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Title: Patient-Specific Three-Dimensional Concomitant Dose From Cone Beam Computed Tomography Exposure in Image-Guided Radiotherapy

Abstract

Purpose: The purpose of the present study was to quantify the concomitant dose received by patients undergoing cone beam computed tomography (CBCT) scanning in different clinical scenarios as a part of image-guided radiotherapy (IGRT) procedures. Methods and Materials: We calculated the three-dimensional concomitant dose received as a result of CBCT scans in 6 patients representing different clinical scenarios: two pelvis, two head and neck, and two chest. We assessed the effect that a daily on-line IGRT strategy would have on the patient dose distribution, assuming 40 CBCT scans throughout the treatment course. The additional dose to the planning target volume margin region was also estimated. Results: In the pelvis, a single CBCT scan delivered a mean dose to the femoral heads of 2-6 cGy and the rectum of 1-2 cGy. An additional dose to the planning target volume was within 1-3 cGy. In the chest, the mean dose to the planning target volume varied from 2.5 to 5 cGy. The lung and spinal cord planning organ at risk volume received {<=}4 cGy and {<=}5 cGy, respectively. In the head and neck, a single CBCT scan delivered a mean dose of 0.3 cGy, with bony structures receiving 0.5-0.8 cGy. The femoralmore » heads received an additional dose of 1.5-2.5 Gy. A reduction of 20-30% in the mean dose to the organs at risk was achieved using bowtie filtration. In the head and neck, the dose to the eyes and brainstem was eliminated by decreasing the craniocaudal field size. Conclusions: The additional dose from on-line IGRT procedures can be clinically relevant. The organ dose can be significantly reduced with the use of appropriate patient-specific settings. The concomitant dose from CBCT should be accounted for and the acquisition settings optimized for optimal IGRT strategies on a patient basis.« less

Authors:
 [1]; ; ;  [1];  [2]
  1. Department of Medical Physics, Velindre Cancer Centre, Cardiff (United Kingdom)
  2. Research Department, Velindre Cancer Centre, Cardiff University School of Medicine, Cardiff (United Kingdom)
Publication Date:
OSTI Identifier:
22056366
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 83; Journal Issue: 1; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEST; COMPUTERIZED TOMOGRAPHY; EYES; HAZARDS; IMAGES; LUNGS; MONTE CARLO METHOD; NECK; PATIENTS; PELVIS; PLANNING; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIOTHERAPY; RECTUM; SPINAL CORD

Citation Formats

Spezi, Emiliano, Downes, Patrick, Jarvis, Richard, Radu, Emil, and Staffurth, John. Patient-Specific Three-Dimensional Concomitant Dose From Cone Beam Computed Tomography Exposure in Image-Guided Radiotherapy. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.06.1972.
Spezi, Emiliano, Downes, Patrick, Jarvis, Richard, Radu, Emil, & Staffurth, John. Patient-Specific Three-Dimensional Concomitant Dose From Cone Beam Computed Tomography Exposure in Image-Guided Radiotherapy. United States. https://doi.org/10.1016/J.IJROBP.2011.06.1972
Spezi, Emiliano, Downes, Patrick, Jarvis, Richard, Radu, Emil, and Staffurth, John. 2012. "Patient-Specific Three-Dimensional Concomitant Dose From Cone Beam Computed Tomography Exposure in Image-Guided Radiotherapy". United States. https://doi.org/10.1016/J.IJROBP.2011.06.1972.
@article{osti_22056366,
title = {Patient-Specific Three-Dimensional Concomitant Dose From Cone Beam Computed Tomography Exposure in Image-Guided Radiotherapy},
author = {Spezi, Emiliano and Downes, Patrick and Jarvis, Richard and Radu, Emil and Staffurth, John},
abstractNote = {Purpose: The purpose of the present study was to quantify the concomitant dose received by patients undergoing cone beam computed tomography (CBCT) scanning in different clinical scenarios as a part of image-guided radiotherapy (IGRT) procedures. Methods and Materials: We calculated the three-dimensional concomitant dose received as a result of CBCT scans in 6 patients representing different clinical scenarios: two pelvis, two head and neck, and two chest. We assessed the effect that a daily on-line IGRT strategy would have on the patient dose distribution, assuming 40 CBCT scans throughout the treatment course. The additional dose to the planning target volume margin region was also estimated. Results: In the pelvis, a single CBCT scan delivered a mean dose to the femoral heads of 2-6 cGy and the rectum of 1-2 cGy. An additional dose to the planning target volume was within 1-3 cGy. In the chest, the mean dose to the planning target volume varied from 2.5 to 5 cGy. The lung and spinal cord planning organ at risk volume received {<=}4 cGy and {<=}5 cGy, respectively. In the head and neck, a single CBCT scan delivered a mean dose of 0.3 cGy, with bony structures receiving 0.5-0.8 cGy. The femoral heads received an additional dose of 1.5-2.5 Gy. A reduction of 20-30% in the mean dose to the organs at risk was achieved using bowtie filtration. In the head and neck, the dose to the eyes and brainstem was eliminated by decreasing the craniocaudal field size. Conclusions: The additional dose from on-line IGRT procedures can be clinically relevant. The organ dose can be significantly reduced with the use of appropriate patient-specific settings. The concomitant dose from CBCT should be accounted for and the acquisition settings optimized for optimal IGRT strategies on a patient basis.},
doi = {10.1016/J.IJROBP.2011.06.1972},
url = {https://www.osti.gov/biblio/22056366}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 83,
place = {United States},
year = {Tue May 01 00:00:00 EDT 2012},
month = {Tue May 01 00:00:00 EDT 2012}
}