A novel and clinically useful dynamic conformal arc (DCA)-based VMAT planning technique for lung SBRT.

Abstract:

PURPOSE:Volumetric modulated arc therapy (VMAT) is gaining popularity for stereotactic treatment of lung lesions for medically inoperable patients. Due to multiple beamlets in delivery of highly modulated VMAT plans, there are dose delivery uncertainties associated with small-field dosimetry error and interplay effects with small lesions. We describe and compare a clinically useful dynamic conformal arc (DCA)-based VMAT (d-VMAT) technique for lung SBRT using flattening filter free (FFF) beams to minimize these effects. MATERIALS AND METHODS:Ten solitary early-stage I-II non-small-cell lung cancer (NSCLC) patients were treated with a single dose of 30 Gy using 3-6 non-coplanar VMAT arcs (clinical VMAT) with 6X-FFF beams in our clinic. These clinically treated plans were re-optimized using a novel d-VMAT planning technique. For comparison, d-VMAT plans were recalculated using DCA with user-controlled field aperture shape before VMAT optimization. Identical beam geometry, dose calculation algorithm, grid size, and planning objectives were used. The clinical VMAT and d-VMAT plans were compared via RTOG-0915 protocol compliances for conformity, gradient indices, and dose to organs at risk (OAR). Additionally, treatment delivery efficiency and accuracy were recorded. RESULTS:All plans met RTOG-0915 requirements. Comparing with clinical VMAT, d-VMAT plans gave similar target coverage with better target conformity, tighter radiosurgical dose distribution with lower gradient indices, and dose to OAR. Lower total number of monitor units and small beam modulation factor reduced beam-on time by 1.75 min (P < 0.001), on average (maximum up to 2.52 min). Beam delivery accuracy was improved by 2%, on average (P < 0.05) and maximum up to 6% in some cases for d-VMAT plans. CONCLUSION:This simple d-VMAT technique provided excellent plan quality, reduced intermediate dose-spillage, and dose to OAR while providing faster treatment delivery by significantly reducing beam-on time. This novel treatment planning approach will improve patient compliance along with potentially reducing intrafraction motion error. Moreover, with less MLC modulation through the target, d-VMAT could potentially minimize small-field dosimetry errors and MLC interplay effects. If available, d-VMAT planning approach is recommended for future clinical lung SBRT plan optimization.

journal_name

J Appl Clin Med Phys

authors

Pokhrel D,Visak J,Sanford L

doi

10.1002/acm2.12878

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

29-38

issue

7

issn

1526-9914

journal_volume

21

pub_type

杂志文章
  • Comparing gamma knife and cyberknife in patients with brain metastases.

    abstract::The authors compared the relative dosimetric merits of Gamma Knife (GK) and CyberKnife (CK) in 15 patients with 26 brain metastases. All patients were initially treated with the Leksell GK 4C. The same patients were used to generate comparative CK treatment plans. The tissue volume receiving more than 12 Gy (V12), the...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v15i1.4095

    authors: Sio TT,Jang S,Lee SW,Curran B,Pyakuryal AP,Sternick ES

    更新日期:2014-01-06 00:00:00

  • Dose variations in tumor volumes and organs at risk during IMRT for head-and-neck cancer.

    abstract::Many head-and-neck cancer (HNC) patients treated with radiotherapy suffer significant anatomical changes due to tumor shrinkage or weight loss. The purpose of this study was to assess dose changes over target volumes and organs at risk during intensity-modulated radiotherapy for HNC patients. Sixteen HNC IMRT patients...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v13i6.3723

    authors: Beltran M,Ramos M,Rovira JJ,Perez-Hoyos S,Sancho M,Puertas E,Benavente S,Ginjaume M,Giralt J

    更新日期:2012-11-08 00:00:00

  • Voxel-based supervised machine learning of peripheral zone prostate cancer using noncontrast multiparametric MRI.

