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Title: Application of a Novel Dose-Uncertainty Model for Dose-Uncertainty Analysis in Prostate Intensity-Modulated Radiotherapy

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
OSTI ID:21438025
 [1];  [2];  [3];  [4]
  1. University of Florida Proton Therapy Institute, University of Florida, Jacksonville, FL (United States)
  2. Department of Radiation Oncology, University of Florida, Gainesville, FL (United States)
  3. Department of Radiologic Science, Korea University, Seoul (Korea, Republic of)
  4. Department of Radiation Oncology, Mayo Clinic Jacksonville, Jacksonville, FL (United States)

Purpose: To analyze dose uncertainty using a previously published dose-uncertainty model, and to assess potential dosimetric risks existing in prostate intensity-modulated radiotherapy (IMRT). Methods and Materials: The dose-uncertainty model provides a three-dimensional (3D) dose-uncertainty distribution in a given confidence level. For 8 retrospectively selected patients, dose-uncertainty maps were constructed using the dose-uncertainty model at the 95% CL. In addition to uncertainties inherent to the radiation treatment planning system, four scenarios of spatial errors were considered: machine only (S1), S1 + intrafraction, S1 + interfraction, and S1 + both intrafraction and interfraction errors. To evaluate the potential risks of the IMRT plans, three dose-uncertainty-based plan evaluation tools were introduced: confidence-weighted dose-volume histogram, confidence-weighted dose distribution, and dose-uncertainty-volume histogram. Results: Dose uncertainty caused by interfraction setup error was more significant than that of intrafraction motion error. The maximum dose uncertainty (95% confidence) of the clinical target volume (CTV) was smaller than 5% of the prescribed dose in all but two cases (13.9% and 10.2%). The dose uncertainty for 95% of the CTV volume ranged from 1.3% to 2.9% of the prescribed dose. Conclusions: The dose uncertainty in prostate IMRT could be evaluated using the dose-uncertainty model. Prostate IMRT plans satisfying the same plan objectives could generate a significantly different dose uncertainty because a complex interplay of many uncertainty sources. The uncertainty-based plan evaluation contributes to generating reliable and error-resistant treatment plans.

OSTI ID:
21438025
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 78, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2010.01.063; PII: S0360-3016(10)00266-X; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
Country of Publication:
United States
Language:
English

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