitary brachytherapy of carcinoma cervix

2016 ◽  
Vol 15 (3) ◽  
pp. 254-262 ◽  
Author(s):  
Mourougan Sinnatamby ◽  
Vivekanandan Nagarajan ◽  
K S. Reddy ◽  
Gunaseelan Karunanidhi ◽  
Vivekanandam Singhavajala
Keyword(s):  
Treatment Planning ◽  
Organs At Risk ◽  
Three Dimensional ◽  
Tumour Volume ◽  
Target Volume ◽  
Mean Value ◽  
Intracavitary Brachytherapy ◽  
Carcinoma Cervix ◽  
Significant Difference ◽  
The Mean

AbstractAimTo compare the image-based three-dimensional treatment planning using AcurosTM BV and AAPM TG-43 algorithm for intracavitary brachytherapy of carcinoma cervix.Materials and methodsTwenty-seven patients with cancer cervix, stage IIB or IIIB with vaginal involvement limited to the upper third of the vagina was included into the study. Intracavitary treatments with the patient in this study done with computed tomography and magnetic resonance imaging compatible ring applicator. Groupe European de Curietherapie and European Society for Therapeutic Radiology and Oncology recommended doses to target volumes and organs at risk compared using dose volume histogram.ResultsThe mean value of Point ‘A’ dose was compared between AcurosTM BV and TG-43, which indicates 0·13% difference. The differences in the mean dose to gross tumour volume for various volumes are V100% 0·28%, V150% 1·22% and V200% 1·03%; all volumes showed small difference but statistical significant (p<0·05). The mean dose of high-risk clinical target volume (HRCTV) D90 using AcurosTM BV was 8·47 Gy, which was 1·63% less compared with TG-43. The mean point A dose using AcurosTM BV is 1·04 times the dose to D90 of mean HRCTV. The same difference was observed in comparison with TG43. D2cc and D0·1cc of the bladder, rectum and sigmoid showed a statistically significant difference (p<0·05) in comparison with TG-43.ConclusionThe differences in dosimetric parameters between the AcurosTM BV and TG-43 proved to be statistically significant. The difference is very small, and they are clinically insignificant.

scholarly journals Evaluation of Volumetric Doses of Organs at Risk in Carcinoma Cervix Patients with HDR Intracavitary Brachytherapy and Comparison of CTbased and Conventional Plans

2019 ◽  
Author(s):  
S Srivastava ◽  
N K Painuly ◽  
S P Mishra ◽  
K Srivastava ◽  
N Singh ◽  
...  
Keyword(s):  
At Risk ◽  
Treatment Planning ◽  
Organs At Risk ◽  
Treatment Plan ◽  
Dose Assessment ◽  
Intracavitary Brachytherapy ◽  
Cervix Carcinoma ◽  
Carcinoma Cervix ◽  
Significant Difference ◽  
True Representation

Background: Brachytherapy treatment planning in cervix carcinoma patients using two dimensional (2D) orthogonal images provides only point dose estimates while CT-based planning provides volumetric dose assessment helping in understanding the correlation between morbidity and the dose to organs at risk (OARs) and treatment volume.Objective: Aim of present study is to compare International Commission on Radiation Units and Measurements Report 38 (ICRU 38) reference point doses to OARs with volumetric doses using 2D images and CT images in patients with cervical cancer.Material and Methods: In this prospective study, 20 patients with cervical cancer stages (IIB-IIIB) were planned for a brachytherapy dose of 7Gy per fraction for three fractions using 2D image-based treatment plan and CT-based plan. ICRU 38 points for bladder and rectum were identified on both 2D image-based plan and CT-based plan and doses (DICRU) at these points were compared to the minimum dose to 2cc volume (D2cc) of bladder and rectum receiving the highest dose.Results: D2cc bladder dose was 1.60 (±0.67) times more than DICRUb bladder dose whereas D2cc rectum dose was 1.13±0.40 times DICRUr. Significant difference was found between DICRUb and D2cc dose for bladder (p=.0.016) while no significant difference was seen between DICRUr and D2cc dose for rectum (p=0.964).Conclusion: The study suggests that ICRU 38 point doses are not the true representation of maximum doses to OARs. CT-based treatment planning is more a reliable tool for OAR dose assessment than the conventional 2D radiograph-based plan.

