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Open Access 01-12-2022 | Magnetic Resonance Imaging | Research

Dosimetric benefit of MR-guided online adaptive radiotherapy in different tumor entities: liver, lung, abdominal lymph nodes, pancreas and prostate

Authors: Lukas Nierer, Chukwuka Eze, Vanessa da Silva Mendes, Juliane Braun, Patrick Thum, Rieke von Bestenbostel, Christopher Kurz, Guillaume Landry, Michael Reiner, Maximilian Niyazi, Claus Belka, Stefanie Corradini

Published in: Radiation Oncology | Issue 1/2022

Abstract

Background

Hybrid magnetic resonance (MR)-Linac systems have recently been introduced into clinical practice. The systems allow online adaption of the treatment plan with the aim of compensating for interfractional anatomical changes. The aim of this study was to evaluate the dose volume histogram (DVH)-based dosimetric benefits of online adaptive MR-guided radiotherapy (oMRgRT) across different tumor entities and to investigate which subgroup of plans improved the most from adaption.

Methods

Fifty patients treated with oMRgRT for five different tumor entities (liver, lung, multiple abdominal lymph nodes, pancreas, and prostate) were included in this retrospective analysis. Various target volume (gross tumor volume GTV, clinical target volume CTV, and planning target volume PTV) and organs at risk (OAR) related DVH parameters were compared between the dose distributions before and after plan adaption.

Results

All subgroups clearly benefited from online plan adaption in terms of improved PTV coverage. For the liver, lung and abdominal lymph nodes cases, a consistent improvement in GTV coverage was found, while many fractions of the prostate subgroup showed acceptable CTV coverage even before plan adaption. The largest median improvements in GTV near-minimum dose (D_98%) were found for the liver (6.3%, p < 0.001), lung (3.9%, p < 0.001), and abdominal lymph nodes (6.8%, p < 0.001) subgroups. Regarding OAR sparing, the largest median OAR dose reduction during plan adaption was found for the pancreas subgroup (-87.0%). However, in the pancreas subgroup an optimal GTV coverage was not always achieved because sparing of OARs was prioritized.

Conclusion

With online plan adaptation, it was possible to achieve significant improvements in target volume coverage and OAR sparing for various tumor entities and account for interfractional anatomical changes.

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Title: Dosimetric benefit of MR-guided online adaptive radiotherapy in different tumor entities: liver, lung, abdominal lymph nodes, pancreas and prostate
Authors: Lukas Nierer
Chukwuka Eze
Vanessa da Silva Mendes
Juliane Braun
Patrick Thum
Rieke von Bestenbostel
Christopher Kurz
Guillaume Landry
Michael Reiner
Maximilian Niyazi
Claus Belka
Stefanie Corradini
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Radiotherapy
Published in: Radiation Oncology / Issue 1/2022
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-022-02021-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dosimetric benefit of MR-guided online adaptive radiotherapy in different tumor entities: liver, lung, abdominal lymph nodes, pancreas and prostate

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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