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Strahlentherapie und Onkologie

Published in:

01-02-2012 | Original article

Dosimetric integration of daily mega-voltage cone-beam CT for image-guided intensity-modulated radiotherapy

Authors: PD Dr. A. Zabel-du Bois, S. Nill, S. Ulrich, U. Oelfke, B. Rhein, P. Haering, S. Milker-Zabel, A. Schwahofer

Published in: Strahlentherapie und Onkologie | Issue 2/2012

Abstract

Purpose

The goal of this work was to compare different methods of incorporating the additional dose of mega-voltage cone-beam CT (MV-CBCT) for image-guided intensity modulated radiotherapy (IMRT) of different tumor entities.

Material and methods

The absolute dose delivered by the MV-CBCT was calculated and considered by creating a scaled IMRT plan (scIMRT) by renormalizing the clinically approved plan (orgIMRT) so that the sum with the MV-CBCT dose yields the same prescribed dose. In the other case, a newly optimized plan (optIMRT) was generated by including the dose distribution of the MV-CBCT as pre-irradiation. Both plans were compared with the orgIMRT plan and a plan where the last fraction was skipped.

Results

No significant changes were observed regarding the 95% conformity index of the target volume. The mean dose of the organs at risk (OAR) increased by approx. 7% for the scIMRT plan and 5% for the optIMRT plan. A significant increase of the mean dose to the outline contour was observed, ranging from 3.1 ± 1.3% (optIMRT) to 13.0 ± 6.1% (scIMRT) for both methods over all entities. If the dose of daily MV-CBCT would have been ignored, the additional dose accumulated to nearly a whole treatment fraction with a general increase of approx. 10% to the OARs and approx. 4% to the target volume.

Conclusion

Both methods of incorporating the additional MV-CBCT dose into the treatment plan are suitable for clinical practice. The dose distribution of the target volume could be achieved as conformal as with the orgIMRT plan, while only a moderate increase of mean dose to OAR was observed.

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Title: Dosimetric integration of daily mega-voltage cone-beam CT for image-guided intensity-modulated radiotherapy
Authors: PD Dr. A. Zabel-du Bois
S. Nill
S. Ulrich
U. Oelfke
B. Rhein
P. Haering
S. Milker-Zabel
A. Schwahofer
Publication date: 01-02-2012
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 2/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0021-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Dosimetric integration of daily mega-voltage cone-beam CT for image-guided intensity-modulated radiotherapy

Abstract

Purpose

Material and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusion

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