scholarly journals Doses to Organs at Risk Calculated Using Plato and Oncentra Softwares in Intracavitary Brachytherapy

2021 ◽  
Vol 19 (01) ◽  
pp. 117-126
Author(s):  
NOR HAFIZAH ABDULLAH ◽  
REDUAN ABDULLAH ◽  
MAZURAWATI MOHAMAD ◽  
AHMAD ZAKARIA ◽  
CHIANG CHEN SUK
Keyword(s):  
At Risk ◽  
Treatment Planning ◽  
Organs At Risk ◽  
Intracavitary Brachytherapy ◽  
Planning Systems ◽  
Organ Doses ◽  
Independent Verification ◽  
Treatment Planning Systems ◽  
Significant Difference ◽  
The Mean

This is a retrospective study, the organ doses to the bladder and rectum were compared between Nucletron PLATO V14.2.3 (BV) and newer version software Oncentra MasterPlan V4.3 (OMP) treatment planning systems (TPS). The treatment data of 32 intracavitary brachytherapy patients at Hospital Universiti Sains Malaysia from January 2010 to June 2015 were used. These data sets were used for catheter reconstruction for both PLATO and OMP TPS followed by independent verification using Excel. There is no significant difference in mean doses to organs at risk (OARs) that calculated by both TPS (p>0.05). The mean percentage of doses calculated by PLATO TPS for bladder and rectum were 66.58 ± 27.42 % and 46.27 ± 14.47 % respectively. While the mean percentage of doses for bladder and rectum calculated by OMP TPS were 65.68 ± 24.24 % and 46.46 ± 16.66 respectively. The mean percentage difference in doses comparison between independent verification calculation and PLATO TPS was 1.96 ± 6.00% and then became 6.37 ± 5.17% when it was compared with OMP TPS. Overall, the dose calculation differences for both versions of TPS were within the range recommended by Nuclear Regulatory Commission (NRC). The dose calculations of the two treatment planning systems showed good agreement and both could be used in planning intracavitary brachytherapy for cervical cancer. Whereas Excel based independent verification suitable to be implemented as routine dose verification programme prior to treatment delivery.

scholarly journals Wits Appraisal of a Qatari Male Population: A Comparative Study. Part II

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Hayder A. Hashim ◽  
Najat Al-Sayed ◽  
Ayah AL-Qaisi
Keyword(s):  
Three Dimensional ◽  
Mean Value ◽  
Cone Beam ◽  
Facial Appearance ◽  
Male Population ◽  
Significant Difference ◽  
The Mean ◽  
Age Range ◽  
Relationship Of ◽  
Gender Specific

Introduction: Cephalometric analysis aims to determine skeletal and dental relationships. The ANB angle, initially suggested by Rediel and applied by Steiner. is the most used angle in establishing the anteroposterior relationship of the mandible to the maxilla. However, limitations to the accuracy of the ANB angle for this purpose have been reported. To avoid these potential sources of inaccuracy a diagnostic tool was introduced by Jenkins and later modified by Jacobson and became known as the “Wits appraisal”. Aims: The aim of this study was to establish the Wits appraisal value in a sample of Qatari males, a group which had not previously been studied in this context, and to compare the findings with those from racially and ethnically differing groups as reported in the literature. Materials and Methods: The sample consisted of 28 lateral cephalometric radiographs of Qatari males with an age range of 15 to 32 years, presenting with a well-balanced facial appearance and an acceptable profile. Results: The mean value of the Wits appraisal for Qatari males in the present study was 0.50 ± 2.96. This differed at a statistically significant level from the mean value in the Jacobson study with no gender significant difference noted. On the other hand, significant differences were found when compared with previous reports on different races. Conclusion: The Wits appraisal value for the Qatari male population studied was 0.5±2.96, a result which is significantly higher than that reported in Jacobson’s study. This study revealed that the Wits appraisal is not ethnicity or gender-specific, and therefore cannot be used to differentiate between different ethnic groups. However, it can find application as an alternative to the ANB angle in the treatment of borderline cases. The application of cone beam computed tomography (CBCT) will enhance the diagnosis and treatment of cases by yielding three-dimensional views.

