scholarly journals DVH Prediction for VMAT in NPC with GRU-RNN: An Improved Method by Considering Biological Effects

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yongdong Zhuang ◽  
Yaoqin Xie ◽  
Luhua Wang ◽  
Shaomin Huang ◽  
Li-Xin Chen ◽  
...  

Purpose. A recurrent neural network (RNN) and its variants such as gated recurrent unit-based RNN (GRU-RNN) were found to be very suitable for dose-volume histogram (DVH) prediction in our previously published work. Using the dosimetric information generated by nonmodulated beams of different orientations, the GRU-RNN model was capable of accurate DVH prediction for nasopharyngeal carcinoma (NPC) treatment planning. On the basis of our previous work, we proposed an improved approach and aimed to further improve the DVH prediction accuracy as well as study the feasibility of applying the proposed method to relatively small-size patient data. Methods. Eighty NPC volumetric modulated arc therapy (VMAT) plans with local IRB’s approval in recent two years were retrospectively and randomly selected in this study. All these original plans were created using the Eclipse treatment planning system (V13.5, Varian Medical Systems, USA) with ≥95% of PGTVnx receiving the prescribed doses of 70 Gy, ≥95% of PGTVnd receiving 66 Gy, and ≥95% of PTV receiving 60 Gy. Among them, fifty plans were used to train the DVH prediction model, and the remaining were used for testing. On the basis of our previously published work, we simplified the 3-layer GRU-RNN model to a single-layer model and further trained every organ at risk (OAR) separately with an OAR-specific equivalent uniform dose- (EUD-) based loss function. Results. The results of linear least squares regression obtained by the new proposed method showed the excellent agreements between the predictions and the original plans with the correlation coefficient r = 0.976 and 0.968 for EUD results and maximum dose results, respectively, and the coefficient r of our previously published method was 0.957 and 0.946, respectively. The Wilcoxon signed-rank test results between the proposed and the previous work showed that the proposed method could significantly improve the EUD prediction accuracy for the brainstem, spinal cord, and temporal lobes with a p value < 0.01. Conclusions. The accuracy of DVH prediction achieved in different OARs showed the great improvements compared to the previous works, and more importantly, the effectiveness and robustness showed by the simplified GRU-RNN trained from relatively small-size DVH samples, fully demonstrated the feasibility of applying the proposed method to small-size patient data. Excellent agreements in both EUD results and maximum dose results between the predictions and original plans indicated the application prospect in a physically and biologically related (or a mixture of both) model for treatment planning.

2013 ◽  
Vol 4 (1) ◽  
pp. 43-49
Author(s):  
M Jahangir Alam ◽  
Syed Md Akram Hussain ◽  
Kamila Afroj ◽  
Shyam Kishore Shrivastava

A three dimensional treatment planning system has been installed in the Oncology Center, Bangladesh. This system is based on the Anisotropic Analytical Algorithm (AAA). The aim of this study is to verify the validity of photon dose distribution which is calculated by this treatment planning system by comparing it with measured photon beam data in real water phantom. To do this verification, a quality assurance program, consisting of six tests, was performed. In this program, both the calculated output factors and dose at different conditions were compared with the measurement. As a result of that comparison, we found that the calculated output factor was in excellent agreement with the measured factors. Doses at depths beyond the depth of maximum dose calculated on-axis or off-axis in both the fields or penumbra region were found in good agreement with the measured dose under all conditions of energy, SSD and field size, for open and wedged fields. In the build up region, calculated and measured doses only agree (with a difference 2.0%) for field sizes > 5 × 5 cm2 up to 25 × 25 cm2. For smaller fields, the difference was higher than 2.0% because of the difficulty in dosimetry in that region. Dose calculation using treatment planning system based on the Anisotropic Analytical Algorithm (AAA) is accurate enough for clinical use except when calculating dose at depths above maximum dose for small field size.DOI: http://dx.doi.org/10.3329/bjmp.v4i1.14686 Bangladesh Journal of Medical Physics Vol.4 No.1 2011 43-49