    abstract:PURPOSE:The aim of this study was to develop and assess the performance of supervised machine learning technique to classify magnetic resonance imaging (MRI) voxels as cancerous or noncancerous using noncontrast multiparametric MRI (mp-MRI), comprised of T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.12992

    authors: Gholizadeh N,Simpson J,Ramadan S,Denham J,Lau P,Siddique S,Dowling J,Welsh J,Chalup S,Greer PB

    更新日期:2020-10-01 00:00:00

  • Surface and build-up dose comparison between Elekta 6 MV flattening filter and flattening-filter-free beams using an advanced Markus ionization chamber and a solid water-equivalent phantom.

    abstract::Using a plane-parallel advanced Markus ionization chamber and a stack of water-equivalent solid phantom blocks, percentage surface and build-up doses of Elekta 6 MV flattening filter (FF) and flattening-filter-free (FFF) beams were measured as a function of the phantom depth for field sizes ranging from 2 × 2 to 10 × ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.13094

    authors: Imae T,Takenaka S,Watanabe Y,Aoki A,Matsuda K,Sasaki K,Saegusa S,Nawa K,Nakagawa K,Abe O

    更新日期:2020-12-01 00:00:00

  • Calibration coefficients of dosimeters used in mammography for various target/filter combinations.

    abstract::A wide variety of existing combinations of target and filter materials (target/filter combinations) are used in mammography equipment. The patient dose depends on the X-ray quality that is derived from the target/filter combination, and a calibration of the dosimeter that is used in the measurement that corresponds to...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v16i6.5604

    authors: Sekimoto M,Katoh Y,Katoh T

    更新日期:2015-11-08 00:00:00

  • Optimal slice thickness for object detection with longitudinal partial volume effects in computed tomography.

    abstract::Longitudinal partial volume effects (z-axial PVE), which occur when an object partly occupies a slice, degrade image resolution and contrast in computed tomography (CT). Z-axial PVE is unavoidable for subslice objects and reduces their contrast according to their fraction contained within the slice. This effect can be...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.12005

    authors: Monnin P,Sfameni N,Gianoli A,Ding S

    更新日期:2017-01-01 00:00:00

  • Impact of grid size on uniform scanning and IMPT plans in XiO treatment planning system for brain cancer.

    abstract::The main purposes of this study are to: 1) evaluate the accuracy of XiO treatment planning system (TPS) for different dose calculation grid size based on head phan-tom measurements in uniform scanning proton therapy (USPT); and 2) compare the dosimetric results for various dose calculation grid sizes based on real com...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v16i5.5510

    authors: Rana S,Zheng Y

    更新日期:2015-09-08 00:00:00

  • A new homogeneity index based on statistical analysis of the dose-volume histogram.

    abstract::The goal of the present study was to develop a new dose-volume histogram (DVH)- based homogeneity index for effectively evaluating the dose homogeneity of intensity-modulated radiotherapy plans. The new index, called the sigma-index ("S-index") is defined as the standard deviation of the normalized differential DVH cu...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v8i2.2390

    authors: Yoon M,Park SY,Shin D,Lee SB,Pyo HR,Kim DY,Cho KH

    更新日期:2007-03-20 00:00:00

  • Dose differences between the three dose calculation algorithms in Leksell GammaPlan.

    abstract::The purpose of this study was to evaluate the dose differences introduced by the TMR 10 and the convolution dose calculation algorithms in GammaPlan version 10, as compared to the TMR classic algorithm in the previous versions of GammaPlan. Computed axial tomographic images of a polystyrene phantom and a human head we...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v15i5.4844

    authors: Xu AY,Bhatnagar J,Bednarz G,Niranjan A,Flickinger J,Lunsford LD,Huq MS

    更新日期:2014-09-08 00:00:00

  • Calculating the peak skin dose resulting from fluoroscopically-guided interventions. Part II: case studies.

