Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound
Background and purpose: During radiotherapy, prostate motion changes over time. Quantifying and accounting for this motion is essential. This study aimed to assess intra-fraction prostate motion and derive duration-dependent planning margins for two treatment techniques. Material and methods: A four...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-01-01
|
| Series: | Physics and Imaging in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631617300738 |
| _version_ | 1818335872556204032 |
|---|---|
| author | Eric Pei Ping Pang Kellie Knight Qiao Fan Sheena Xue Fei Tan Khong Wei Ang Zubin Master Wing-Ho Mui Ronnie Wing-Kin Leung Marilyn Baird Jeffrey Kit Loong Tuan |
| author_facet | Eric Pei Ping Pang Kellie Knight Qiao Fan Sheena Xue Fei Tan Khong Wei Ang Zubin Master Wing-Ho Mui Ronnie Wing-Kin Leung Marilyn Baird Jeffrey Kit Loong Tuan |
| author_sort | Eric Pei Ping Pang |
| collection | DOAJ |
| description | Background and purpose: During radiotherapy, prostate motion changes over time. Quantifying and accounting for this motion is essential. This study aimed to assess intra-fraction prostate motion and derive duration-dependent planning margins for two treatment techniques. Material and methods: A four-dimension (4D) transperineal ultrasound Clarity® system was used to track prostate motion. We analysed 1913 fractions from 60 patients undergoing volumetric-modulated arc therapy (VMAT) to the prostate. The mean VMAT treatment duration was 3.4 min. Extended monitoring was conducted weekly to simulate motion during intensity-modulated radiation therapy (IMRT) treatment (an additional seven minutes). A motion-time trend analysis was conducted and the mean intra-fraction motion between VMAT and IMRT treatments compared. Duration-dependent margins were calculated and anisotropic margins for VMAT and IMRT treatments were derived. Results: There were statistically significant differences in the mean intra-fraction motion between VMAT and the simulated IMRT duration in the inferior (0.1 mm versus 0.3 mm) and posterior (−0.2 versus −0.4 mm) directions respectively (p ≪ 0.01). An intra-fraction motion trend inferiorly and posteriorly was observed. The recommended minimum anisotropic margins are 1.7 mm/2.7 mm (superior/inferior); 0.8 mm (left/right), 1.7 mm/2.9 mm (anterior/posterior) for VMAT treatments and 2.9 mm/4.3 mm (superior/inferior), 1.5 mm (left/right), 2.8 mm/4.8 mm (anterior/posterior) for IMRT treatments. Smaller anisotropic margins were required for VMAT compared to IMRT (differences ranging from 1.2 to 1.6 mm superiorly/inferiorly, 0.7 mm laterally and 1.1–1.9 mm anteriorly/posteriorly). Conclusions: VMAT treatment is preferred over IMRT as prostate motion increases with time. Larger margins should be employed in the inferior and posterior directions for both treatment durations. Duration-dependent margins should be applied in the presence of prolonged imaging and verification time. Keywords: Prostate, Intra-fraction movement, 4D Clarity ultrasound system, Real-time tracking, Margins |
| first_indexed | 2024-12-13T14:30:20Z |
| format | Article |
| id | doaj.art-1d821e25b4644a889e16e4c1add596a0 |
| institution | Directory Open Access Journal |
| issn | 2405-6316 |
| language | English |
| last_indexed | 2024-12-13T14:30:20Z |
| publishDate | 2018-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj.art-1d821e25b4644a889e16e4c1add596a02022-12-21T23:41:51ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162018-01-015102107Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasoundEric Pei Ping Pang0Kellie Knight1Qiao Fan2Sheena Xue Fei Tan3Khong Wei Ang4Zubin Master5Wing-Ho Mui6Ronnie Wing-Kin Leung7Marilyn Baird8Jeffrey Kit Loong Tuan9Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore; Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging & Radiation Sciences, Monash University, Wellington Road, Clayton, VIC 3800, Australia; Corresponding author at: Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging & Radiation Sciences, Monash University, Wellington Road, Clayton, VIC 3800, AustraliaCentre for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, Singapore 169857, SingaporeDivision of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, SingaporeDivision of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, SingaporeDivision