Author(s):  
J. Avevor ◽  
S. N. A. Tagoe ◽  
J. H. Amuasi ◽  
J. J. Fletcher ◽  
I. Shirazu

Intracavitary brachytherapy procedures are used for cervical cancer treatment, by the insertion of radioactive implants directly into the diseased tissues. During the treatment process, the bladder together with surrounding tissues are exposed to radiations. Clinical complications do results from high doses received by parts of the bladder during intracavitary brachytherapy of the cervix. The aim of this study is to assess the dose delivered to the bladder using Gafchromic films and compare it with the optimized dose calculated by the Brachy Prowess 4.60 Treatment Planning System (TPS) reports for empirical validation and system verification. Fletcher suite applicators were used to perform thirty (30) different clinical insertions on the constructed cervix phantom and results evaluated. The mean difference between the doses calculated by the TPS and the doses measured by the Gafchromic film for the bladder at the distance of 0.5cm from the edge of the film was 16.3 % (range -35.33 to +39.37). At a distance of 1.5cm for the bladder, the mean difference was 19.4% (range -49.48 to +30.39). The TPS calculated maximum dose was typically higher than the measured maximum dose. However, in some cases, the measured doses were found to be higher than the doses calculated by the TPS. This is due to positional inaccuracies of the sources during treatment planning. It is recommended that in vivo dosimetry be performed in addition to computation.


Author(s):  
Muhammad Masud Rana ◽  
S.M. Azharul Islam ◽  
M. Moinul Islam ◽  
Md. Shakilur Rahman ◽  
Sarwar Alam ◽  
...  

The Pencil Beam Convolution (PBC) algorithm in radiation treatment planning system is widely used to calculate the radiation dose distribution in radiotherapy planning. A new photon dose calculation algorithm known as Anisotropic Analytical Algorithm (AAA) by Varian Medical Systems is applied to investigate the difference of dose distribution by using AAA and PBC algorithms for the lung cancer with an inhomogeneity of its low density. In the present work, radiotherapy treatment planning of 10 lung cancer patients are designed with 6 MV photon beam using three-dimensional conformal radiation therapy (3DCRT) and dose distribution was calculated by the AAA and the PBC Algorithms. The dose distribution performance is evaluated by dose profile curve along transversal slice of PTV and Dose Volume Histogram (DVH) covered by the 95% isodose of PTV. The mean dose of organ at risks did not changed significantly but the volume of the PTV covered by the 95% isodose curve was decreased by 6% with inhomogeneity due to the algorithms. The dose distribution and the accuracy in calculating the absorbed dose of the AAA algorithm of the Varian Eclipse treatment planning system is analyzed and discussed.


2016 ◽  
Vol 15 (3) ◽  
pp. 269-275
Author(s):  
H. Fujita ◽  
N. Kuwahata ◽  
H. Hattori ◽  
H. Kinoshita ◽  
H. Fukuda

AbstractPurposeThe aim of this study was to evaluate the dosimetric aspects of whole brain radiotherapy (WBRT) using an irregular surface compensator (ISC) in contrast to conventional radiotherapy techniques.MethodsTreatment plans were devised for 20 patients. The Eclipse treatment planning system (Varian Medical Systems) was used for dose calculation. For the ISC, a fluence editor application was used to extend the range of optimal fluence. The treatment plan with the ISC was compared with the conventional technique in terms of doses in the planning target volume (PTV), dose homogeneity index (DHI), three-dimensional (3D) maximum dose, eye and lens doses and monitor unit (MU) counts required for treatment.ResultsCompared with conventional WBRT, the ISC significantly reduced the DHI, 3D maximum dose and volumes receiving 105% of the prescription dose, in addition to reducing both eye and lens doses (p<0·05 for all comparisons). In contrast, MU counts were higher for the ISC technique than for conventional WBRT (828 versus 328, p<0·01).ConclusionThe ISC technique for WBRT considerably improved the dose homogeneity in the PTV. As patients who receive WBRT have improved survival, the long-term side effects of radiotherapy are highly important.


