Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans
Background and purpose: Radiotherapy (RT) treatment planning is as a standard based on a computed tomography (CT) scan obtained at the planning stage (pCT), while most of the decisions whether to treat by RT are based on diagnostic CT scans (dCT). Bone metastases (BM) are the most common palliative...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Physics and Imaging in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631623000477 |
| _version_ | 1797691953633034240 |
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| author | Suvi Larjavaara Satu Strengell Tiina Seppälä Mikko Tenhunen Anu Anttonen |
| author_facet | Suvi Larjavaara Satu Strengell Tiina Seppälä Mikko Tenhunen Anu Anttonen |
| author_sort | Suvi Larjavaara |
| collection | DOAJ |
| description | Background and purpose: Radiotherapy (RT) treatment planning is as a standard based on a computed tomography (CT) scan obtained at the planning stage (pCT), while most of the decisions whether to treat by RT are based on diagnostic CT scans (dCT). Bone metastases (BM) are the most common palliative RT target. The objective of this study was to investigate if a palliative RT treatment plan of BMs could be made based on a dCT with sufficient accuracy and safety, without sacrificing any treatment quality. Materials and methods: A retrospective study with 60 BMs of 8 anatomical sites was performed. RT planning was performed using intensity-modulated radiation therapy/volumetric modulated arc therapy techniques in dCT and transferred to pCT. The dose of clinical target volumes (CTVs), D(CTVV95%, V50%), were compared between plans for dCT and pCT. Patient setup was investigated in cone-beam CT scans. Results: The differences of D(CTVV95%, V50%) between dCT and pCT plans were the lowest in the pelvis (1.0%, 1.1%), lumbar spine (0.6%, 0.7%) and thoracic spine (0.7%, 2.1%), while the differences were higher in cervical spine (3.7%, 1.9%), long bones (2.3%, 0.8%), and costae (1.6%, 1.4%). The patient set-up was acceptable for 100% of the pelvic and lumbar, for 92% of thoracic spine cases, and for <80% of cases in other sites. Conclusion: This study showed the feasibility of using dCT images in palliative RT planning of BMs in thoracic, lumbar spine and pelvic sites, indicating the potential suitability of this strategy for clinical use. |
| first_indexed | 2024-03-12T02:20:51Z |
| format | Article |
| id | doaj.art-14b86523c8ce477294551e89c86f60d1 |
| institution | Directory Open Access Journal |
| issn | 2405-6316 |
| language | English |
| last_indexed | 2024-03-12T02:20:51Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj.art-14b86523c8ce477294551e89c86f60d12023-09-06T04:52:25ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162023-07-0127100456Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scansSuvi Larjavaara0Satu Strengell1Tiina Seppälä2Mikko Tenhunen3Anu Anttonen4Corresponding author.; Comprehensive Cancer Center, Helsinki University Central Hospital, PL180, 00029 HUS, FinlandComprehensive Cancer Center, Helsinki University Central Hospital, PL180, 00029 HUS, FinlandComprehensive Cancer Center, Helsinki University Central Hospital, PL180, 00029 HUS, FinlandComprehensive Cancer Center, Helsinki University Central Hospital, PL180, 00029 HUS, FinlandComprehensive Cancer Center, Helsinki University Central Hospital, PL180, 00029 HUS, FinlandBackground and purpose: Radiotherapy (RT) treatment planning is as a standard based on a computed tomography (CT) scan obtained at the planning stage (pCT), while most of the decisions whether to treat by RT are based on diagnostic CT scans (dCT). Bone metastases (BM) are the most common palliative RT target. The objective of this study was to investigate if a palliative RT treatment plan of BMs could be made based on a dCT with sufficient accuracy and safety, without sacrificing any treatment quality. Materials and methods: A retrospective study with 60 BMs of 8 anatomical sites was performed. RT planning was performed using intensity-modulated radiation therapy/volumetric modulated arc therapy techniques in dCT and transferred to pCT. The dose of clinical target volumes (CTVs), D(CTVV95%, V50%), were compared between plans for dCT and pCT. Patient setup was investigated in cone-beam CT scans. Results: The differences of D(CTVV95%, V50%) between dCT and pCT plans were the lowest in the pelvis (1.0%, 1.1%), lumbar spine (0.6%, 0.7%) and thoracic spine (0.7%, 2.1%), while the differences were higher in cervical spine (3.7%, 1.9%), long bones (2.3%, 0.8%), and costae (1.6%, 1.4%). The patient set-up was acceptable for 100% of the pelvic and lumbar, for 92% of thoracic spine cases, and for <80% of cases in other sites. Conclusion: This study showed the feasibility of using dCT images in palliative RT planning of BMs in thoracic, lumbar spine and pelvic sites, indicating the potential suitability of this strategy for clinical use.http://www.sciencedirect.com/science/article/pii/S2405631623000477Palliative careRadiotherapy setup errorsRadiotherapy planningComputer-assistedNeoplasm metastasis |
| spellingShingle | Suvi Larjavaara Satu Strengell Tiina Seppälä Mikko Tenhunen Anu Anttonen Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans Physics and Imaging in Radiation Oncology Palliative care Radiotherapy setup errors Radiotherapy planning Computer-assisted Neoplasm metastasis |
| title | Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans |
| title_full | Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans |
| title_fullStr | Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans |
| title_full_unstemmed | Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans |
| title_short | Palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans |
| title_sort | palliative intensity modulated radiotherapy of bone metastases based on diagnostic instead of planning computed tomography scans |
| topic | Palliative care Radiotherapy setup errors Radiotherapy planning Computer-assisted Neoplasm metastasis |
| url | http://www.sciencedirect.com/science/article/pii/S2405631623000477 |
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