Near Real-Time Assessment of Anatomic and Dosimetric Variations for Head and Neck Radiation Therapy via Graphics Processing Unit-based Dose Deformation Framework.

Purpose: The purpose of this study was to systematically monitor anatomic variations and their dosimetric consequences during intensity modulated radiation therapy (IMRT) for head and neck (H&N) cancer by using a graphics processing unit (GPU)-based deformable image registration (DIR) framework. Met...

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Publicado en:International Journal of Radiation Oncology, Biology, Physics Vol. 92; no. 2; pp. 415 - 423
Autores principales: Qi, X Sharon, Santhanam, Anand, Neylon, John, Min, Yugang, Armstrong, Tess, Sheng, Ke, Staton, Robert J, Pukala, Jason, Pham, Andrew, Low, Daniel A, Lee, Steve P, Steinberg, Michael, Manon, Rafael, Chen, Allen M, Kupelian, Patrick
Formato: research Journal Article
Publicado: Pergamon Press - An Imprint of Elsevier Science Jun2015
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: International Journal of Radiation Oncology, Biology, Physics
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      dt: Jun2015
      vid: 92
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        2013004655
        10.1016/j.ijrobp.2015.01.033
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        atl: Near Real-Time Assessment of Anatomic and Dosimetric Variations for Head and Neck Radiation Therapy via Graphics Processing Unit-based Dose Deformation Framework.
      aug:
        au:
          Qi, X Sharon
          Santhanam, