Intensity modulated arc therapy implementation in a three phase adaptive 18F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer
- Author
- Dieter Berwouts, Ana Maria Luiza Olteanu (UGent) , Bruno Speleers (UGent) , Fréderic Duprez (UGent) , Indira Madani (UGent) , Tom Vercauteren (UGent) , Wilfried De Neve (UGent) and Werner De Gersem (UGent)
- Organization
- Abstract
- Background: This study investigates the implementation of a new intensity modulated arc therapy (IMAT) class solution in comparison to a 6-static beam step-and-shoot intensity modulated radiotherapy (s-IMRT) for three-phase adaptive F-18-FDG-PET-voxel-based dose-painting-by-numbers (DPBN) for head-and-neck cancer. Methods: We developed F-18-FDG-PET-voxel intensity-based IMAT employing multiple arcs and compared it to clinically used s-IMRT DPBN. Three IMAT plans using F-18-FDG-PET/CT acquired before treatment (phase I), after 8 fractions (phase II) and CT acquired after 18 fractions (phase III) were generated for each of 10 patients treated with 3 s-IMRT plans based on the same image sets. Based on deformable image registration (ABAS, version 0.41, Elekta CMS Software, Maryland Heights, MO), doses of the 3 plans were summed on the pretreatment CT using validated in-house developed software. Dosimetric indices in targets and organs-at-risk (OARs), biologic conformity of treatment plans set at <= 5 %, treatment quality and efficiency were compared between IMAT and s-IMRT for the whole group and for individual patients. Results: Doses to most organs-at-risk (OARs) were significantly better in IMAT plans, while target levels were similar for both types of plans. On average, IMAT ipsilateral and contralateral parotid mean doses were 14.0 % (p = 0.001) and 12.7 % (p < 0.001) lower, respectively. Pharyngeal constrictors D-50% levels were similar or reduced with up to 54.9 % for IMAT compared to s-IMRT for individual patient cases. IMAT significantly improved biologic conformity by 2.1 % for treatment phases I and II. 3D phantom measurements reported an agreement of >= 95 % for 3 % and 3 mm criteria for both treatment modalities. IMAT delivery time was significantly shortened on average by 41.1 %. Conclusions: IMAT implementation significantly improved the biologic conformity as compared to s-IMRT in adaptive dose-escalated DPBN treatments. The better OAR sparing and faster delivery highly improved the treatment efficiency.
- Keywords
- Intensity modulated radiotherapy, Head-and-neck cancer, Dose-painting, Adaptive intensity modulated arc therapy, RADIATION-THERAPY, OROPHARYNGEAL CANCER, HELICAL TOMOTHERAPY, IMRT, RADIOTHERAPY, CARCINOMA, VMAT, OPTIMIZATION, SMARTARC, DELIVERY
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Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8037032
- MLA
- Berwouts, Dieter, et al. “Intensity Modulated Arc Therapy Implementation in a Three Phase Adaptive 18F-FDG-PET Voxel Intensity-Based Planning Strategy for Head-and-Neck Cancer.” RADIATION ONCOLOGY, vol. 11, 2016, doi:10.1186/s13014-016-0629-3.
- APA
- Berwouts, D., Olteanu, A. M. L., Speleers, B., Duprez, F., Madani, I., Vercauteren, T., … De Gersem, W. (2016). Intensity modulated arc therapy implementation in a three phase adaptive 18F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer. RADIATION ONCOLOGY, 11. https://doi.org/10.1186/s13014-016-0629-3
- Chicago author-date
- Berwouts, Dieter, Ana Maria Luiza Olteanu, Bruno Speleers, Fréderic Duprez, Indira Madani, Tom Vercauteren, Wilfried De Neve, and Werner De Gersem. 2016. “Intensity Modulated Arc Therapy Implementation in a Three Phase Adaptive 18F-FDG-PET Voxel Intensity-Based Planning Strategy for Head-and-Neck Cancer.” RADIATION ONCOLOGY 11. https://doi.org/10.1186/s13014-016-0629-3.
