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Evaluation of measures related to dosimetric uncertainty of VMAT plans

Dosimetric uncertainty is most often not included in the process of creating and selecting plans for treatment. Treatment planning and the physician's choice of treatment plan is instead often based only on evaluation of clinical goals of the calculated absorbed dose distribution. Estimation of...

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Autores principales: Götstedt, Julia, Karlsson, Anna, Bäck, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113703/
https://www.ncbi.nlm.nih.gov/pubmed/36519586
http://dx.doi.org/10.1002/acm2.13862
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author Götstedt, Julia
Karlsson, Anna
Bäck, Anna
author_facet Götstedt, Julia
Karlsson, Anna
Bäck, Anna
author_sort Götstedt, Julia
collection PubMed
description Dosimetric uncertainty is most often not included in the process of creating and selecting plans for treatment. Treatment planning and the physician's choice of treatment plan is instead often based only on evaluation of clinical goals of the calculated absorbed dose distribution. Estimation of the dosimetric uncertainty could potentially have impact in the process of comparing and selecting volumetric modulated arc therapy (VMAT) plans. In this study, different measures for estimation of dosimetric uncertainty based on treatment plan parameters for plans with similar dose distributions were evaluated. VMAT plans with similar dose distributions but with different treatment plan designs were created using three different optimization methods for each of ten patient cases (tonsil and prostate cancer). Two plans were optimized in Eclipse, one with and one without the use of aperture shape controller, and one plan was optimized in RayStation. The studied measures related to dosimetric uncertainty of treatment plans were aperture‐based complexity metric analysis, investigation of modulation level of multi leaf collimator leaves, gantry speed and dose rate, quasi‐3D measurements and evaluation of simulations of realistic delivery variations. The results showed that there can be variations in dosimetric uncertainty for treatment plans with similar dose distributions. Dosimetric uncertainty assessment could therefore have impact on the choice of plan to be used for treatment and lead to a decrease in the uncertainty level of the delivered absorbed dose distribution. This study showed that aperture shape complexity had a larger impact on dosimetric uncertainty compared to modulation level of MLC, gantry speed and dose rate.
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spelling pubmed-101137032023-04-20 Evaluation of measures related to dosimetric uncertainty of VMAT plans Götstedt, Julia Karlsson, Anna Bäck, Anna J Appl Clin Med Phys Radiation Oncology Physics Dosimetric uncertainty is most often not included in the process of creating and selecting plans for treatment. Treatment planning and the physician's choice of treatment plan is instead often based only on evaluation of clinical goals of the calculated absorbed dose distribution. Estimation of the dosimetric uncertainty could potentially have impact in the process of comparing and selecting volumetric modulated arc therapy (VMAT) plans. In this study, different measures for estimation of dosimetric uncertainty based on treatment plan parameters for plans with similar dose distributions were evaluated. VMAT plans with similar dose distributions but with different treatment plan designs were created using three different optimization methods for each of ten patient cases (tonsil and prostate cancer). Two plans were optimized in Eclipse, one with and one without the use of aperture shape controller, and one plan was optimized in RayStation. The studied measures related to dosimetric uncertainty of treatment plans were aperture‐based complexity metric analysis, investigation of modulation level of multi leaf collimator leaves, gantry speed and dose rate, quasi‐3D measurements and evaluation of simulations of realistic delivery variations. The results showed that there can be variations in dosimetric uncertainty for treatment plans with similar dose distributions. Dosimetric uncertainty assessment could therefore have impact on the choice of plan to be used for treatment and lead to a decrease in the uncertainty level of the delivered absorbed dose distribution. This study showed that aperture shape complexity had a larger impact on dosimetric uncertainty compared to modulation level of MLC, gantry speed and dose rate. John Wiley and Sons Inc. 2022-12-15 /pmc/articles/PMC10113703/ /pubmed/36519586 http://dx.doi.org/10.1002/acm2.13862 Text en © 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Radiation Oncology Physics
Götstedt, Julia
Karlsson, Anna
Bäck, Anna
Evaluation of measures related to dosimetric uncertainty of VMAT plans
title Evaluation of measures related to dosimetric uncertainty of VMAT plans
title_full Evaluation of measures related to dosimetric uncertainty of VMAT plans
title_fullStr Evaluation of measures related to dosimetric uncertainty of VMAT plans
title_full_unstemmed Evaluation of measures related to dosimetric uncertainty of VMAT plans
title_short Evaluation of measures related to dosimetric uncertainty of VMAT plans
title_sort evaluation of measures related to dosimetric uncertainty of vmat plans
topic Radiation Oncology Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113703/
https://www.ncbi.nlm.nih.gov/pubmed/36519586
http://dx.doi.org/10.1002/acm2.13862
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