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30.08.2019 | Original Research

Impact of choice of dose calculation algorithm on PTV and OAR doses in lung SBRT

verfasst von: Kashmiri L. Chopra, Matthew M. Harkenrider, B. Emami, Edward Melian, Jaiteerth S. Avadhani, T. S. Kehwar, D. V. Rai, Anil Sethi

Erschienen in: Journal of Radiation Oncology | Ausgabe 3/2019

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Abstract

Background

Five dose calculation algorithms commonly used in lung SBRT planning are evaluated for their dosimetric impact on planning target volume (PTV) and organ-at-risk (OAR) doses.

Methods and materials

Treatment plans for thirty lung SBRT patients were included in this multi-institutional planning study. Lung SBRT plans were initially generated using BrainLab Pencil Beam (PB) convolution algorithm to deliver 50 Gy in 5 fractions to PTV (PB_OP plans). Plans were recalculated using BrainLab Monte Carlo (MC) algorithm with the same beam parameters, field settings, and MUs (MC_NO plans) to investigate accuracy limits of PB plans. Next, these plans were re-optimized via MU scaling in MC algorithm while keeping original beam parameters and settings (MC_OP). Further, with these new MUs, all patient plans were recalculated with Pinnacle collapsed cone convolution superposition (CCC), Eclipse anisotropic analytic algorithm (AAA), and Eclipse Acuros XB (AXB) algorithms, and are referred to as AP_NO, AAA_NO, and AXB_NO plans, respectively. DVH of PTV and OARs were used to calculate dosimetric parameters for comparison with MC_OP plans. Patient plans were compared based on PTV size as well as the location in the lung: island targets, adjacent to the ribs/chest wall, or mixed.

Results

Lung SBRT plans using PB dose algorithm overestimated target doses by 10–20% of prescribed dose and these differences were highlighted mainly in the target periphery/dose-buildup region as seen in D_min and D₉₀. Compared with MC, both Pinnacle and AAA plans overestimated PTV dose in the penumbra region, whereas Acuros plans were in good agreement with MC plans. PTV dose differences ranged 3–5% among Pinnacle, AAA, and Acuros. In general, Acuros AXB performed well for adjacent and mixed targets near the ribs and chest wall, whereas Pinnacle CCC was favored for island targets. OAR D_max and lung V₂₀ were better reproduced in Pinnacle, whereas D_mean were comparable among all TPS.

Conclusion

Knowing the strengths and limitations of clinical treatment planning system allows more consistent and accurate dose comparison for patients enrolled in protocol studies.

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Titel: Impact of choice of dose calculation algorithm on PTV and OAR doses in lung SBRT
verfasst von: Kashmiri L. Chopra
Matthew M. Harkenrider
B. Emami
Edward Melian
Jaiteerth S. Avadhani
T. S. Kehwar
D. V. Rai
Anil Sethi
Publikationsdatum: 30.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Radiation Oncology / Ausgabe 3/2019
Print ISSN: 1948-7894
Elektronische ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-019-00399-7

Springer Medizin

Impact of choice of dose calculation algorithm on PTV and OAR doses in lung SBRT