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Cone-Beam Computed Tomography and Deformable Registration-Based “Dose of the Day” Calculations for Adaptive Proton Therapy

Veiga, C; Alshaikhi, J; Amos, R; Lourenço, AM; Modat, M; Ourselin, S; Royle, G; (2015) Cone-Beam Computed Tomography and Deformable Registration-Based “Dose of the Day” Calculations for Adaptive Proton Therapy. International Journal of Particle Therapy , 2 (2) pp. 404-414. 10.14338/IJPT-14-00024.1. Green open access

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Abstract

Purpose: The aim of this work was to evaluate the feasibility of cone-beam computed tomography (CBCT) and deformable image registration (DIR)–based ‘‘dose of the day’’ calculations for adaptive proton therapy. Methods: Intensity-modulated radiation therapy (IMRT) and proton therapy plans were designed for 3 head and neck patients that required replanning, and hence had a replan computed tomography (CT). Proton plans were generated for different beam arrangements and optimizations: intensity modulated proton therapy and single-field uniform dose. We used an in-house DIR software implemented at our institution to generate a deformed CT, by warping the planning CT onto the daily CBCT. This CBCT had a similar patient geometry to the replanned CT. Dose distributions on the replanned CT were considered the gold standard for ‘‘dose of the day’’ calculations, and were compared with doses on deformed CT (our method) and directly on the calibrated CBCT and rigidly aligned planning CT (alternative methods) in terms of dose difference (DD), by calculating the percentage of voxels whose DD was smaller than 2% of the prescribed dose (DD2%-pp) and the root mean square of the DD distribution (DDRMS). Results: Using a deformed CT, the DD2%-pp within the CBCT imaging volume was 93.2% 6 0.7% for IMRT, and 87% 6 3% for proton plans. In a region of higher dose gradient, we found that although DD2%-pp was 94.3% 6 0.2% for IMRT, in proton plans, it dropped to 74% 6 4%. A larger number of treatment beams and single-field uniform dose optimization appear to make the proton plans less sensitive to DIR errors. For example, within the treated volume, the DDRMS was reduced from 2.6% 6 0.6% of the prescribed doseto 1.0% 6 1.3% ofthe prescribed dose when using single-field uniform dose optimization. Conclusions: Promising results were found for DIR- and CBCT-based proton dose calculations. Proton dose calculations were, however, more sensitive to registration errors than IMRT doses were, particularly in high dose gradient regions.

Type: Article
Title: Cone-Beam Computed Tomography and Deformable Registration-Based “Dose of the Day” Calculations for Adaptive Proton Therapy
Open access status: An open access version is available from UCL Discovery
DOI: 10.14338/IJPT-14-00024.1
Publisher version: http://dx.doi.org/10.14338/IJPT-14-00024.1
Language: English
Additional information: Distributed under the Creative Commons Attribution-Non-Commercial 4.0 International License (CC-BY), as described at http://creativecommons.org/licenses/by/3.0/. This license permits non-commercial use, including reproduction, adaptation, and distribution of the article provided the original author and source are credited.
Keywords: Adaptive radiation therapy; cone-beam computed tomography; deformable image registration; head and neck cancer
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/1474693
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