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• W2024734536 abstract "Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (phase 0 to 9 for inhale-exhale-inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases by Demons deformable image registration. The resultant displacement field is then applied on the dose map of the gating phase to estimate the actual dose map for each phase. To condense the 4D dose volume for convenient clinical use, we fit the dose values of each voxel pixels, D, to a sinusoidal function: D(n) = Asin (2nπ/10 + ϕ) + b, where n is the phase index, A, b, and ϕ are fitting parameters that have the same size as that of the dose volume. The A maps describe variation of dose amplitude due to motion and the b maps are the mean delivered dose over the entire respiration cycle. The ϕ maps show the optimality of gating phase for each voxel, since the solution of 2nπ/10 + ϕ = -π/2 gives the optimal phase index n. The sinusoidal function accurately models the dose change during the respiratory motion, with a mean fitting error (root-mean-square of fitting residual) of 4.6% averaged on body volumes. In the eight patients, the A maps clearly show dramatic mean dose variation of 3.3 Gy on OARs with maximum values ranging from 5.1 Gy to 13.7 Gy. Two of eight patients have about 100cm3 volumes covered by more than 5 Gy deviation. The b maps are similar to dose distributions calculated on the average CT with slight deformation caused by respiratory motion. The optimal gating phase calculated from the ϕ maps highly varies across the patient, with the optimal gating phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. In SBRT for patients with pancreatic cancer, the delivered dose on OARs significantly deviates from the calculated dose of a treatment plan due to respiratory motion. A new algorithmic tool is developed to conveniently quantify the dose variation during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR." @default.
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• W2024734536 date "2014-09-01" @default.
• W2024734536 modified "2023-09-27" @default.
• W2024734536 title "Motion Effects on Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy" @default.
• W2024734536 doi "https://doi.org/10.1016/j.ijrobp.2014.05.2574" @default.
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