| Wu Ailin,Jiang Xiao,Wu Aidong,Zhu Lei,Yang Yidong,Liu Yunqin,Qian Liting.Effects of tissue heterogeneity on dose evaluation of brachytherapy for cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2021,41(7):486-491 |
| Effects of tissue heterogeneity on dose evaluation of brachytherapy for cervical cancer |
| Received:December 30, 2020 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.07.002 |
| KeyWords:Tissue heterogeneity 192Ir source Brachytherapy Monte Carlo simulation Dose evaluation |
| FundProject:国家自然科学基金（11805198，81671681） |
| Author Name | Affiliation | E-mail | | Wu Ailin | Department of Radiation Oncology, West Branch of The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, China | | | Jiang Xiao | School of Physics, University of Science and Technology of China, Hefei 230026, China | | | Wu Aidong | Department of Radiation Oncology, West Branch of The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, China | aidongwu@21cn.com | | Zhu Lei | School of Physics, University of Science and Technology of China, Hefei 230026, China | | | Yang Yidong | School of Physics, University of Science and Technology of China, Hefei 230026, China | | | Liu Yunqin | Department of Radiation Oncology, West Branch of The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, China | | | Qian Liting | Department of Radiation Oncology, West Branch of The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, China | |
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| Abstract:: |
| Objective To evaluate the impacts of tissue heterogeneity on dose calculation of cervical brachytherapy by comparing the doses calculated by two clinically used dose calculation method and the CT image-based Monte Carlo (MC) method. Methods This study retrospectively selected 11 patients with cervical cancer treated with 3D brachytherapy in Anhui Provincial Cancer Hospital from January 2018 to June 2020. The dose distribution of each plan was calculated via three methods, dose calculation method described in American Association of Physicist in Medicine(AAPM) Task Group No. 43 Report (TG43-BT),Acuros BV(BV-BT) used to perform accurate dose calculations in high-dose-rate (HDR) brachytherapy with phantom heterogeneity, and CT image-based EGSnrc tool kit used to perform Monte Carlosimulation (MC-BT).The dose volumes(V3 Gy, V6 Gy, V9 Gy, and V12 Gy),target volume doses(D98, D90, D50), D2 cm3 of organs at risk (OARs) calculated by the three methods were compared. Results The HRCTV D90 obtained by TG43-BT was 6.274 Gy, which was even overestimated by around 5% compared to the result calculated by MC-BT. Meanwhile,TG43-BT overestimated the dose volumesand the target volume doses compared to MC-BT.Except for D50 and V12 Gy, the differences between the doses to tumor calculated by BV-BT and MC-BT were not statistically significant(P>0.05).There was also no significant statistical difference between the D2 cm3 of rectum, small intestine, and sigmoid calculated by BV-BT and MC-BT (P>0.05). In contrast, the dose to D2 cm3 of bladder determined by MC-BT was 4.609 Gy, which was notably higher than those deter mined by TG43-BT and BV-BT. Conclusions TG43-BT overestimated the doses to tumor targets and most OARs since the effects of tissue heterogeneity were not taken into consideration. BV-BT performed efficient calculation and most of the dose distributionin target volume and OARs obtained by BV-BT were consistent with that calculated by MC-BT. Nevertheless, low accuracy occurred for the regions near the sources and full bladder, which warrants further caution in clinical evaluation. |
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