Yang Bo,Wang Zhiqun,Li Wenbo,Zhu Qizhen,Li Rui,Zhang Xin,Pan Junsheng,Hu Ke,Zhang Fuquan,Qiu Jie.Dosimetric feasibility of iterative kV CBCT for radiation therapy planning for pelvis[J].Chinese Journal of Radiological Medicine and Protection,2021,41(11):851-855
Dosimetric feasibility of iterative kV CBCT for radiation therapy planning for pelvis
Received:March 04, 2021  
DOI:10.3760/cma.j.issn.0254-5098.2021.11.010
KeyWords:Iterative cone beam CT  Radiation therapy planning  Dose  Gamma pass rate
FundProject:"十三五"国家重点研发计划项目(2016YFC0105206,2016YFC0105207)
Author NameAffiliationE-mail
Yang Bo Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Wang Zhiqun Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Li Wenbo Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Zhu Qizhen Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Li Rui Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Zhang Xin Varian Medical System, Beijing 100176, China  
Pan Junsheng Varian Medical System, Beijing 100176, China  
Hu Ke Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Zhang Fuquan Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China  
Qiu Jie Department of Radiationtherapy, Peking Union Medical College Hospital 100730, China qj_ww@139.com 
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Abstract::
      Objective To study the feasibility of using pelvic iterative cone beam CT images for dose calculation of radiation therapy planning, so as to provide support for adaptive radiotherapy. Methods The CIRS 062 M phantom was scanned by Varian Halcyon v2.0 o-ring accelerator, and the average CT number under different scattering conditions was calculated, and then the ICBCT-ED conversion curve was established. CT images of CIRS 002PRA pelvic IMRT phantom and ICBCT images at different positions were collected. Treatment plan using VMAT technique based on CT image was designed and transplanted into ICBCT image with dose recalculated. The differences of gamma passing rate among target volume, organs at risk and 3-dimensional dose were compared. Based on the actual treatment plan of patients, the differences of 3-dimensional dose gamma passing rate in 10 pelvic patients were analyzed retrospectively. Results There was a large CT value deviation at central position between the isolated no-scattering condition and the full-scattering condition, and the maximum deviation was 144 HU. The CT values of other positions in full-scattering condition were similar to those of the central position, and the maximum deviation was less than 50 HU. Based on the calculated result of ICBCT images at different positions of the pelvic phantom, the dose deviation of the target volume or organs at risk was less than 1 Gy. Compared with the plan based on CT images, the average 3-dimensional dose gamma passing rate under the criteria of 1% dose difference (DD)/1 mm distance-to-agreement (DTA) and 2% DD/2 mm DTA in plan based on ICBCT images were (88.86 ±1.18)% and (98.38±0.89)%, respectively. The ranges of average 3-dimensional dose gamma passing rate under the criteria of 2% DD/2 mm DTA and 3% DD/3 mm DTA in 10 patients with pelvic tumors were 90.03%-95.43% and 93.58%-97.78%, respectively, and the worst result was only 85.90% and 92.90%, respectively. The main reason of the worst result was the dose difference caused by large variation of bladder contour due to over-filling. Conclusions Under comprehensive scattering conditions, the ICBCT-ED conversion curve is reconstructed and the treatment plan can be designed by using the ICBCT image of Halcyon v2.0 linear accelerator. The accuracy meets the standards of clinical application, which provides assurance for adaptive radiotherapy in the future.
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