Cone beam CT pre- and post-daily treatment for assessing geometrical and dosimetric intrafraction variability during radiotherapy of prostate cancer

Giacomo Reggiori, Pietro Mancosu, Angelo Tozzi, Marie C. Cantone, Simona Castiglioni, Paola Lattuada, Francesca Lobefalo, Luca Cozzi, Antonella Fogliata, Piera Navarria, Marta Scorsetti

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Abstract

The purpose of this study was to quantify the relationship between treatment time and dose uncertainty due to intrafraction organ motion in prostate cancer radiotherapy (RT). Ten consecutive patients with prostate cancer treated by radical RT by volumetric modulated arc therapy (RapidArc) were considered. For each patient, pre- and post-treatment cone beam computed tomography (CBCT) was performed in 10 fractions. The prostate, rectum and bladder were contoured on each CBCT. The change in organ position, volume and dosimetric uncertainty induced by organ motion were evaluated. Interval time between the two CBCTs ranged between 4 and 16 min (mean 7.3 ± 0.7 min). Treatment with intrafraction prostate motion >3mm and > 5 mm were 24% and 5%, respectively. Regarding change in centroid position and volume, a poor time correlation was found for target and rectum, while a constant increase was obtained for bladder. The agreement index was highly correlated to time (r = -0.89 for bladder, r = -0.95 for rectum, and r= -0.84 for prostate). In terms of difference in dose volume histogram between pre- and post-CBCT, the dose uncertainties for the targets and rectum amplified with the increasing time. The increasing intrafraction dose uncertainty with time requires the use of an RT technique with minimization of treatment time to improve confidence in planning dose distribution.

Original languageEnglish
Pages (from-to)141-152
Number of pages12
JournalJournal of Applied Clinical Medical Physics
Volume12
Issue number1
Publication statusPublished - 2011

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Cone-Beam Computed Tomography
Radiotherapy
Cones
radiation therapy
Prostatic Neoplasms
cones
cancer
rectum
Tomography
Rectum
Uncertainty
bladder
dosage
organs
Prostate
Urinary Bladder
tomography
Therapeutics
Intensity-Modulated Radiotherapy
Organ Size

Keywords

  • CBCT
  • Intrafraction motion
  • Prostate RT
  • RapidArc

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Instrumentation

Cite this

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title = "Cone beam CT pre- and post-daily treatment for assessing geometrical and dosimetric intrafraction variability during radiotherapy of prostate cancer",
abstract = "The purpose of this study was to quantify the relationship between treatment time and dose uncertainty due to intrafraction organ motion in prostate cancer radiotherapy (RT). Ten consecutive patients with prostate cancer treated by radical RT by volumetric modulated arc therapy (RapidArc) were considered. For each patient, pre- and post-treatment cone beam computed tomography (CBCT) was performed in 10 fractions. The prostate, rectum and bladder were contoured on each CBCT. The change in organ position, volume and dosimetric uncertainty induced by organ motion were evaluated. Interval time between the two CBCTs ranged between 4 and 16 min (mean 7.3 ± 0.7 min). Treatment with intrafraction prostate motion >3mm and > 5 mm were 24{\%} and 5{\%}, respectively. Regarding change in centroid position and volume, a poor time correlation was found for target and rectum, while a constant increase was obtained for bladder. The agreement index was highly correlated to time (r = -0.89 for bladder, r = -0.95 for rectum, and r= -0.84 for prostate). In terms of difference in dose volume histogram between pre- and post-CBCT, the dose uncertainties for the targets and rectum amplified with the increasing time. The increasing intrafraction dose uncertainty with time requires the use of an RT technique with minimization of treatment time to improve confidence in planning dose distribution.",
keywords = "CBCT, Intrafraction motion, Prostate RT, RapidArc",
author = "Giacomo Reggiori and Pietro Mancosu and Angelo Tozzi and Cantone, {Marie C.} and Simona Castiglioni and Paola Lattuada and Francesca Lobefalo and Luca Cozzi and Antonella Fogliata and Piera Navarria and Marta Scorsetti",
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T1 - Cone beam CT pre- and post-daily treatment for assessing geometrical and dosimetric intrafraction variability during radiotherapy of prostate cancer

AU - Reggiori, Giacomo

AU - Mancosu, Pietro

AU - Tozzi, Angelo

AU - Cantone, Marie C.

AU - Castiglioni, Simona

AU - Lattuada, Paola

AU - Lobefalo, Francesca

AU - Cozzi, Luca

AU - Fogliata, Antonella

AU - Navarria, Piera

AU - Scorsetti, Marta

PY - 2011

Y1 - 2011

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