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    Comparison of the dosimetric accuracy of proton breast treatment plans delivered with SGRT and CBCT setups

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    Author
    MacFarlane, Michael J
    Jiang, Kai
    Mundis, Michelle
    Nichols, Elizabeth
    Gopal, Arun
    Chen, Shifeng
    Biswal, Nrusingh C
    Date
    2021-07-20
    Journal
    Journal of Applied Clinical Medical Physics
    Publisher
    Wiley-Blackwell
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1002/acm2.13357
    Abstract
    Purpose: To compare the dosimetric accuracy of surface-guided radiation therapy (SGRT) and cone-beam computed tomography (CBCT) setups in proton breast treatment plans. Methods: Data from 30 patients were retrospectively analyzed in this IRB-approved study. Patients were prescribed 4256–5040 cGy in 16–28 fractions. CBCT and AlignRT (SGRT; Vision RT Ltd.) were used for treatment setup during the first three fractions, then daily AlignRT and weekly CBCT thereafter. Each patient underwent a quality assurance CT (QA-CT) scan midway through the treatment course to assess anatomical and dosimetric changes. To emulate the SGRT and CBCT setups during treatment, the planning CT and QA-CT images were registered in two ways: (1) by registering the volume within the CTs covered by the CBCT field of view; and (2) by contouring and registering the surface surveyed by the AlignRT system. The original plan was copied onto these two datasets and the dose was recalculated. The clinical treatment volume (CTV): V95%; heart: V25Gy, V15Gy, and mean dose; and ipsilateral lung: V20Gy, V10Gy, and V5Gy, were recorded. Multi and univariate analyses of variance were performed to assess the differences in dose metric values between the planning CT and the SGRT and CBCT setups. Results: The CTV V95% and lung V20Gy, V10Gy, and V5Gy dose metrics were all significantly (p < 0.01) lower on the QA-CT in both the CBCT and SGRT setup. The differences were not clinically significant and were, on average, 1.4–1.6% lower for CTV V95% and 1.8%–6.0% lower for the lung dose metrics. When comparing the lung and CTV V95% dose metrics between the CBCT and SGRT setups, no significant difference was observed. This indicates that the SGRT setup provides similar dosimetric accuracy as CBCT. Conclusion: This study supports the daily use of SGRT systems for the accurate dose delivery of proton breast treatment plans.
    Rights/Terms
    © 2021 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.
    Keyword
    CBCT
    SBRT
    Breast Neoplasms--radiotherapy
    Cone-Beam Computed Tomography
    Radiotherapy
    Radiotherapy Planning, Computer-Assisted
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16282
    ae974a485f413a2113503eed53cd6c53
    10.1002/acm2.13357
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