IJMPCERO  Vol.7 No.1 , February 2018
Dosimetric Comparison between Bone and Target Matching Considering Interfractional Prostate Motion in Volumetric Modulated Arc Therapy
Abstract: Adequate matching methods are critical for accurate volumetric-modulated arc therapy (VMAT). We investigated the dosimetric differences in the target and organs at risk (OARs) between bone matching and target matching in patients with prostate cancer treated with VMAT. The relationship between the dosimetric differences and interfractional motion of the prostate was also evaluated. Forty patients with prostate cancer classified as intermediate risk were enrolled in a study to assess the differences in dosimetry between two matching methods. These patients were treated with VMAT and prescribed dose was 78 Gy. The dose distribution was calculated using cone-beam computed tomography (CBCT) for this study. We selected clinical target volume (CTV) as the target, and the rectum and bladder as the OARs. The Dmean, D98, D95, and D2 to the target and V10-V70 to the OARs were calculated as different dose from target matching value minus bone matching value. Multiple regression analysis was used to evaluate the effect of interfractional motion of the prostate on the differences in dose. The CTV D95 values differed by -0.22 ± 1.01 Gy (mean ± standard deviation). Rectum and bladder V70 values differed by 4.6% ± 7.2% and -2.6% ± 7.2%, respectively. There was a correlation between interfractional motion of the prostate and the dose differences to OARs (R2 = 0.73 - 0.94). The dose differences to OARs also varied depending on the direction of the prostate’s motion. We found that bone matching resulted in an increased rectal dose and high risk of decreasing dose to the CTV.
Cite this paper: Nakahara, R. , Ishii, K. , Wakai, N. , Kawamorita, R. , Okada, W. , Kishimoto, S. , Kubo, K. , Nakajima, T. and Hasegawa, M. (2018) Dosimetric Comparison between Bone and Target Matching Considering Interfractional Prostate Motion in Volumetric Modulated Arc Therapy. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 7, 47-60. doi: 10.4236/ijmpcero.2018.71005.

[1]   Zelefsky, M.J., Fuks, Z., Happersett, L., Lee, H.J., Ling, C.C., Burman, C.M., Hunt, M., Wolfe, T., Venkatraman, E. and Jackson, A. (2000) Clinical Experience with Intensity Modulated Radiation Therapy (IMRT) in Prostate Cancer. Radiotherapy and Oncology, 55, 241-249.

[2]   Pollack, A., Hanlon, A., Horwitz, E.M., Feigenberg, S., Uzzo, R.G. and Price, R.A. (2003) Radiation Therapy Dose Escalation for Prostate Cancer: A Rationale for IMRT. World Journal of Urology, 21, 200-208.

[3]   Chung, H.T., Xia, P., Chan, L.W., Park-Somers, E., and Roach, M. (2009) Does Image-Guided Radiotherapy Improve Toxicity Profile in Whole Pelvic-Treated High-Risk Prostate Cancer? Comparison between IG-IMRT and IMRT. International Journal of Radiation Oncology* Biology* Physics, 73, 53-60.

[4]   Mohler, J.L. (2010) The 2010 NCCN Clinical Practice Guidelines in Oncology on Prostate Cancer. Harborside Press, LLC.

[5]   Varadhan, R., Hui, S.K., Way, S. and Nisi, K. (2009) Assessing Prostate, Bladder and Rectal Doses during Image Guided Radiation Therapy—Need for Plan Adaptation? Journal of Applied Clinical Medical Physics, 10, 56-74.

[6]   Zelefsky, M.J., Kollmeier, M., Cox, B., Fidaleo, A., Sperling, D., Pei, X., Carver, B., Coleman, J., Lovelock, M. and Hunt, M. (2012) Improved Clinical Outcomes with High-Dose Image Guided Radiotherapy Compared with Non-IGRT for the Treatment of Clinically Localized Prostate Cancer. International Journal of Radiation Oncology* Biology* Physics, 84, 125-129.

[7]   Valeriani, M., Bracci, S., Osti, M.F., Falco, T., Agolli, L., De Sanctis, V. and Enrici, R.M. (2013) Intermediate-Risk Prostate Cancer Patients Treated with Androgen Deprivation Therapy and a Hypofractionated Radiation Regimen with or without Image Guided Radiotherapy. Radiation Oncology, 8, 137.

[8]   Lattanzi, J., McNeeley, S., Hanlon, A., Schultheiss, T.E. and Hanks, G.E. (2000) Ultrasound-Based Stereotactic Guidance of Precision Conformal External Beam Radiation Therapy in Clinically Localized Prostate Cancer. Urology, 55, 73-78.

[9]   Barney, B.M., Lee, R.J., Handrahan, D., Welsh, K.T., Cook, J.T. and Sause, W.T. (2011) Image-Guided Radiotherapy (IGRT) for Prostate Cancer Comparing kV Imaging of Fiducial Markers with Cone Beam Computed Tomography (CBCT). International Journal of Radiation Oncology* Biology* Physics, 80, 301-305.