    abstract::Part II of this review article presents four case studies for which peak skin doses are calculated following the methods outlined in Part I of this review. The data available in the cases ranges from proprietary dose reports to fluoroscopy time and number of digital acquisition frames only. Flowcharts are provided for...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v13i1.3693

    authors: Jones AK,Pasciak AS

    更新日期:2012-01-05 00:00:00

  • Strategies to optimize stereotactic radiosurgery plans for brain tumors with volumetric-modulated arc therapy.

    abstract:PURPOSE:Prescription practice in SRS plans for brain tumors differs significantly for different modalities. In this retrospective study, the strategies to optimize SRS plans for brain tumors with volumetric arc therapy (VMAT) were presented. METHODS:Fifty clinically treated cases were stratified by the maximum target ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.12818

    authors: Wang D,DeNittis A,Hu Y

    更新日期:2020-03-01 00:00:00

  • Characterization of an inorganic scintillator for small-field dosimetry in MR-guided radiotherapy.

    abstract:INTRODUCTION:Aim of this study is to dosimetrically characterize a new inorganic scintillator designed for magnetic resonance-guided radiotherapy (MRgRT) in the presence of 0.35 tesla magnetic field (B). METHODS:The detector was characterized in terms of signal to noise ratio (SNR), reproducibility, dose linearity, an...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.13012

    authors: Cusumano D,Placidi L,D'Agostino E,Boldrini L,Menna S,Valentini V,De Spirito M,Azario L

    更新日期:2020-09-01 00:00:00

  • Analysis of esophageal-sparing treatment plans for patients with high-grade esophagitis.

    abstract::We retrospectively generated IMRT plans for 14 NSCLC patients who had experienced grade 2 or 3 esophagitis (CTCAE version 3.0). We generated 11-beam and reduced esophagus dose plan types to compare changes in the volume and length of esophagus receiving doses of 50, 55, 60, 65, and 70 Gy. Changes in planning target vo...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v14i4.4248

    authors: Niedzielski J,Bluett JB,Williamson RT,Liao Z,Gomez DR,Court LE

    更新日期:2013-07-08 00:00:00

  • Trajectory log analysis and cone-beam CT-based daily dose calculation to investigate the dosimetric accuracy of intensity-modulated radiotherapy for gynecologic cancer.

    abstract::This study evaluated unexpected dosimetric errors caused by machine control accuracy, patient setup errors, and patient weight changes/internal organ deformations. Trajectory log files for 13 gynecologic plans with seven- or nine-beam dynamic multileaf collimator (MLC) intensity-modulated radiation therapy (IMRT), and...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.13163

    authors: Utena Y,Takatsu J,Sugimoto S,Sasai K

    更新日期:2021-01-10 00:00:00

  • Detector system dose verification comparisons for arc therapy: couch vs. gantry mount.

    abstract::The aim of this study was to assess the performance of a gantry-mounted detector system and a couch set detector system using a systematic multileaf collimator positional error manually introduced for volumetric-modulated arc therapy. Four head and neck and esophagus VMAT plans were evaluated by measurement using an e...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v15i3.4495

    authors: Manikandan A,Sarkar B,Nandy M,Sureka CS,Gossman MS,Sujatha N,Rajendran VT

    更新日期:2014-05-08 00:00:00

  • Beam-specific planning target volumes incorporating 4D CT for pencil beam scanning proton therapy of thoracic tumors.

    abstract::The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties, and patient setup variations. Ten consecutive patients that were previ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v16i6.5678

    authors: Lin L,Kang M,Huang S,Mayer R,Thomas A,Solberg TD,McDonough JE,Simone CB 2nd

    更新日期:2015-11-08 00:00:00

  • In vivo dosimetry and shielding disk alignment verification by EBT3 GAFCHROMIC film in breast IOERT treatment.