scholarly journals Comparison of Valgus Correction Angle between Patients with Developmental Dysplasia Hip and Normal Volunteers Measured by Three-Dimensional Reconstruction and X-Ray

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Aobo Zhang ◽  
Qing Han ◽  
Bingpeng Chen ◽  
Chenyu Wang ◽  
Xue Zhao ◽  
...  
Keyword(s):  
3D Reconstruction ◽  
Three Dimensional ◽  
Mean Value ◽  
Normal Group ◽  
Correction Angle ◽  
X Ray ◽  
Normal Volunteers ◽  
Significant Difference ◽  
The Mean ◽  
Valgus Correction Angle

Background and purpose. A new method of three-dimensional (3D) reconstruction technology was used to take place of X-ray in measuring valgus correction angle (VCA) of both DDH patients and normal volunteers to improve precision. Two different ways to define VCA according to the various conditions of patients were compared and analyzed. Methods. Bilateral VCA of 50 DDH patients and 56 normal volunteers were measured by Mimics software in the 3D method and X-ray in 2D. Two VCA (the upper VCA and the lower VCA) were measured in both two methods. Every VCA was measured by observer A and observer B for twice separately. The statistical analyses of the differences were calculated among the measurements of the VCA. Results. The mean value of the upper VCA measured in 3D was 4.95°±0.76° in DDH group and 5.56°±0.62° in the normal group with significant difference (t=−6.457, p<0.01). The VCA of DDH group and normal group measured by 3D was larger than 2D, both the upper VCA and the lower VCA. The differences indicated statistically significant. The mean value of lower VCA was 0.60° smaller than the mean value of upper VCA in normal volunteers. The mean value of the lower VCA was 0.58° larger than the mean value of the upper VCA in DDH patients. Conclusions. Compared to X-ray, 3D reconstruction technology is more accurate without conventional limitations. The lower VCA of DDH patients should be regarded as the femoral intramedullary guide angle in TKA, especially for patients with femoral deformities.

scholarly journals Intra-fractional dosimetric analysis of image-guided intracavitary brachytherapy of cervical cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Junfang Yan ◽  
Jiawei Zhu ◽  
Kai Chen ◽  
Lang Yu ◽  
Fuquan Zhang
Keyword(s):  
Cervical Cancer ◽  
Treatment Planning ◽  
Organs At Risk ◽  
Cone Beam Ct ◽  
Ct Scanning ◽  
Target Volume ◽  
High Dose Rate ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Image Guided

Abstract Background To assess the intra-fractional dosimetric variations of image-guided brachytherapy of cervical cancer. Methods A total of 38 fractions (9 patients) undergoing brachytherapy for cervical cancer underwent a CT scanning for treatment planning (planning CT) and a Cone-beam CT (CBCT) scanning immediately prior to delivery (pre-delivery CBCT). The variations of volumes as well as the dosimetric impact from treatment planning to delivery (intra-application) were evaluated. The dose volume histogram parameters including volume, D90 of high-risk clinical target volume (HRCTV) and D2cc of organs at risk (OARs) were recorded. Results The relative differences (mean ± 1SD) of the volume and D90 HRCTV across the two scans were − 2.0 ± 3.3% and − 1.2 ± 4.5%, respectively. The variations of D2cc for bladder, rectum, sigmoid and small intestine are − 0.6 ± 17.1%, 9.3 ± 14.6%, 7.2% ± 20.5% and 1.5 ± 12.6%, respectively. Most of them are statistically nonsignificant except the D2cc for rectum, which showed a significant increase (P = 0.001). Using 5% and 10% uncertainty of physical dose for HRCTV at a 6 Gy × 5 high-dose-rate schedule, the possibility of total equivalent doses in 2 Gy fractions (EQD2) lower than 85 Gy is close to 0% and 3%, respectively. Performing similar simulation at 15% and 20% uncertainty of a 4 Gy physical dose for OARs, the possibility of total EQD2 dose exceeding 75 Gy is about 70%. Less than 1% of the total EQD2 of OARs would exceed 80 Gy. Conclusions Average intra-fractional dosimetric variation of HRCTV was small in an interval of less than 1 h, and the possibility of total EQD2 exceeding 85 Gy is higher than 97%. The intra-fractional dosimetric variations of OARs might result in an overdose for OARs in a single fraction or the whole treatment. It is necessary to detect unfavorable anatomical changes by re-imaging and take interventions to minimize applied doses and reduce the risk of complications.

