Automated inverse optimization facilitates lower doses to normal tissue in pancreatic stereotactic body radiotherapy.
Automated inverse optimization facilitates lower doses to normal tissue in pancreatic stereotactic body radiotherapy.
复制标题
自动化的逆优化促进了胰腺立体定位放射疗法中对正常组织的较低剂量。
DOI：
10.1371/journal.pone.0191036
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Portelance L
中科院分区：
文献类型：
--
作者：
Mihaylov IB;Mellon EA;Yechieli R;Portelance L
逆规划是一个反复试错的迭代过程。这项工作引入了一种全自动逆优化方法，其中治疗计划密切针对独特的患者解剖结构。自动优化应用于胰腺立体定向放射治疗（SBRT）。自动化是基于逐步减少剂量-体积直方图（DVHs）。使用五个均匀间隔的点，从1%到70%的危险器官（OAR）体积。通过多次优化运行，这些DVH点的剂量迭代降低。随着每次优化运行，到桨的剂量减少，而目标上的剂量均匀性增加。当达到预先规定的剂量非均匀性时，迭代过程终止。回顾性研究12例胰腺病例。评估靶剂量、十二指肠、肠、胃和脊髓的最大剂量。此外，计算肝脏和肾脏的平均剂量。将自动优化方案与基于国家方案的实际治疗方案进行比较。治疗方案和自动优化方案的处方剂量达到计划目标体积（PTV）的95%相同。十二指肠、肠、胃和脊髓的最大剂量平均差值分别为-4.6 Gy、-1.8 Gy、-1.6 Gy和-2.4 Gy。负号表示自动优化后的较低剂量。对肝脏和肾脏的平均剂量的平均差异分别为-0.6 Gy和-1.1 Gy至-1.5 Gy。自动逆优化具有巨大的潜力，个性化和定制放射治疗，以特定的病人解剖。它可用于正常组织保留或用于等毒性剂量递增。
Inverse planning is trial-and-error iterative process. This work introduces a fully automated inverse optimization approach, where the treatment plan is closely tailored to the unique patient anatomy. The auto-optimization is applied to pancreatic stereotactic body radiotherapy (SBRT). The automation is based on stepwise reduction of dose-volume histograms (DVHs). Five uniformly spaced points, from 1% to 70% of the organ at risk (OAR) volumes, are used. Doses to those DVH points are iteratively decreased through multiple optimization runs. With each optimization run the doses to the OARs are decreased, while the dose homogeneity over the target is increased. The iterative process is terminated when a pre-specified dose heterogeneity over the target is reached. Twelve pancreatic cases were retrospectively studied. Doses to the target, maximum doses to duodenum, bowel, stomach, and spinal cord were evaluated. In addition, mean doses to liver and kidneys were tallied. The auto-optimized plans were compared to the actual treatment plans, which are based on national protocols. The prescription dose to 95% of the planning target volume (PTV) is the same for the treatment and the auto-optimized plans. The average difference for maximum doses to duodenum, bowel, stomach, and spinal cord are -4.6 Gy, -1.8 Gy, -1.6 Gy, and -2.4 Gy respectively. The negative sign indicates lower doses with the auto-optimization. The average differences in the mean doses to liver and kidneys are -0.6 Gy, and -1.1 Gy to -1.5 Gy respectively. Automated inverse optimization holds great potential for personalization and tailoring of radiotherapy to particular patient anatomies. It can be utilized for normal tissue sparing or for an isotoxic dose escalation.
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影响因子：
2.1
作者：
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通讯作者：
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Siebers, J. V.
DOI：
10.1016/j.ijrobp.2009.08.021
发表时间：
2010-05-01
影响因子：
7
作者：
Mihaylov, Ivaylo B.;Fatyga, Mirek;Lerma, Fritz A.
通讯作者：
Lerma, Fritz A.