    abstract::Intraoperative electron radiation therapy (IOERT) cannot usually benefit, as conventional external radiotherapy, from software systems of treatment planning based on computed tomography and from common dose verify procedures. For this reason, in vivo film dosimetry (IVFD) proves to be an effective methodology to evalu...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v16i1.5065

    authors: Severgnini M,de Denaro M,Bortul M,Vidali C,Beorchia A

    更新日期:2014-01-08 00:00:00

  • Generation of wedge-shaped dose distributions through dynamic multileaf collimator dose delivery.

    abstract::A new method of generating wedge-shaped dose distributions through dynamic multileaf collimator dose delivery rather than computer-controlled jaw motion is presented. The method starts with the calculation of a wedge-shaped beam profile for the desired wedge angle. The resultant wedge beam profile is then passed to th...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v6i3.2060

    authors: Zhu J

    更新日期:2005-07-01 00:00:00

  • Gamma Knife® icon CBCT offers improved localization workflow for frame-based treatment.

    abstract:OBJECT:The purpose of this study was to compare two methods of stereotactic localization in Gamma Knife treatment planning: cone beam computed tomography (CBCT) or fiducial. While the fiducial method is the traditional method of localization, CBCT is now available for use with the Gamma Knife Icon. This study seeks to ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.12745

    authors: Duggar WN,Morris B,Fatemi A,Bonds J,He R,Kanakamedala M,Rey-Dios R,Vijayakumar S,Yang C

    更新日期:2019-11-01 00:00:00

  • A seed specific dose kernel method for low-energy brachytherapy dosimetry.

    abstract::We describe a method for independently verifying the dose distributions from pre- and post-implant brachytherapy source distributions. Monte Carlo calculations have been performed to characterize the three-dimensional dose distribution in water phantom from a low-energy brachytherapy source. The calculations are perfo...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v4i1.2543

    authors: DeMarco JJ,Solberg TD,Agazaryan N

    更新日期:2003-01-01 00:00:00

  • A fast, independent dose check of HDR plans.

    abstract::High dose rate (HDR) brachytherapy often involves optimization routines to calculate the dwell times and positions of a radioactive source along specified applicator paths. These routines optimize the dwells in such a way as to deliver the prescribed dose at one or more points while satisfying various constraints. The...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v4i2.2530

    authors: Lachaine ME,Gorman JC,Palisca MG

    更新日期:2003-04-01 00:00:00

  • Combination effects of tissue heterogeneity and geometric targeting error in stereotactic body radiotherapy for lung cancer using CyberKnife.

    abstract::We have investigated the combined effect of tissue heterogeneity and its variation associated with geometric error in stereotactic body radiotherapy (SBRT) for lung cancer. The treatment plans for eight lung cancer patients were calculated using effective path length (EPL) correction and Monte Carlo (MC) algorithms, w...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v16i5.5397

    authors: Kang KM,Jeong BK,Choi HS,Yoo SH,Hwang UJ,Lim YK,Jeong H

    更新日期:2015-09-08 00:00:00

  • Generation and verification of QFix kVue Calypso-compatible couch top model for a dedicated stereotactic linear accelerator with FFF beams.

    abstract::This study details the generation, verification, and implementation of a treatment planning system (TPS) couch top model for patient support system used in conjunction with a dedicated stereotactic linear accelerator. Couch top model was created within the TPS using CT simulation images of the kVue Calpyso-compatible ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v16i4.5441

    authors: Gardner SJ,Gulam M,Song K,Li H,Huang Y,Zhao B,Qin Y,Snyder K,Kim J,Gordon J,Chetty IJ,Wen N

    更新日期:2015-07-08 00:00:00

  • Radiation treatment planning and delivery strategies for a pregnant brain tumor patient.

    abstract::The management of a pregnant patient in radiation oncology is an infrequent event requiring careful consideration by both the physician and physicist. The aim of this manuscript was to highlight treatment planning techniques and detail measurements of fetal dose for a pregnant patient recently requiring treatment for ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.12262

    authors: Labby ZE,Barraclough B,Bayliss RA,Besemer AE,Dunkerley DAP,Howard SP

    更新日期:2018-09-01 00:00:00

  • Using mean dose rate to compare relative dosimetric efficiency with respect to source type and source change schedules for HDR brachytherapy.