Comparative dosimetry of brachytherapy treatment planning between a volume-based plan by CT and a point-based plan by TAUS in CT datasets for brachytherapy

2021 ◽  
pp. 1-8
Author(s):  
Chaiyaporn Pintakham ◽  
Ekkasit Tharavichitkul ◽  
Somsak Wanwilairat ◽  
Wannapha Nobnop
Keyword(s):  
At Risk ◽  
Treatment Planning ◽  
Sigmoid Colon ◽  
Clinical Target Volume ◽  
Organs At Risk ◽  
Target Volume ◽  
Reference Points ◽  
Uterine Perforation ◽  
Target Dose ◽  
The Mean

Abstract Aim: To evaluate comparative dosimetry of brachytherapy treatment planning between a volume-based plan by computed tomography (CT) and a point-based plan by transabdominal ultrasound (TAUS) in CT datasets for brachytherapy. Materials and methods: From 2019 to 2021, 59 different datasets of CT images were collected from 38 patients treated by intracavitary brachytherapy with tandem ovoid or tandem ring applicators. At that time, TAUS was performed to prevent uterine perforation and to evaluate topography of the cervix during application. In volume-based planning by CT, the target dose was used to keep the dose at 90% of high-risk clinical target volume (HR-CTV), to give a dose of at least 7Gy, while in the point-based plan by TAUS, the target dose was used to keep the minimum dose to eight cervix reference points (measured by TAUS), to give a dose of at least 7Gy. The doses to targets and organs at risk were evaluated and compared between volume-based planning by CT and the point-based plan by TAUS. Results: Of 59 fractions, a tandem ovoid applicator was used in 48 fractions (81·3%). In the volume-based plan by CT, the mean doses to HR-CTV(D90), intermediate-risk clinical target volume (IR-CTV)(D90), bladder(D2cc), rectum(D2cc) and sigmoid colon(D2cc) were 7·0, 3·9, 4·9, 2·9 and 3·3 Gy, respectively, while in the point-based plan by TAUS, the mean doses to HR-CTV(D90), IR-CTV(D90), bladder(D2cc), rectum(D2cc) and sigmoid colon(D2cc) were 8·2, 4·6, 5·9, 3·4 and 3·9 Gy, respectively. The percentages of mean dose differences between TAUS and CT of HR-CTV(D90), IR-CTV(D90), bladder(D2cc), rectum(D2cc) and sigmoid colon(D2cc) were 17·7, 19·5, 20·5, 19·5, 21·3 and 19·8%, respectively. With the target dose to the point-based plan by TAUS (7 Gy to the cervix reference points), this was close to D98 of HR-CTV with a mean percentage of difference of 0·6%. Findings: The point-based plan by TAUS showed higher values to targets and organs at risk than the volume-based plan by CT. With the point-based plan by TAUS, it was close to D98 of HR-CTV.

Clinical dosimetry optimization in spinal metastases

2009 ◽  
Vol 8 (1) ◽  
pp. 35-40
Author(s):  
P. Pedrosa ◽  
C. Lucena ◽  
I.J. Sainz
Keyword(s):  
Organs At Risk ◽  
Three Dimensional ◽  
Spinal Metastases ◽  
Target Volume ◽  
The Body ◽  
High Dose ◽  
Prescription Dose ◽  
The Mean ◽  
Posterior Anterior ◽  
Anterior Posterior

