Respiratory motion-management in stereotactic body radiation therapy for lung cancer - A dosimetric comparison in an anthropomorphic lung phantom (LuCa).

Ehrbar, Stefanie; Perrin, Rosalind; Peroni, Marta; Bernatowicz, Kinga; Parkel, Thomas; Pytko, Izabela; Klöck, Stephan; Guckenberger, Matthias; Tanadini-Lang, Stephanie; Weber, Damien Charles; Lomax, Antony (2016). Respiratory motion-management in stereotactic body radiation therapy for lung cancer - A dosimetric comparison in an anthropomorphic lung phantom (LuCa). Radiotherapy and oncology, 121(2), pp. 328-334. Elsevier 10.1016/j.radonc.2016.10.011

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BACKGROUND AND PURPOSE The objective of this study was to compare the latest respiratory motion-management strategies, namely the internal-target-volume (ITV) concept, the mid-ventilation (MidV) principle, respiratory gating and dynamic couch tracking. MATERIALS AND METHODS An anthropomorphic, deformable and dynamic lung phantom was used for the dosimetric validation of these techniques. Stereotactic treatments were adapted to match the techniques and five distinct respiration patterns, and delivered to the phantom while radiographic film measurements were taken inside the tumor. To report on tumor coverage, these dose distributions were used to calculate mean doses (Dmean), changes in homogeneity indices (ΔH2-98), gamma agreement, and areas covered by the planned minimum dose (A>Dmin). RESULTS All techniques achieved good tumor coverage (A>Dmin>99.0%) and minor changes in Dmean (±3.2%). Gating and tracking strategies showed superior results in gamma agreement and ΔH2-98 compared to ITV and MidV concepts, which seem to be more influenced by the interplay and the gradient effect. For lung, heart and spinal cord, significant dose differences between the four techniques were found (p<0.05), with lowest doses for gating and tracking strategies. CONCLUSION Active motion-management techniques, such as gating or tracking, showed superior tumor dose coverage and better organ dose sparing than the passive techniques based on tumor margins.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Weber, Damien Charles

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-8140

Publisher:

Elsevier

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

26 Apr 2017 11:16

Last Modified:

26 Apr 2017 11:37

Publisher DOI:

10.1016/j.radonc.2016.10.011

PubMed ID:

27817945

Uncontrolled Keywords:

Couch tracking; Lung phantom; Radiotherapy; Respiratory motion management; Stereotactic body radiation therapy

BORIS DOI:

10.7892/boris.94248

URI:

https://boris.unibe.ch/id/eprint/94248

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