[10]   Langen, K.M., Zhang, Y., Andrews, R.D., Hurley, M.E., Meeks, S.L., Poole, D.O., Willoughby, T.R. and Kupelian, P.A. (2005) Initial Experience with Megavoltage (MV) CT Guidance for Daily Prostate Alignments. International Journal of Radiation Oncology* Biology* Physics, 62, 1517-1524.

[11]   Nijkamp, J., Pos, F.J., Nuver, T.T., De Jong, R., Remeijer, P., Sonke, J.-J. and Lebesque, J.V. (2008) Adaptive Radiotherapy for Prostate Cancer using Kilovoltage Cone-Beam Computed Tomography: First Clinical Results. International Journal of Radiation Oncology Biology Physics, 70, 75-82.

[12]   Nakamura, K., Akimoto, T., Mizowaki, T., Hatano, K., Kodaira, T., Nakamura, N., Kozuka, T., Shikama, N. and Kagami, Y. (2011) Patterns of Practice in Intensity-Modulated Radiation Therapy and Image-Guided Radiation Therapy for Prostate Cancer in Japan. Japanese Journal of Clinical Oncology, 42, 53-57.

[13]   Bissonnette, J.P., Balter, P.A., Dong, L., Langen, K.M., Lovelock, D.M., Miften, M., Moseley, D.J., Pouliot, J., Sonke, J.J. and Yoo, S. (2012) Quality Assurance for Image-Guided Radiation Therapy Utilizing CT-Based Technologies: A Report of the AAPM TG-179. Medical Physics, 39, 1946-1963.

[14]   Thongphiew, D., Wu, Q.J., Lee, W.R., Chankong, V., Yoo, S., McMahon, R. and Yin, F.F. (2009) Comparison of Online IGRT Techniques for Prostate IMRT Treatment: Adaptive vs. Repositioning Correction. Medical Physics, 36, 1651-1662.

[15]   Rivest, D., Riauka, T., Murtha, A. and Fallone, B. (2009) Dosimetric Implications of Two Registration Based Patient Positioning Methods in Prostate Image Guided Radiation Therapy (IGRT). Radiology and Oncology, 43, 203-212.

[16]   Hirose, Y., Nakamura, M., Tomita, T., Kitsuda, K., Notogawa, T., Miki, K., Nakamura, K. and Ishigaki, T. (2014) Evaluation of Different Set-Up Error Corrections on Dose-Volume Metrics in Prostate IMRT using CBCT Images. Journal of Radiation Research, 55, 966-975.

[17]   Rijkhorst, E.-J., Lakeman, A., Nijkamp, J., de Bois, J., van Herk, M., Lebesque, J.V. and Sonke, J.-J. (2009) Strategies for Online Organ Motion Correction for Intensity-Modulated Radiotherapy of Prostate Cancer: Prostate, Rectum, and Bladder Dose Effects. International Journal of Radiation Oncology Biology Physics, 75, 1254-1260.

[18]   Langen, K. and Jones, D. (2001) Organ Motion and Its Management. International Journal of Radiation Oncology Biology Physics, 50, 265-278.

[19]   Palombarini, M., Mengoli, S., Fantazzini, P., Cadioli, C., Degli Esposti, C. and Frezza, G.P. (2012) Analysis of Inter-Fraction Setup Errors and Organ Motion by Daily Kilovoltage Cone Beam Computed Tomography in Intensity Modulated Radiotherapy of Prostate Cancer. Radiation Oncology, 7, 56.

[20]   Nichol, A.M., Brock, K.K., Lockwood, G.A., Moseley, D.J., Rosewall, T., Warde, P.R., Catton, C.N. and Jaffray, D.A. (2007) A Magnetic Resonance Imaging Study of Prostate Deformation Relative to Implanted Gold Fiducial Markers. International Journal of Radiation Oncology Biology Physics, 67, 48-56.

[21]   Kim, J., Hammoud, R., Pradhan, D., Zhong, H., Jin, R.Y., Movsas, B. and Chetty, I.J. (2010) Prostate Localization on Daily Cone-Beam Computed Tomography Images: Accuracy Assessment of Similarity Metrics. International Journal of Radiation Oncology Biology Physics, 77, 1257-1265.

[22]   Michalski, J.M., Gay, H., Jackson, A., Tucker, S.L. and Deasy, J.O. (2010) Radiation Dose-Volume Effects in Radiation-Induced Rectal Injury. International Journal of Radiation Oncology Biology Physics, 76, S123-S129.

[23]   Sato, H., Abe, E., Utsunomiya, S., Kaidu, M., Yamana, N., Tanaka, K., Ohta, A., Obinata, M., Liu, J. and Kawaguchi, G. (2015) Superiority of a Soft Tissue-Based Setup using Cone-Beam Computed Tomography over a Bony Structure-Based Setup in Intensity-Modulated Radiotherapy for Prostate Cancer. Journal of Applied Clinical Medical Physics, 16, 239-245.

[24]   Onozato, Y., Kadoya, N., Fujita, Y., Arai, K., Dobashi, S., Takeda, K., Kishi, K., Umezawa, R., Matsushita, H. and Jingu, K. (2014) Evaluation of On-Board kV Cone Beam Computed Tomography-Based Dose Calculation with Deformable Image Registration using Hounsfield Unit Modifications. International Journal of Radiation Oncology Biology Physics, 89, 416-423.