Positron emission tomography guided dose painting by numbers of lung cancer: Alanine dosimetry in an anthropomorphic phantom

Iosif Papoutsis; Ingerid Skjei Knudtsen; Erlend Peter Skaug Sande; Bernt Louni Rekstad; Michel Öllers; Wouter van Elmpt; Marius Røthe Arnesen; Eirik Malinen

doi:10.1016/j.phro.2022.02.013

Positron emission tomography guided dose painting by numbers of lung cancer: Alanine dosimetry in an anthropomorphic phantom

Iosif Papoutsis, Ingerid Skjei Knudtsen^*, Erlend Peter Skaug Sande, Bernt Louni Rekstad, Michel Öllers, Wouter van Elmpt, Marius Røthe Arnesen, Eirik Malinen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background and purpose: Dose painting by numbers (DPBN) require a high degree of dose modulation to fulfill the image-based voxel wise dose prescription. The aim of this study was to assess the dosimetric accuracy of 18F-fluoro-2-deoxy-glucose positron emission tomography(18F-FDG-PET)-based DPBN in an anthropomorphic lung phantom using alanine dosimetry.

Materials and methods: A linear dose prescription based on 18F-FDG-PET image intensities within the gross tumor volume (GTV) of a lung cancer patient was employed. One DPBN scheme with low dose modulation (Scheme A; minimum/maximum fraction dose to the GTV 2.92/4.26 Gy) and one with a high modulation (Scheme B; 2.81/4.52 Gy) were generated. The plans were transferred to a computed tomograpy (CT) scan of a thorax phantom based on CT images of the patient. Using volumetric modulated arc therapy (VMAT), DPBN was delivered to the phantom with embedded alanine dosimeters. A plan was also delivered to an intentionally misaligned phantom. Absorbed doses at various points in the phantom were measured by alanine dosimetry.

Results: A pointwise comparison between GTV doses from prescription, treatment plan calculation and VMAT delivery showed high correspondence, with a mean and maximum dose difference of <0.1 Gy and 0.3 Gy, respectively. No difference was found in dosimetric accuracy between scheme A and B. The misalignment caused deviations up to 1 Gy between prescription and delivery.

Conclusion: DPBN can be delivered with high accuracy, showing that the treatment may be applied correctly from a dosimetric perspective. Still, misalignment may cause considerable dosimetric erros, indicating the need for patient immobilization and monitoring.

Original language	English
Pages (from-to)	101-107
Number of pages	7
Journal	Physics & Imaging in Radiation Oncology
Volume	21
DOIs	https://doi.org/10.1016/j.phro.2022.02.013
Publication status	Published - Jan 2022

Keywords

Dose painting by numbers
Electron paramagnetic resonance
FEASIBILITY
HEAD
IMPACT
IMRT
Imaging for radiotherapy
RADIOTHERAPY
RECONSTRUCTION
RESPIRATORY MOTION
Radiotherapy
STAGE
THERAPY
TRIAL
Volumetric modulated arc therapy

Access to Document

10.1016/j.phro.2022.02.013Licence: CC BY

Cite this

@article{53774cebad8d4a98b134f76ac38c83f6,

title = "Positron emission tomography guided dose painting by numbers of lung cancer: Alanine dosimetry in an anthropomorphic phantom",

abstract = "Background and purpose: Dose painting by numbers (DPBN) require a high degree of dose modulation to fulfill the image-based voxel wise dose prescription. The aim of this study was to assess the dosimetric accuracy of 18F-fluoro-2-deoxy-glucose positron emission tomography(18F-FDG-PET)-based DPBN in an anthropomorphic lung phantom using alanine dosimetry.Materials and methods: A linear dose prescription based on 18F-FDG-PET image intensities within the gross tumor volume (GTV) of a lung cancer patient was employed. One DPBN scheme with low dose modulation (Scheme A; minimum/maximum fraction dose to the GTV 2.92/4.26 Gy) and one with a high modulation (Scheme B; 2.81/4.52 Gy) were generated. The plans were transferred to a computed tomograpy (CT) scan of a thorax phantom based on CT images of the patient. Using volumetric modulated arc therapy (VMAT), DPBN was delivered to the phantom with embedded alanine dosimeters. A plan was also delivered to an intentionally misaligned phantom. Absorbed doses at various points in the phantom were measured by alanine dosimetry.Results: A pointwise comparison between GTV doses from prescription, treatment plan calculation and VMAT delivery showed high correspondence, with a mean and maximum dose difference of <0.1 Gy and 0.3 Gy, respectively. No difference was found in dosimetric accuracy between scheme A and B. The misalignment caused deviations up to 1 Gy between prescription and delivery.Conclusion: DPBN can be delivered with high accuracy, showing that the treatment may be applied correctly from a dosimetric perspective. Still, misalignment may cause considerable dosimetric erros, indicating the need for patient immobilization and monitoring.",

keywords = "Dose painting by numbers, Electron paramagnetic resonance, FEASIBILITY, HEAD, IMPACT, IMRT, Imaging for radiotherapy, RADIOTHERAPY, RECONSTRUCTION, RESPIRATORY MOTION, Radiotherapy, STAGE, THERAPY, TRIAL, Volumetric modulated arc therapy",

author = "Iosif Papoutsis and {Skjei Knudtsen}, Ingerid and {Peter Skaug Sande}, Erlend and {Louni Rekstad}, Bernt and Michel {\"O}llers and {van Elmpt}, Wouter and {R{\o}the Arnesen}, Marius and Eirik Malinen",

note = "{\textcopyright} 2022 Published by Elsevier B.V. on behalf of European Society of Radiotherapy & Oncology.",

year = "2022",

month = jan,

doi = "10.1016/j.phro.2022.02.013",

language = "English",

volume = "21",

pages = "101--107",

journal = "Physics & Imaging in Radiation Oncology",

issn = "2405-6316",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Positron emission tomography guided dose painting by numbers of lung cancer