Author(s):  
J. Avevor ◽  
S. N. A Tagoe ◽  
J. H. Amuasi ◽  
J. J. Fletcher ◽  
I. Shirazu

Internal radiation therapy, refers to as brachytherapy, involve putting a source of radiation with high photon in or near a cancerous tissues. The type of brachytherapy used most often to treat cervical cancer is known as intracavitary brachytherapy. Unfortunately however, the radiation source placed in the cervix irradiate the normal tissues of rectum and other nearby organs during intracavitary brachytherapy of the cervix treatment. This high doses received by parts of the rectum is a concern for clinicians and the general public. The aim of this study is to assess the dose delivered to the rectum using Gafchromic films and compare it with the optimized dose calculated by the Brachy Prowess 4.60 Treatment Planning System (TPS) reports for empirical validation and system verification. Fletcher suite applicators were used to perform thirty (30) different clinical insertions on the constructed cervix phantom and results evaluated. The mean difference between the doses calculated by the TPS and the doses measured by the Gafchromic film for the rectum at the distance of 0.5cm from the edges of the film was 23.1% (range -42.42 to +40.41). At a distance of 1.5cm for the rectum the mean was 22.5% (range -49.45 to +46.48). The TPS calculated maximum dose was typically higher than the measured maximum dose. However, in some cases, the measured doses were found to be higher than the doses calculated by the TPS. This is due to positional inaccuracies of the sources during treatment planning. It is recommended that in vivo dosimetry should be performed in addition to computation.


Nukleonika ◽  
2021 ◽  
Vol 66 (2) ◽  
pp. 47-53
Author(s):  
Edyta Dąbrowska-Szewczyk ◽  
Anna Zawadzka ◽  
Beata Brzozowska ◽  
Agnieszka Walewska ◽  
Paweł Kukołowicz

Abstract Purpose According to the available international recommendations, at least one independent verification of the calculations of number of monitor unit (MU) is required for every patient treated by teleradiotherapy. The aim of this study was to estimate the differences of dose distributions calculated with two treatment planning systems: Eclipse (Varian) and Oncentra MasterPlan (Elekta). Materials and methods The analysis was performed for 280 three-dimensional conformal radiotherapy treatment (3D-CRT) plans with photon beams from Varian accelerators: CL 600C/D X6 MV (109 plans), CL 2300C/D X6 MV (43 plans), and CL 2300C/D X15 MV (128 plans). The mean doses in the planning target volume (PTV) and doses at the isocenter point obtained with Eclipse and Oncentra MasterPlan (OMP) were compared with Wilcoxon matched-pairs signed rank test. Additionally, the treatment planning system (TPS) calculations were compared with dosimetric measurements performed in the inhomogeneous phantom. Results Data were analysed for 6 MV plans and for 15 MV plans separately, independently of the treatment machine. The dose values calculated in Eclipse were significantly (p <0.001) higher compared to calculations of OMP system. The average difference of the mean dose to PTV was (1.4 ± 1.0)% for X6 MV and (2.5 ± 0.6)% for X15 MV. Average dose disparities at the isocenter point were (1.3 ± 1.9)% and (2.1 ± 1.0)% for X6 MV and X15 MV beams, respectively. The largest differences were observed in lungs, air cavities, and bone structures. Moreover the variation in dosimetric measurements was less as compared to Eclipse calculations. Conclusions OMP calculations were introduced as the independent MU verification tool with the first action level range equal to 3.5%.


2020 ◽  
Vol 61 (2) ◽  
pp. 307-313 ◽  
Author(s):  
Masaru Isono ◽  
Yuichi Akino ◽  
Hirokazu Mizuno ◽  
Yoshihiro Tanaka ◽  
Norihisa Masai ◽  
...  