    abstract::Remote afterloading devices used for high-dose-rate (HDR) brachytherapy may be supplied with different sources, and these sources typically have differing initial source strengths. In addition, the proposed frequency for source changes may also vary, depending upon the source type. Dosimetric parameters unique to each...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v14i6.4239

    authors: Davis SD,Parker W,Evans MD

    更新日期:2013-11-04 00:00:00

  • SWIMRT: a graphical user interface using sliding window algorithm to construct a fluence map machine file.

    abstract::A custom-made computer program, SWIMRT, to construct "multileaf collimator (MLC) machine" file for intensity-modulated radiotherapy (IMRT) fluence maps was developed using MATLAB and the sliding window algorithm. The user can either import a fluence map with a graphical file format created by an external treatment-pla...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v7i2.2231

    authors: Chow JC,Grigorov GN,Yazdani N

    更新日期:2006-05-25 00:00:00

  • Intrafractional relationship changes between an external breathing signal and fiducial marker positions in pancreatic cancer patients.

    abstract:BACKGROUND AND PURPOSE:The purpose of this study of pancreatic cancer patients treated with respiratory-guided stereotactic body radiotherapy (SBRT) on a standard linac was to investigate (a) the intrafractional relationship change (IRC) between a breathing signal and the tumor position, (b) the impact of IRC on the de...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.12841

    authors: Pettersson N,Oderinde OM,Murphy J,Simpson D,Cerviño LI

    更新日期:2020-03-01 00:00:00

  • Defining the dose-volume criteria for laryngeal sparing in locally advanced oropharyngeal cancer utilizing split-field IMRT, whole-field IMRT and VMAT.

    abstract:PURPOSE:To determine the optimal dose-volume constraint for laryngeal sparing using three commonly employed intensity modulated radiation therapy (IMRT) approaches in patients with oropharyngeal cancer treated to the bilateral neck. MATERIALS AND METHODS:Thirty patients with stage II-IVA oropharynx cancers received de...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1002/acm2.13009

    authors: Wilke C,Takiar V,Wang H,Moreno AC,Tung SS,Quinlan-Davidson SR,Garden AS,Rosenthal DI,Fuller CD,Gunn GB,Reddy JP,Morrison WH,Wang C,Zhao G,Hutcheson KA,Phan J

    更新日期:2020-12-05 00:00:00

  • Stereotactic IMRT for prostate cancer: setup accuracy of a new stereotactic body localization system.

    abstract::The purpose of this work is to prospectively assess the setup accuracy that can be achieved with a stereotactic body localizer (SBL) in immobilizing patients for stereotactic intensity-modulated radiotherapy (IMRT) for prostate cancer. By quantifying this important factor and target mobility in the SBL, we expect to p...

    journal_title:Journal of applied clinical medical physics

    pub_type: 临床试验,杂志文章

    doi:10.1120/jacmp.v5i2.1947

    authors: Wang L,Jacob R,Chen L,Ma C,Movsas B,Feigenberg S,Konski A

    更新日期:2004-04-01 00:00:00

  • Utilization of cone beam CT for reconstruction of dose distribution delivered in image-guided radiotherapy of prostate carcinoma - bony landmark setup compared to fiducial markers setup.

    abstract::The purpose of this study was to compare two different styles of prostate IGRT: bony landmark (BL) setup vs. fiducial markers (FM) setup. Twenty-nine prostate patients were treated with daily BL setup and 30 patients with daily FM setup. Delivered dose distribution was reconstructed on cone-beam CT (CBCT) acquired onc...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章

    doi:10.1120/jacmp.v14i3.4203

    authors: Paluska P,Hanus J,Sefrova J,Rouskova L,Grepl J,Jansa J,Kasaova L,Hodek M,Zouhar M,Vosmik M,Petera J

    更新日期:2013-05-06 00:00:00