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Title: Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy

Abstract

Purpose and Objective: Propose a novel method for individualized selection of beam angles and treatment isocenter in tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: For each patient, beam and isocenter selection starts with the fully automatic generation of a large database of IMRT plans (up to 847 in this study); each of these plans belongs to a unique combination of isocenter position, lateral beam angle, and medial beam angle. The imposed hard planning constraint on patient maximum dose may result in plans with unacceptable target dose delivery. Such plans are excluded from further analyses. Owing to differences in beam setup, database plans differ in mean doses to organs at risk (OARs). These mean doses are used to construct 2-dimensional graphs, showing relationships between: (1) contralateral breast dose and ipsilateral lung dose; and (2) contralateral breast dose and heart dose (analyzed only for left-sided). The graphs can be used for selection of the isocenter and beam angles with the optimal, patient-specific tradeoffs between the mean OAR doses. For 30 previously treated patients (15 left-sided and 15 right-sided tumors), graphs were generated considering only the clinically applied isocenter with 121 tangential beam angle pairs. For 20 of the 30more » patients, 6 alternative isocenters were also investigated. Results: Computation time for automatic generation of 121 IMRT plans took on average 30 minutes. The generated graphs demonstrated large variations in tradeoffs between conflicting OAR objectives, depending on beam angles and patient anatomy. For patients with isocenter optimization, 847 IMRT plans were considered. Adding isocenter position optimization next to beam angle optimization had a small impact on the final plan quality. Conclusion: A method is proposed for individualized selection of beam angles in tangential breast IMRT. This may be especially important for patients with cardiac risk factors or an enhanced risk for the development of contralateral breast cancer.« less

Authors:
 [1];  [1];  [2]; ;  [1];  [3];  [1]
  1. Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands)
  2. (Italy)
  3. Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy)
Publication Date:
OSTI Identifier:
22649943
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 98; Journal Issue: 2; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BEAMS; CALCULATION METHODS; GRAPH THEORY; MAMMARY GLANDS; NEOPLASMS; OPTIMIZATION; PATIENTS; RADIATION DOSES; RADIATION HAZARDS; RADIOTHERAPY

Citation Formats

Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl, Spadola, Sara, Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna, Breedveld, Sebastiaan, Baaijens, Margreet, Lanconelli, Nico, and Heijmen, Ben. Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.02.008.
Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl, Spadola, Sara, Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna, Breedveld, Sebastiaan, Baaijens, Margreet, Lanconelli, Nico, & Heijmen, Ben. Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy. United States. doi:10.1016/J.IJROBP.2017.02.008.
Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl, Spadola, Sara, Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna, Breedveld, Sebastiaan, Baaijens, Margreet, Lanconelli, Nico, and Heijmen, Ben. Thu . "Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy". United States. doi:10.1016/J.IJROBP.2017.02.008.
@article{osti_22649943,
title = {Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy},
author = {Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl and Spadola, Sara and Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna and Breedveld, Sebastiaan and Baaijens, Margreet and Lanconelli, Nico and Heijmen, Ben},
abstractNote = {Purpose and Objective: Propose a novel method for individualized selection of beam angles and treatment isocenter in tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: For each patient, beam and isocenter selection starts with the fully automatic generation of a large database of IMRT plans (up to 847 in this study); each of these plans belongs to a unique combination of isocenter position, lateral beam angle, and medial beam angle. The imposed hard planning constraint on patient maximum dose may result in plans with unacceptable target dose delivery. Such plans are excluded from further analyses. Owing to differences in beam setup, database plans differ in mean doses to organs at risk (OARs). These mean doses are used to construct 2-dimensional graphs, showing relationships between: (1) contralateral breast dose and ipsilateral lung dose; and (2) contralateral breast dose and heart dose (analyzed only for left-sided). The graphs can be used for selection of the isocenter and beam angles with the optimal, patient-specific tradeoffs between the mean OAR doses. For 30 previously treated patients (15 left-sided and 15 right-sided tumors), graphs were generated considering only the clinically applied isocenter with 121 tangential beam angle pairs. For 20 of the 30 patients, 6 alternative isocenters were also investigated. Results: Computation time for automatic generation of 121 IMRT plans took on average 30 minutes. The generated graphs demonstrated large variations in tradeoffs between conflicting OAR objectives, depending on beam angles and patient anatomy. For patients with isocenter optimization, 847 IMRT plans were considered. Adding isocenter position optimization next to beam angle optimization had a small impact on the final plan quality. Conclusion: A method is proposed for individualized selection of beam angles in tangential breast IMRT. This may be especially important for patients with cardiac risk factors or an enhanced risk for the development of contralateral breast cancer.},
doi = {10.1016/J.IJROBP.2017.02.008},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 98,
place = {United States},
year = {Thu Jun 01 00:00:00 EDT 2017},
month = {Thu Jun 01 00:00:00 EDT 2017}
}