AbstractIntroduction: Radiotherapy is commonly used to treat spinal metastases. The aim of this study was to compare conventional dosimetry (posterior–anterior fields) with an optimized three-dimensional conformal plan (using oblique fields).Material and Methods: Fifteen patients were selected, and split into three groups of five based on tumour localization: cervical, dorsal and lumbar. Reference planning comprised of two fields: anterior–posterior. The planning target volume (PTV) was covered with 90% of the prescribed doses, minimizing anterior field weight and not exceeding 120%. The alternative consisted of three fields: two oblique posterior fields with wedge and anterior field. The PTV was covered with 95% of the prescription dose, minimizing the anterior field weight with 107% of overdose as a limit. The patient received 8 Gy in one fraction; retreatment with an additional fraction was feasible, safe and effective if persistent or recurrent bone pain was present. Five fractions of 4 Gy were used for cervical cases. To consider the future patients toxicity we evaluated the mean dose, V90 and V70 parameters in each plan.Results: Dosimetric parameters of organs at risk were not significantly different from one trial to another. The optimized plan followed ICRU criteria, reaching PTV coverage of 95–107% range of the prescription dose. In the conventional plan, high dose had to be accepted to obtain 90% of coverage in the target.Conclusions: In contrast with the anterior–posterior configuration, oblique fields improve dose conformity and limit high dose all of the body except the spinal cord.

Impact of CT-based planning and bladder volume changes on the dosimetry of vaginal vault brachytherapy

2021 ◽  
pp. 1-7
Author(s):  
Jeyaanth Venkatasai ◽  
Jebakarunya Ramireddy ◽  
Arvind Sathyamurthy ◽  
Henry Finlay Godson ◽  
Reka Karuppusami ◽  
...  
Keyword(s):  
Clinical Target Volume ◽  
Organs At Risk ◽  
Three Dimensional ◽  
Target Volume ◽  
Bladder Distension ◽  
Full Bladder ◽  
The Mean ◽  
2D And 3D ◽  
Planning Ct ◽  
Empty Bladder

Abstract Aim: To compare dose to target and organs at risk (OARs) in conventional plan (2D) versus computed tomography (CT)-based three-dimensional (3D) plan in vaginal cuff brachytherapy (VBT) and to compare the effect of bladder distension on target and OARs dosimetry. Materials and methods: Post-hysterectomy patients with an indication for VBT were included in the study. All patients underwent planning CT scans with a full bladder and an empty bladder protocol. For each CT, two plans were generated—one library-based 2D plan and another CT-based 3D plan. Dosimetric parameters were recorded for clinical target volume (CTV) and OARs. Results: A total of 92 observations were made from data collected from 46 patients. Difference between CTV dose in terms of 2D and 3D plans were not statistically significant for CTV (p = 0·11). Significant reduction in D0·1cc, D1cc and D2cc dose parameters were observed in bladder, rectum, sigmoid and bowel doses with the 3D plan (p < 0·001). Bladder distension showed a 20% reduction in dose for bowel (p < 0·001). Bladder distension also showed a 6·12% (p = 0·047) increase in D2cc, but there was a significant reduction in the mean dose to the bladder. Conclusion: Our study demonstrates the dosimetric benefits with 3D CT-based planning for VBT over 2D-based conventional planning and benefit of bladder distension in the reduction of bowel dose without compromising dose to the target volume.

scholarly journals Independent verification of treatment planning system calculations

Nukleonika ◽  
2021 ◽  
Vol 66 (2) ◽  
pp. 47-53
Author(s):  
Edyta Dąbrowska-Szewczyk ◽  
Anna Zawadzka ◽  
Beata Brzozowska ◽  
Agnieszka Walewska ◽  
Paweł Kukołowicz
Keyword(s):  
Treatment Planning ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Rank Test ◽  
Average Dose ◽  
Independent Verification ◽  
The Mean