- Chicago author-date (all authors)
- Berwouts, Dieter, Ana Maria Luiza Olteanu, Bruno Speleers, Fréderic Duprez, Indira Madani, Tom Vercauteren, Wilfried De Neve, and Werner De Gersem. 2016. “Intensity Modulated Arc Therapy Implementation in a Three Phase Adaptive 18F-FDG-PET Voxel Intensity-Based Planning Strategy for Head-and-Neck Cancer.” RADIATION ONCOLOGY 11. doi:10.1186/s13014-016-0629-3.
- Vancouver
- 1.Berwouts D, Olteanu AML, Speleers B, Duprez F, Madani I, Vercauteren T, et al. Intensity modulated arc therapy implementation in a three phase adaptive 18F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer. RADIATION ONCOLOGY. 2016;11.
- IEEE
- [1]D. Berwouts et al., “Intensity modulated arc therapy implementation in a three phase adaptive 18F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer,” RADIATION ONCOLOGY, vol. 11, 2016.
@article{8037032, abstract = {{Background: This study investigates the implementation of a new intensity modulated arc therapy (IMAT) class solution in comparison to a 6-static beam step-and-shoot intensity modulated radiotherapy (s-IMRT) for three-phase adaptive F-18-FDG-PET-voxel-based dose-painting-by-numbers (DPBN) for head-and-neck cancer. Methods: We developed F-18-FDG-PET-voxel intensity-based IMAT employing multiple arcs and compared it to clinically used s-IMRT DPBN. Three IMAT plans using F-18-FDG-PET/CT acquired before treatment (phase I), after 8 fractions (phase II) and CT acquired after 18 fractions (phase III) were generated for each of 10 patients treated with 3 s-IMRT plans based on the same image sets. Based on deformable image registration (ABAS, version 0.41, Elekta CMS Software, Maryland Heights, MO), doses of the 3 plans were summed on the pretreatment CT using validated in-house developed software. Dosimetric indices in targets and organs-at-risk (OARs), biologic conformity of treatment plans set at <= 5 %, treatment quality and efficiency were compared between IMAT and s-IMRT for the whole group and for individual patients. Results: Doses to most organs-at-risk (OARs) were significantly better in IMAT plans, while target levels were similar for both types of plans. On average, IMAT ipsilateral and contralateral parotid mean doses were 14.0 % (p = 0.001) and 12.7 % (p < 0.001) lower, respectively. Pharyngeal constrictors D-50% levels were similar or reduced with up to 54.9 % for IMAT compared to s-IMRT for individual patient cases. IMAT significantly improved biologic conformity by 2.1 % for treatment phases I and II. 3D phantom measurements reported an agreement of >= 95 % for 3 % and 3 mm criteria for both treatment modalities. IMAT delivery time was significantly shortened on average by 41.1 %. Conclusions: IMAT implementation significantly improved the biologic conformity as compared to s-IMRT in adaptive dose-escalated DPBN treatments. The better OAR sparing and faster delivery highly improved the treatment efficiency.}}, articleno = {{52}}, author = {{Berwouts, Dieter and Olteanu, Ana Maria Luiza and Speleers, Bruno and Duprez, Fréderic and Madani, Indira and Vercauteren, Tom and De Neve, Wilfried and De Gersem, Werner}}, issn = {{1748-717X}}, journal = {{RADIATION ONCOLOGY}}, keywords = {{Intensity modulated radiotherapy,Head-and-neck cancer,Dose-painting,Adaptive intensity modulated arc therapy,RADIATION-THERAPY,OROPHARYNGEAL CANCER,HELICAL TOMOTHERAPY,IMRT,RADIOTHERAPY,CARCINOMA,VMAT,OPTIMIZATION,SMARTARC,DELIVERY}}, language = {{eng}}, pages = {{9}}, title = {{Intensity modulated arc therapy implementation in a three phase adaptive 18F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer}}, url = {{http://doi.org/10.1186/s13014-016-0629-3}}, volume = {{11}}, year = {{2016}}, }
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