Premium
SU‐E‐J‐88: Margin Reduction of Level II/III Planning Target Volume for Image‐Guided Simultaneous Integrated Boost Head‐And‐Neck Treatment
Author(s) -
Can S,
Neylon J,
Qi S,
Santhanam A,
Low D
Publication year - 2014
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.4888140
Subject(s) - tomotherapy , margin (machine learning) , nuclear medicine , medicine , radiation treatment planning , dosimetry , image guided radiation therapy , radiation therapy , head and neck , radiology , surgery , computer science , machine learning
Purpose: To investigate the feasibility of improved normal tissue sparing for head‐and‐neck (H' N) image‐guided radiotherapy (IGRT) by employing tighter CTV‐to‐PTV margins for target level II/III though a GPU‐based deformable image registration and dose accumulation framework. Methods: Ten H' N simultaneous integrated boost cases treated on TomoTherapy were retrospectively analyzed. Weekly kVCT scans in addition to daily MVCT scans were acquired for each patient. Reduced margin plans were generated with 0‐ mm margin for level II and III PTV (while 3‐5 mm margin for PTV1) and compared with the standard margin plan using 3‐5mm margin to all CTV1‐3 (reference plan). An in‐house developed GPU‐based 3D image deformation tool was used to register and deform the weekly KVCTs with the planning CT and determine the delivered mean/minimum/maximum dose, dose volume histograms (DVHs), etc. Results: Compared with the reference plans, the averaged cord maximum, the right and left parotid doses reduced by 22.7 %, 16.5 %, and 9 % respectively in the reduced margin plans. The V95 for PTV2 and PTV3 were found within 2 and 5% between the reference and tighter margin plans. For the reduced margin plans, the averaged cumulative mean doses were consistent with the planned dose for PTV1, PTV2 and PTV3 within 1.5%, 1.7% and 1.4%. Similar dose variations of the delivered dose were seen for the reference and tighter margin plans. The delivered maximum and mean doses for the cord were 3.55 % and 2.37% higher than the planned doses; a 5 % higher cumulative mean dose for the parotids was also observed for the delivered dose than the planned doses in both plans. Conclusion: By imposing tighter CTV‐to‐PTV margins for level II and III targets for H' N irradiation, acceptable cumulative doses were achievable when coupled with weekly kVCT guidance while improving normal structure sparing.