Interfractional dose accumulation for MR-guided liver SBRT: Variation among algorithms is highly patient- and fraction-dependent
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Interfractional dose accumulation for MR-guided liver SBRT : Variation among algorithms is highly patient- and fraction-dependent. / Wahlstedt, Isak; Smith, Abraham George; Andersen, Claus Erik; Behrens, Claus Preibisch; Nørring Bekke, Susanne; Boye, Kristian; van Overeem Felter, Mette; Josipovic, Mirjana; Petersen, Jens; Risumlund, Signe Lenora; Tascón-Vidarte, José David; van Timmeren, Janita Elizabeth; Vogelius, Ivan Richter.
In: Radiotherapy and Oncology, Vol. 182, 109448, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Interfractional dose accumulation for MR-guided liver SBRT
T2 - Variation among algorithms is highly patient- and fraction-dependent
AU - Wahlstedt, Isak
AU - Smith, Abraham George
AU - Andersen, Claus Erik
AU - Behrens, Claus Preibisch
AU - Nørring Bekke, Susanne
AU - Boye, Kristian
AU - van Overeem Felter, Mette
AU - Josipovic, Mirjana
AU - Petersen, Jens
AU - Risumlund, Signe Lenora
AU - Tascón-Vidarte, José David
AU - van Timmeren, Janita Elizabeth
AU - Vogelius, Ivan Richter
N1 - Publisher Copyright: © 2022 The Author(s)
PY - 2023
Y1 - 2023
N2 - Background and purpose: Daily plan adaptations could take the dose delivered in previous fractions into account. Due to high dose delivered per fraction, low number of fractions, steep dose gradients, and large interfractional organ deformations, this might be particularly important for liver SBRT. This study investigates inter-algorithm variation of interfractional dose accumulation for MR-guided liver SBRT. Materials and methods: We assessed 27 consecutive MR-guided liver SBRT treatments of 67.5 Gy in three (n = 15) or 50 Gy in five fractions (n = 12), both prescribed to the GTV. We calculated fraction doses on daily patient anatomy, warped these doses to the simulation MRI using seven different algorithms, and accumulated the warped doses. Thus, we obtained differences in planned doses and warped or accumulated doses for each algorithm. This enabled us to calculate the inter-algorithm variations in warped doses per fraction and in accumulated doses per treatment course. Results: The four intensity-based algorithms were more consistent with planned PTV dose than affine or contour-based algorithms. The mean (range) variation of the dose difference for PTV D95% due to dose warping by these intensity-based algorithms was 10.4 percentage points (0.3 to 43.7) between fractions and 8.6 (0.3 to 24.9) between accumulated treatment doses. As seen by these ranges, the variation was very dependent on the patient and the fraction being analyzed. Nevertheless, no correlations between patient or plan characteristics on the one hand and inter-algorithm dose warping variation on the other hand was found. Conclusion: Inter-algorithm dose accumulation variation is highly patient- and fraction-dependent for MR-guided liver SBRT. We advise against trusting a single algorithm for dose accumulation in liver SBRT.
AB - Background and purpose: Daily plan adaptations could take the dose delivered in previous fractions into account. Due to high dose delivered per fraction, low number of fractions, steep dose gradients, and large interfractional organ deformations, this might be particularly important for liver SBRT. This study investigates inter-algorithm variation of interfractional dose accumulation for MR-guided liver SBRT. Materials and methods: We assessed 27 consecutive MR-guided liver SBRT treatments of 67.5 Gy in three (n = 15) or 50 Gy in five fractions (n = 12), both prescribed to the GTV. We calculated fraction doses on daily patient anatomy, warped these doses to the simulation MRI using seven different algorithms, and accumulated the warped doses. Thus, we obtained differences in planned doses and warped or accumulated doses for each algorithm. This enabled us to calculate the inter-algorithm variations in warped doses per fraction and in accumulated doses per treatment course. Results: The four intensity-based algorithms were more consistent with planned PTV dose than affine or contour-based algorithms. The mean (range) variation of the dose difference for PTV D95% due to dose warping by these intensity-based algorithms was 10.4 percentage points (0.3 to 43.7) between fractions and 8.6 (0.3 to 24.9) between accumulated treatment doses. As seen by these ranges, the variation was very dependent on the patient and the fraction being analyzed. Nevertheless, no correlations between patient or plan characteristics on the one hand and inter-algorithm dose warping variation on the other hand was found. Conclusion: Inter-algorithm dose accumulation variation is highly patient- and fraction-dependent for MR-guided liver SBRT. We advise against trusting a single algorithm for dose accumulation in liver SBRT.
KW - Deformable image registration
KW - Dose accumulation
KW - Liver metastases
KW - MR-guided radiotherapy
KW - Radiotherapy
KW - SABR
U2 - 10.1016/j.radonc.2022.109448
DO - 10.1016/j.radonc.2022.109448
M3 - Journal article
C2 - 36566988
AN - SCOPUS:85149621034
VL - 182
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
SN - 0167-8140
M1 - 109448
ER -
ID: 340544171