T2 - Alanine dosimetry in an anthropomorphic phantom

AU - Papoutsis, Iosif

AU - Skjei Knudtsen, Ingerid

AU - Peter Skaug Sande, Erlend

AU - Louni Rekstad, Bernt

AU - Öllers, Michel

AU - van Elmpt, Wouter

AU - Røthe Arnesen, Marius

AU - Malinen, Eirik

PY - 2022/1

Y1 - 2022/1

N2 - Background and purpose: Dose painting by numbers (DPBN) require a high degree of dose modulation to fulfill the image-based voxel wise dose prescription. The aim of this study was to assess the dosimetric accuracy of 18F-fluoro-2-deoxy-glucose positron emission tomography(18F-FDG-PET)-based DPBN in an anthropomorphic lung phantom using alanine dosimetry.Materials and methods: A linear dose prescription based on 18F-FDG-PET image intensities within the gross tumor volume (GTV) of a lung cancer patient was employed. One DPBN scheme with low dose modulation (Scheme A; minimum/maximum fraction dose to the GTV 2.92/4.26 Gy) and one with a high modulation (Scheme B; 2.81/4.52 Gy) were generated. The plans were transferred to a computed tomograpy (CT) scan of a thorax phantom based on CT images of the patient. Using volumetric modulated arc therapy (VMAT), DPBN was delivered to the phantom with embedded alanine dosimeters. A plan was also delivered to an intentionally misaligned phantom. Absorbed doses at various points in the phantom were measured by alanine dosimetry.Results: A pointwise comparison between GTV doses from prescription, treatment plan calculation and VMAT delivery showed high correspondence, with a mean and maximum dose difference of <0.1 Gy and 0.3 Gy, respectively. No difference was found in dosimetric accuracy between scheme A and B. The misalignment caused deviations up to 1 Gy between prescription and delivery.Conclusion: DPBN can be delivered with high accuracy, showing that the treatment may be applied correctly from a dosimetric perspective. Still, misalignment may cause considerable dosimetric erros, indicating the need for patient immobilization and monitoring.

AB - Background and purpose: Dose painting by numbers (DPBN) require a high degree of dose modulation to fulfill the image-based voxel wise dose prescription. The aim of this study was to assess the dosimetric accuracy of 18F-fluoro-2-deoxy-glucose positron emission tomography(18F-FDG-PET)-based DPBN in an anthropomorphic lung phantom using alanine dosimetry.Materials and methods: A linear dose prescription based on 18F-FDG-PET image intensities within the gross tumor volume (GTV) of a lung cancer patient was employed. One DPBN scheme with low dose modulation (Scheme A; minimum/maximum fraction dose to the GTV 2.92/4.26 Gy) and one with a high modulation (Scheme B; 2.81/4.52 Gy) were generated. The plans were transferred to a computed tomograpy (CT) scan of a thorax phantom based on CT images of the patient. Using volumetric modulated arc therapy (VMAT), DPBN was delivered to the phantom with embedded alanine dosimeters. A plan was also delivered to an intentionally misaligned phantom. Absorbed doses at various points in the phantom were measured by alanine dosimetry.Results: A pointwise comparison between GTV doses from prescription, treatment plan calculation and VMAT delivery showed high correspondence, with a mean and maximum dose difference of <0.1 Gy and 0.3 Gy, respectively. No difference was found in dosimetric accuracy between scheme A and B. The misalignment caused deviations up to 1 Gy between prescription and delivery.Conclusion: DPBN can be delivered with high accuracy, showing that the treatment may be applied correctly from a dosimetric perspective. Still, misalignment may cause considerable dosimetric erros, indicating the need for patient immobilization and monitoring.

KW - Dose painting by numbers

KW - Electron paramagnetic resonance

KW - FEASIBILITY

KW - HEAD

KW - IMPACT

KW - IMRT

KW - Imaging for radiotherapy

KW - RADIOTHERAPY

KW - RECONSTRUCTION

KW - RESPIRATORY MOTION

KW - Radiotherapy

KW - STAGE

KW - THERAPY

KW - TRIAL

KW - Volumetric modulated arc therapy

U2 - 10.1016/j.phro.2022.02.013

DO - 10.1016/j.phro.2022.02.013

M3 - Article

C2 - 35243040

SN - 2405-6316

VL - 21

SP - 101

EP - 107

JO - Physics & Imaging in Radiation Oncology

JF - Physics & Imaging in Radiation Oncology

ER -

Positron emission tomography guided dose painting by numbers of lung cancer: Alanine dosimetry in an anthropomorphic phantom

Abstract

Keywords

Access to Document

Fingerprint

Cite this