Inter-Breath-Hold Geometric and Dosimetric Variations in Organs at Risk during Pancreatic Stereotactic Body Radiotherapy: Implications for Adaptive Radiation Therapy.
Inter-Breath-Hold Geometric and Dosimetric Variations in Organs at Risk during Pancreatic Stereotactic Body Radiotherapy: Implications for Adaptive Radiation Therapy.
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DOI：
10.3390/cancers15174332
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发表时间：
2023-08-30
期刊：
影响因子：
5.2
通讯作者：
Han-Oh, Sarah
中科院分区：
文献类型：
--
作者：
Hooshangnejad, Hamed;Miles, Devin;Hill, Colin;Narang, Amol;Ding, Kai;Han-Oh, Sarah
关键词：
深吸气屏气 (DIBH) 技术广泛用于 CT 模拟和治疗过程中的运动管理，其基本假设是风险器官 (OAR) 几何形状的屏气间变化最小。本研究使用来自 20 名患者的独特数据集，对胰腺癌立体定向放射治疗 (SBRT) 中多次 DIBH CT 扫描之间的 OAR 几何变化进行了新颖的研究，并讨论了对计划准确性和 OAR 毒性的影响。我们证明了胰腺 SBRT 期间腹部 OAR 因屏气几何变化而产生的显着剂量变化。具有实时 OAR 跟踪功能的现代自适应放射治疗 (ART) 技术或许能够减少这些不确定性。胰腺癌是癌症相关死亡的第四大原因，每年有近 60,000 例病例，5 年总生存率不到 10%。放射治疗 (RT) 作为局部抗癌治疗非常有益。由于解剖变异备受关注，运动管理技术（例如 DIBH）通常用于最大限度地减少 OAR 毒性；然而，DIBH 之间的变异性尚未得到充分研究。在这里，我们对胰腺癌放疗中使用多种 DIBH 运动管理技术的患者解剖学再现性进行了前所未有的系统分析。我们使用了 20 名患者的数据；每位患者可进行 4 次 DIBH 扫描，以设计 80 个 SBRT 计划。我们的结果表明 (i) 同一受试者 DIBH 扫描之间的 OAR 几何形状和剂量存在相当大的差异； (ii) 为一次扫描设计的 RT 计划可能无法直接适用于另一次扫描； (iii) 使用 DIBH 模拟 CT 设计的 RT 治疗会导致 DIBH 治疗实施中不同的剂量测定； (iv) 这证实了适应性放射治疗 (ART)（例如 MR-Linacs）对于胰腺放疗的重要性。 ART 治疗实施技术可以解释参考计划和预定计划之间的解剖学差异，从而避免由于 DIBH 患者设置之间的解剖学差异而导致的 OAR 毒性。
Deep-inspiration breath-hold (DIBH) techniques are widely used for motion management during CT simulation and treatment delivery, with the underlying assumption of minimal inter-breath-hold variation in organ-at-risk (OAR) geometry. Using a unique dataset from 20 patients, this study presents a novel investigation of the OAR geometric variation between multiple DIBH CT scans in pancreatic cancer stereotactic body radiotherapy (SBRT), and discusses implications for plan accuracy and OAR toxicity. We demonstrated significant dosimetric variation in abdominal OARs during pancreatic SBRT from inter-breath-hold geometric variation. Modern adaptive radiation therapy (ART) techniques with real-time OAR tracking may be able to reduce these uncertainties. Pancreatic cancer is the fourth leading cause of cancer-related death, with nearly 60,000 cases each year and less than a 10% 5-year overall survival rate. Radiation therapy (RT) is highly beneficial as a local-regional anticancer treatment. As anatomical variation is of great concern, motion management techniques, such as DIBH, are commonly used to minimize OARs toxicities; however, the variability between DIBHs has not been well studied. Here, we present an unprecedented systematic analysis of patients’ anatomical reproducibility over multiple DIBH motion-management technique uses for pancreatic cancer RT. We used data from 20 patients; four DIBH scans were available for each patient to design 80 SBRT plans. Our results demonstrated that (i) there is considerable variation in OAR geometry and dose between same-subject DIBH scans; (ii) the RT plan designed for one scan may not be directly applicable to another scan; (iii) the RT treatment designed using a DIBH simulation CT results in different dosimetry in the DIBH treatment delivery; and (iv) this confirms the importance of adaptive radiation therapy (ART), such as MR-Linacs, for pancreatic RT delivery. The ART treatment delivery technique can account for anatomical variation between referenced and scheduled plans, and thus avoid toxicities of OARs because of anatomical variations between DIBH patient setups.
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影响因子：
5.2
作者：
Huang, Xinyue;Hooshangnejad, Hamed;China, Debarghya;Feng, Ziwei;Lee, Junghoon;Bell, Muyinatu A. Lediju;Ding, Kai
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DOI：
10.1016/j.ijrobp.2018.07.184
发表时间：
2018-11-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
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作者：
Feng Z;Rao AD;Cheng Z;Shin EJ;Moore J;Su L;Kim SH;Wong J;Narang A;Herman JM;McNutt T;Li D;Ding K
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影响因子：
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作者：
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作者：
Hooshangnejad, Hamed;Youssefian, Sina;Ding, Kai
通讯作者：
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影响因子：
2.9
作者：
Artinyan, Avo;Soriano, Perry A.;Kim, Joseph
通讯作者：
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