of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, SingaporeTuen Mun Hospital, 23 Tsing Chung Koon Road, Tuen Mun, New Territories, Hong KongTuen Mun Hospital, 23 Tsing Chung Koon Road, Tuen Mun, New Territories, Hong KongFaculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging & Radiation Sciences, Monash University, Wellington Road, Clayton, VIC 3800, AustraliaDivision of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, SingaporeBackground and purpose: During radiotherapy, prostate motion changes over time. Quantifying and accounting for this motion is essential. This study aimed to assess intra-fraction prostate motion and derive duration-dependent planning margins for two treatment techniques. Material and methods: A four-dimension (4D) transperineal ultrasound Clarity® system was used to track prostate motion. We analysed 1913 fractions from 60 patients undergoing volumetric-modulated arc therapy (VMAT) to the prostate. The mean VMAT treatment duration was 3.4 min. Extended monitoring was conducted weekly to simulate motion during intensity-modulated radiation therapy (IMRT) treatment (an additional seven minutes). A motion-time trend analysis was conducted and the mean intra-fraction motion between VMAT and IMRT treatments compared. Duration-dependent margins were calculated and anisotropic margins for VMAT and IMRT treatments were derived. Results: There were statistically significant differences in the mean intra-fraction motion between VMAT and the simulated IMRT duration in the inferior (0.1 mm versus 0.3 mm) and posterior (−0.2 versus −0.4 mm) directions respectively (p ≪ 0.01). An intra-fraction motion trend inferiorly and posteriorly was observed. The recommended minimum anisotropic margins are 1.7 mm/2.7 mm (superior/inferior); 0.8 mm (left/right), 1.7 mm/2.9 mm (anterior/posterior) for VMAT treatments and 2.9 mm/4.3 mm (superior/inferior), 1.5 mm (left/right), 2.8 mm/4.8 mm (anterior/posterior) for IMRT treatments. Smaller anisotropic margins were required for VMAT compared to IMRT (differences ranging from 1.2 to 1.6 mm superiorly/inferiorly, 0.7 mm laterally and 1.1–1.9 mm anteriorly/posteriorly). Conclusions: VMAT treatment is preferred over IMRT as prostate motion increases with time. Larger margins should be employed in the inferior and posterior directions for both treatment durations. Duration-dependent margins should be applied in the presence of prolonged imaging and verification time. Keywords: Prostate, Intra-fraction movement, 4D Clarity ultrasound system, Real-time tracking, Marginshttp://www.sciencedirect.com/science/article/pii/S2405631617300738 |
| spellingShingle | Eric Pei Ping Pang Kellie Knight Qiao Fan Sheena Xue Fei Tan Khong Wei Ang Zubin Master Wing-Ho Mui Ronnie Wing-Kin Leung Marilyn Baird Jeffrey Kit Loong Tuan Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound Physics and Imaging in Radiation Oncology |
| title | Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound |
| title_full | Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound |
| title_fullStr | Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound |
| title_full_unstemmed | Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound |
| title_short | Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound |
| title_sort | analysis of intra fraction prostate motion and derivation of duration dependent margins for radiotherapy using real time 4d ultrasound |
| url | http://www.sciencedirect.com/science/article/pii/S2405631617300738 |
| work_keys_str_mv | AT ericpeipingpang analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT kellieknight analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT qiaofan analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT sheenaxuefeitan analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT khongweiang analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT zubinmaster analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT winghomui analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT ronniewingkinleung analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT marilynbaird analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound AT jeffreykitloongtuan analysisofintrafractionprostatemotionandderivationofdurationdependentmarginsforradiotherapyusingrealtime4dultrasound |