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Impact of contrast-enhanced CT in the dosimetry of SBRT for liver metastases treated with MR-Linac

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机构: [1]Chengdu Univ Technol, Coll Comp Sci & Cyber Secur, Chengdu, Peoples R China [2]Univ Elect Sci & Technol China, Affiliated Canc Hosp, Sichuan Canc Hosp & Inst, Dept Radiat Oncol, Chengdu, Peoples R China [3]Sichuan Canc Ctr, Sichuan Clin Res Ctr Canc, Chengdu, Peoples R China [4]Wenzhou Univ Technol, Dept Sch Data Sci & Artificial Intelligence, Wenzhou, Peoples R China [5]Sichuan Univ, West China Univ Hosp 2, Dept Gynecol & Obstet, Chengdu, Peoples R China
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关键词: MR-Linac Contrast media Liver cancer SBRT Synthetic CT MR guided adaptive radiotherapy

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Background To investigate the impact of using contrast-enhanced computed tomography (CHCT) in the dosimetry of stereotactic body radiation therapy (SBRT) for liver metastases treated with MR-Linac. Methods A retrospective study was conducted on 21 liver cancer patients treated with SBRT (50 Gy in 5 fractions) using a 1.5 Tesla Unity MR-Linac. The clinical treatment plans optimised on plain computed tomography (pCT) were used as reference. The electronic density (ED) of regions of interest (ROIs) including the liver, duodenum, esophagus, spinal cord, heart, ribs, and lungs, from pCT and CHCT, was analysed. The average ED of each ROI from CHCT was used to generate synthetic CT (sCT) images by assigning the average ED value from the CHCT to the pCT. Clinical plans were recalculated on sCT images. Dosimetric comparisons between the original treatment plan (TPpCT) and the sCT plan (TPsCT) were performed using dose-volume histogram (DVH) parameters, and gamma analysis. Results Significant ED differences (p < 0.05) were observed in the liver, great vessels, heart, lungs, and spinal cord between CHCT and pCT, with the lungs showing the largest differences (average deviation of 11.73% and 12.15% for the left and right lung, respectively). The target volume covered by the prescribed dose (V-Dpre), and the dose received by 2% and 98% of the volume (D-2%, and D-98%, respectively) showed statistical differences (p < 0.05), while the gradient index (GI) and the conformity index (CI) did not. Average deviations in target volume dosimetric parameters were below 1.02%, with a maximum deviation of 5.57% for. For the organs at risk (OARs), significant differences (p < 0.05) were observed for D-0.35cc and D-1.2cc of the spinal cord, D-10cc for the stomach, D-0.5cc for the heart, and D-30% for the liver-GTV, with mean deviations lower than 1.83% for all the above OARs. Gamma analysis using 2%-2 mm criteria yielded a median value of 95.64% (range 82.22-99.65%) for the target volume and 99.40% (range 58-100%) for the OARs. Conclusion The findings suggest that the use of CHCT in the SBRT workflow for liver metastases may result in minor target volume overdosage, indicating its potential for adoption in clinical settings. However, its use should be further explored in a broader context and tied to personalized treatment approaches.

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 2 区 核医学 3 区 肿瘤学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 核医学 3 区 肿瘤学
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出版当年[2023]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q2 ONCOLOGY
最新[2023]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2023版]

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第一作者机构: [1]Chengdu Univ Technol, Coll Comp Sci & Cyber Secur, Chengdu, Peoples R China [2]Univ Elect Sci & Technol China, Affiliated Canc Hosp, Sichuan Canc Hosp & Inst, Dept Radiat Oncol, Chengdu, Peoples R China [3]Sichuan Canc Ctr, Sichuan Clin Res Ctr Canc, Chengdu, Peoples R China
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通讯机构: [1]Chengdu Univ Technol, Coll Comp Sci & Cyber Secur, Chengdu, Peoples R China [4]Wenzhou Univ Technol, Dept Sch Data Sci & Artificial Intelligence, Wenzhou, Peoples R China
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