Abstract Purpose According to the available international recommendations, at least one independent verification of the calculations of number of monitor unit (MU) is required for every patient treated by teleradiotherapy. The aim of this study was to estimate the differences of dose distributions calculated with two treatment planning systems: Eclipse (Varian) and Oncentra MasterPlan (Elekta). Materials and methods The analysis was performed for 280 three-dimensional conformal radiotherapy treatment (3D-CRT) plans with photon beams from Varian accelerators: CL 600C/D X6 MV (109 plans), CL 2300C/D X6 MV (43 plans), and CL 2300C/D X15 MV (128 plans). The mean doses in the planning target volume (PTV) and doses at the isocenter point obtained with Eclipse and Oncentra MasterPlan (OMP) were compared with Wilcoxon matched-pairs signed rank test. Additionally, the treatment planning system (TPS) calculations were compared with dosimetric measurements performed in the inhomogeneous phantom. Results Data were analysed for 6 MV plans and for 15 MV plans separately, independently of the treatment machine. The dose values calculated in Eclipse were significantly (p <0.001) higher compared to calculations of OMP system. The average difference of the mean dose to PTV was (1.4 ± 1.0)% for X6 MV and (2.5 ± 0.6)% for X15 MV. Average dose disparities at the isocenter point were (1.3 ± 1.9)% and (2.1 ± 1.0)% for X6 MV and X15 MV beams, respectively. The largest differences were observed in lungs, air cavities, and bone structures. Moreover the variation in dosimetric measurements was less as compared to Eclipse calculations. Conclusions OMP calculations were introduced as the independent MU verification tool with the first action level range equal to 3.5%.

scholarly journals Comparative dosimetric study between point and volume based brachytherapy in definitive treatment of de novo carcinoma cervix

2016 ◽  
Author(s):  
Rahat Hadi ◽  
Mohammad Azam ◽  
Pooja Gupta ◽  
Satyajeet Rath ◽  
Mohammad Ali ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Treatment Planning ◽  
Clinical Target Volume ◽  
De Novo ◽  
Target Volume ◽  
Definitive Treatment ◽  
High Dose ◽  
Carcinoma Cervix ◽  
Cross Sectional ◽  
The Mean

Introduction: Cervical cancer has a high incidence in developing countries including India. Brachytherapy (BT) is an important component in the curative management of carcinoma of the cervix, and significantly improves survival. In gynaecologic BT, correlation between the radiation dose and the normal tissue effects have been assessed using point doses. Since 1985, these points have been defined in the international commission of radiation units and measurements (ICRU-38) report. However GEC-ESTRO recommended volume based treatment planning in their respective series (I-IV). For cervical cancer BT, the correlation of ICRU point doses and volume based treatment planning is investigational till date. Analysis becomes feasible when cross sectional image-based treatment planning for BT using computerized tomography (CT) or magnetic resonance imaging (MRI) is utilised as per GEC-ESTRO recommendation. Methods: It is a retrospective pilot study includes patients (pts.) of carcinoma cervix treated with high dose rate (HDR) BT 9 Gy in 2 fractions 1 week apart. All volume based dosimeteric parameters regarding high risk clinical target volume (HRCTV), intermediate risk clinical target volume (IRCTV) like D90, D100 and for organ at risk (OAR) D 0.1 cc, D 1.0 cc and D 2.0 cc were delineated and dose coverage was analysed in point dose based planning. Results: We have analysed twenty pts. of squamous cell carcinoma (SCC) cervix. The median age was 52 yrs. (41-65 yrs), stage II B 10 pts. & III B 10 pts. The mean value of D90 & D100 in HRCTV during I and II session were 8.64, 6.75 and 5.76, 4.36 Gy respectively. Same values for IRCTV were 6.31, 4.91 and 3.68, 3.15 Gy respectively. Analysis of OARs demonstrated that mean dose received by 0.1, volume of bladder during I and II session received 10.68, 9.47, by 1 cc volume 8.39, 7.57 and by 2 cc volume 6.84, 6.21 Gy respectively. The mean dose received by 0.1 cc of rectum were 11.59, 10.12, by 1 cc volume 9.53, 8.19 and by 2 cc volume 7.76, 6.81 Gy respectively. In point based analysis mean dose delivered to bladder point during I and II session were 5.63, 6.02 and to rectum point were 5.98, 5.46 Gy respectively. Doses to 0.1 cc volume of bladder and rectum were higher in volume based BT as compared to point based BT in respective fractions. Conclusion: Both HRCTV and IRCTV had better dose coverage in 1st fraction as compared to 2nd fraction. Point doses to bladder and rectum is underestimated in point based (ICRU-38) BT. We need more number of pts in prospective randomized trial for more consistent result.

Sign in / Sign up

Export Citation Format

Share Document