期刊论文详细信息
Radiation Oncology
A novel implementation of mARC treatment for non-dedicated planning systems using converted IMRT plans
Christian Ruebe1  Norbert Licht1  Frank Nuesken1  Yvonne Dzierma1 
[1] Department of Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, D-66421 Homburg, Saarland, Germany
关键词: Beam angle optimization;    IMRT to arc conversion;    Siemens Artiste;    Modulated arc (mARC);   
Others  :  1153225
DOI  :  10.1186/1748-717X-8-193
 received in 2012-12-06, accepted in 2013-08-01,  发布年份 2013
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【 摘 要 】

Background

The modulated arc (mARC) technique has recently been introduced by Siemens as an analogue to VMAT treatment. However, up to now only one certified treatment planning system supports mARC planning. We therefore present a conversion algorithm capable of converting IMRT plans created by any treatment planning system into mARC plans, with the hope of expanding the availability of mARC to a larger range of clinical users and researchers. As additional advantages, our implementation offers improved functionality for planning hybrid arcs and provides an equivalent step-and-shoot plan for each mARC plan, which can be used as a back-up concept in institutions where only one linac is equipped with mARC.

Methods

We present a feasibility study to outline a practical implementation of mARC plan conversion using Philips Pinnacle and Prowess Panther. We present examples for three different kinds of prostate and head-and-neck plans, for 6 MV and flattening-filter-free (FFF) 7 MV photon energies, which are dosimetrically verified.

Results

It is generally more difficult to create good quality IMRT plans in Pinnacle using a large number of beams and few segments. We present different ways of optimization as examples. By careful choosing the beam and segment arrangement and inversion objectives, we achieve plan qualities similar to our usual IMRT plans. The conversion of the plans to mARC format yields functional plans, which can be irradiated without incidences. Absolute dosimetric verification of both the step-and-shoot and mARC plans by point dose measurements showed deviations below 5% local dose, mARC plans deviated from step-and-shoot plans by no more than 1%. The agreement between GafChromic film measurements of planar dose before and after mARC conversion is excellent. The comparison of the 3D dose distribution measured by PTW Octavius 729 2D-Array with the step-and-shoot plans and with the TPS is well above the pass criteria of 90% of the points falling within 5% local dose and 3 mm distance to agreement. For all plans, the treatment time was noticeably reduced by conversion to mARC.

Conclusions

We present the feasibility test for converting IMRT step-and-shoot plans from the RTP-output of any treatment planning system (Philips Pinnacle and Prowess Panther, in our case) into mARC plans. The feasibility and dosimetric equivalence is demonstrated for the examples of a prostate and a head-and-neck patient.

【 授权许可】

   
2013 Dzierma et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Salter BJ, Sarkar V, Wang B, Shukla H, Szegedi M, Rassiah-Szegedi P: Rotational IMRT delivery using a digital linear accelerator in a very high dose rate ’burst mode’. Phys Med Biol 2011, 56:1931-1946.
  • [2]Kainz K, Chen GP, Chang YW, Prah D, Qi XS, Shukla HP, Stahl J, Li XA: A planning and delivery study of a rotational IMRT technique with burst delivery. Med Phys 2011, 38(9):5104-5118.
  • [3]Otto K: Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys 2008, 35(1):310-317.
  • [4]Teoh M, Clark CH, Wood K, Whitaker S, Nisbet A: Volumetric modulated arc therapy: a review of current literature and clinical use in practice. BJR 2011, 84:967-996.
  • [5]Chan OSH, Lee MCH, Hung AWM, Chang ATY, Yeung RMW, Lee AWM: The superiority of hybrid-volumetric arc therapy (VMAT) technique over double arcs VMAT and 3D-conformal technique in the treatment of locally advanced non-small cell lung cancer – A planning study. Radiother Oncol 2011, 101:298-302.
  • [6]IMPAC Medical Systems: RTPConnect Radiotherapy Treatment Planning Import/Export, Interface Specification. Stockholm, Sweden: Elekta AB (publ.); 2013. LED17001(14.0). Accessible online at http://www.elekta.com/dms/elekta/elekta-assets/Elekta-Software/pdfs/technical-references/LED17001.pdf webcite
  • [7]Bzdusek K, Friberger H, Eriksson K, Hårdemark B, Robinson D, Kaus M: Development and evaluation of an efficient approach to volumetric arc therapy planning. Med Phys 2009, 36(6):2328-2339.
  • [8]The International Commission on Radiation Units and Measurements: Report 83 - Prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). J ICRU 2010, 10(1):97-99.
  • [9]Dzierma Y, Licht N, Nuesken F, Ruebe C: Beam properties and stability of a flattening-filter-free 7 MV beam – an overview. Med Phys 2012, 39(5):2595-2602.
  • [10]Bratengeier K, Gainey MB, Flentje M: Fast IMRT by increasing the beam number and reducing the number of segments. Radiother Oncol 2011, 6:170. BioMed Central Full Text
  • [11]Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M: Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes? Radiother Oncol 2009, 93(2):259-265.
  • [12]Vanetti E, Clivio A, Nicolini G, Fogliata A, Ghosh-Laskar S, Agarwal JP, Upreti RR, Budrukkar A, Murthy V, Deshpande DD, Shrivastava SK, Dinshaw KA, Cozzi L: Volumetric modulated arc therapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT. Radiother Oncol 2009, 92:111-117.
  • [13]Jia X, Men C, Lou Y, Jiang SB: Beam orientation optimization for intensity modulated radiation therapy using adaptive I(2,1)-minimization. Phys Med Biol 2011, 56(19):6205-6222.
  • [14]Breedveld S, Storchi PR, Voeat PW, Heijmen BJ: iCycle: Integrated, multicriterial beam angle, and profile optimization for generation of coplanar and noncoplanar IMRT plans. Med Phys 2012, 39(2):951-963.
  • [15]Naravanan VK, Vaitheeswaran R, Bhangle JR, Basu S, Maiya V, Zade B: An experimental investigation on the effect of beam angle optimization on the reduction of beam numbers in IMRT of head and neck tumors. J Appl Clin Med Phys 2012, 13(4):3912.
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