دورية أكاديمية
Cone-Beam CT Images as an Indicator of QACT During Adaptive Proton Therapy of Extremity Sarcomas.
| العنوان: | Cone-Beam CT Images as an Indicator of QACT During Adaptive Proton Therapy of Extremity Sarcomas. |
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| المؤلفون: | Biswal NC; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201.; Maryland Proton Treatment Center, Baltimore, MD 21201., Zhang B; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201.; Maryland Proton Treatment Center, Baltimore, MD 21201., Nichols E; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201.; Maryland Proton Treatment Center, Baltimore, MD 21201., Witek ME; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201.; Maryland Proton Treatment Center, Baltimore, MD 21201., Regine WF; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201.; Maryland Proton Treatment Center, Baltimore, MD 21201., Yi B; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201.; Maryland Proton Treatment Center, Baltimore, MD 21201. |
| المصدر: | International journal of particle therapy [Int J Part Ther] 2024 Apr 26; Vol. 12, pp. 100017. Date of Electronic Publication: 2024 Apr 26 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101674108 Publication Model: eCollection Cited Medium: Internet ISSN: 2331-5180 (Electronic) Linking ISSN: 23315180 NLM ISO Abbreviation: Int J Part Ther Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2024- : [New York] : Elsevier Original Publication: Gainesville, FL : International Journal of Particle Therapy, [2014]- |
| مستخلص: | Purpose: Periodic quality assurance CTs (QACTs) are routine in proton beam therapy. In this study, we tested whether the necessity for a QACT could be determined by evaluating the change in beam path length (BPL) on daily cone-beam CT (CBCT). Patients and Methods: In this Institutional Review Board-approved study, we retrospectively analyzed 959 CBCT images from 78 patients with sarcomas treated with proton pencil-beam scanning. Plans on 17 QACTs out of a total of 243 were clinically determined to be replanned for various reasons. Daily CBCTs were retrospectively analyzed by automatic ray-tracing of each beam from the isocenter to the skin surface along the central axis. A script was developed for this purpose. Patterns of change in BPL on CBCT images were compared to those from adaptive planning using weekly QACTs. Results: Sixteen of the 17 adaptive replans showed BPL changes ≥4 mm for at least 1 of the beams on 3 consecutive CBCT sessions. Similarly, 43 of 63 nonadaptively planned patients had BPL changes <4 mm for all of the beams. A new QACT criterium of a BPL change of any beam ≥4 mm on 3 consecutive CBCT sessions resulted in a sensitivity of 94.1% and a specificity of 68.3%. Had the BPL change been used as the QACT predictor, a total of 37 QACTs would have been performed rather than 243 QACTs in clinical practice. Conclusion: The use of BPL changes on CBCT images represented a significant reduction (85%) in total QACT burden while maintaining treatment quality and accuracy. QACT can be performed only when it is needed, but not in a periodic manner. The benefits of reducing QACT frequency include reducing imaging dose and optimizing patient time and staff resources. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| References: | J Appl Clin Med Phys. 2021 Aug;22(8):168-174. (PMID: 34302421) Radiat Oncol. 2024 Jan 23;19(1):13. (PMID: 38263237) Radiother Oncol. 2022 Aug;173:93-101. (PMID: 35667573) Cancer J. 2014 Nov-Dec;20(6):409-14. (PMID: 25415687) Adv Radiat Oncol. 2022 Sep 09;8(1):101069. (PMID: 36213549) Radiother Oncol. 2021 Jun;159:136-143. (PMID: 33771576) Clin Oncol (R Coll Radiol). 2017 Aug;29(8):500-506. (PMID: 28506520) Int J Part Ther. 2020 Aug 03;7(1):41-53. (PMID: 33094135) J Appl Clin Med Phys. 2017 Jan;18(1):82-89. (PMID: 28291933) J Appl Clin Med Phys. 2017 Nov;18(6):79-87. (PMID: 28901659) J Appl Clin Med Phys. 2022 May;23(5):e13550. (PMID: 35128788) Med Phys. 2022 Nov;49(11):6794-6801. (PMID: 35933322) Int J Part Ther. 2022 May 6;9(1):1-11. (PMID: 35774491) Radiat Oncol. 2016 Apr 30;11:64. (PMID: 27129305) Cancers (Basel). 2023 Jul 30;15(15):. (PMID: 37568697) Radiother Oncol. 2020 Oct;151:228-233. (PMID: 32777242) Med Phys. 2018 Mar;45(3):1191-1203. (PMID: 29360157) Int J Radiat Oncol Biol Phys. 2016 May 1;95(1):549-559. (PMID: 27084664) |
| فهرسة مساهمة: | Keywords: Beam path length; Cone-beam CT; Extremity sarcomas; Proton adaptive therapy; QACT |
| تواريخ الأحداث: | Date Created: 20240718 Latest Revision: 20240719 |
| رمز التحديث: | 20240719 |
| مُعرف محوري في PubMed: | PMC11252065 |
| DOI: | 10.1016/j.ijpt.2024.100017 |
| PMID: | 39022119 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2331-5180 |
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| DOI: | 10.1016/j.ijpt.2024.100017 |