Universität zu Köln

Mendes, Vanessa Da Silva, Nierer, Lukas, Li, Minglun, Corradini, Stefanie, Reiner, Michael, Kamp, Florian, Niyazi, Maximilian, Kurz, Christopher, Landry, Guillaume and Belka, Claus (2021). Dosimetric comparison of MR-linac-based IMRT and conventional VMAT treatment plans for prostate cancer. Radiat. Oncol., 16 (1). LONDON: BMC. ISSN 1748-717X

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Abstract

Background The aim of this study was to evaluate and compare the performance of intensity modulated radiation therapy (IMRT) plans, planned for low-field strength magnetic resonance (MR) guided linear accelerator (linac) delivery (labelled IMRT MRL plans), and clinical conventional volumetric modulated arc therapy (VMAT) plans, for the treatment of prostate cancer (PCa). Both plans used the original planning target volume (PTV) margins. Additionally, the potential dosimetric benefits of MR-guidance were estimated, by creating IMRT MRL plans using smaller PTV margins. Materials and methods 20 PCa patients previously treated with conventional VMAT were considered. For each patient, two different IMRT MRL plans using the low-field MR-linac treatment planning system were created: one with original (orig.) PTV margins and the other with reduced (red.) PTV margins. Dose indices related to target coverage, as well as dose-volume histogram (DVH) parameters for the target and organs at risk (OAR) were compared. Additionally, the estimated treatment delivery times and the number of monitor units (MU) of each plan were evaluated. Results The dose distribution in the high dose region and the target volume DVH parameters (D-98%, D-50%, D-2% and V-95%) were similar for all three types of treatment plans, with deviations below 1% in most cases. Both IMRT MRL plans (orig. and red. PTV margins) showed similar homogeneity indices (HI), however worse values for the conformity index (CI) were also found when compared to VMAT. The IMRT MRL plans showed similar OAR sparing when the orig. PTV margins were used but a significantly better sparing was feasible when red. PTV margins were applied. Higher number of MU and longer predicted treatment delivery times were seen for both IMRT MRL plans. Conclusions A comparable plan quality between VMAT and IMRT MRL plans was achieved, when applying the same PTV margin. However, online MR-guided adaptive radiotherapy allows for a reduction of PTV margins. With a red. PTV margin, better sparing of the surrounding tissues can be achieved, while maintaining adequate target coverage. Nonetheless, longer treatment delivery times, characteristic for the IMRT technique, have to be expected.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mendes, Vanessa Da Silva UNSPECIFIED UNSPECIFIED UNSPECIFIED Nierer, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Li, Minglun UNSPECIFIED UNSPECIFIED UNSPECIFIED Corradini, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Reiner, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Kamp, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Niyazi, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurz, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED Landry, Guillaume UNSPECIFIED UNSPECIFIED UNSPECIFIED Belka, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-583483
DOI:	10.1186/s13014-021-01858-7
Journal or Publication Title:	Radiat. Oncol.
Volume:	16
Number:	1
Date:	2021
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1748-717X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VOLUMETRIC-MODULATED ARC; IMAGE-GUIDED RADIOTHERAPY; RADIATION-THERAPY SMART; STEP-AND-SHOOT; ADAPTIVE RADIOTHERAPY; LINEAR-ACCELERATOR; ONLINE; QUALITY; CONFORMITY; DELIVERY Multiple languages Oncology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58348