Abstract Modern treatment machines have shown small inter-unit variability regarding beam data. Recently, vendor-provided average beam data, such as the Representative Beam Data (RBD) of the TrueBeam (Varian Medical Systems, Palo Alto, CA, USA), has been used for modeling of the Eclipse (Varian Medical Systems) treatment planning system. However, RBD does not provide multi-leaf collimator (MLC) parameters, such as MLC leaf transmission factor (LTF) and dosimetric leaf gap (DLG). We performed a web-based multi-institutional survey to investigate these parameters as well as the measurement protocols and customization of the parameters for intensity-modulated radiotherapy (IMRT) and/or volumetric modulated radiotherapy (VMAT) commissioning. We collected 69 sets of linear accelerator (linac) data from 58 institutions. In order to measure MLC parameters, most institutions used farmer-type ionization chambers with a sensitive volume of 0.6 cm3, water phantoms, source surface distance of 90 cm with 10 cm depth, and a vendor-provided plan. The LTF showed small inter-unit variabilities, although the DLG showed large variations. For optimization of the parameters for IMRT/VMAT calculations, DLG values were upwardly adjusted at many institutions, whereas the LTF values were modestly changed. We clarified that MLC parameters were measured under the same conditions at more than half of the facilities. Most institutions customized parameters in a similar manner for IMRT/VMAT. The median measured and customized values obtained in our study will be valuable to verify MLC installation accuracy and to shorten the iterative processes of finding the optimal values.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nazmiye Donmez Kesen ◽  
Aydin Cakir ◽  
Murat Okutan ◽  
Hatice Bilge

In this study, dose distributions and outputs of circular fields with dimensions of 5 cm and smaller, for 6 and 9 MeV nominal energies from the Siemens ONCOR Linac, were measured and compared with data from a treatment planning system using the pencil beam algorithm in electron beam calculations. All dose distribution measurements were performed using the GafChromic EBT film; these measurements were compared with data that were obtained from the Computerized Medical Systems (CMS) XiO treatment planning system (TPS). Output measurements were performed using GafChromic EBT film, an Advanced Markus ion chamber, and thermoluminescent dosimetry (TLD). Although it is used in many clinics, there is not a substantial amount of detailed information in the literature about use of the pencil beam algorithm to model electron beams. Output factors were consistent; differences from the values obtained from the TPS were at maximum. When the dose distributions from the TPS were compared with the measurements from the ion chamber and GafChromic EBT films, it was observed that the results were consistent with 2 cm diameter fields and larger, but the outputs for 1 cm diameter fields and smaller were not consistent.


2021 ◽  
Author(s):  
Yanhua Duan ◽  
Yan Shao ◽  
Hua Chen ◽  
Hao Wang ◽  
Hengle Gu ◽  
...  

Abstract Purpose: The plan quality of the stereotactic body radiation therapy (SBRT) plan is affected by the patient’s planning target volume (PTV). The predictability of PTV volume and cut-off points were investigated to judge the suitability of manual and automatic plans for lung SBRT patients.Methods: The manual and automatic SBRT plans were retrospectively designed using the Pinnacle 16.2 treatment planning system (TPS) for 98 lung cancer patients. the suitability of manual and automatic plans for each patient is comprehensively evaluated. Receiver operating characteristic (ROC) analysis was used to investigate the predictability of PTV volume and determine the cut-off point. Once the cut-off point exists, all patients were divided into two groups according to this cut-off point. The Wilcoxon signed-rank test was performed for the dosimetric comparisons between the two groups. Results: ROC analysis showed that PTV volume (AUC [Area under curve]: 0.918, p= 0.005) has diagnostic power to predict the suitability of manual and automatic plans for lung SBRT patients. The cut-off points of 22.675cc were selected for PTV volume. Regardless of some comparable results, the CI, GI, V10, and V20 of automatic plans were found to be better than manual plans below the cut-off points, and the manual plan is superior to the automatic plan in HI, GI, heart d15cc, V10, V20 above the cut-off points.Conclusion: The PTV volume of cut-off points (22.675cc) are predictive of the suitability of manual and automatic plan using Pinnacle TPS for lung SBRT patients. Automatic plans were recommended for patients with PTV volumes less than 22.675cc, and manual plans can be tried for patients with larger PTV volumes.


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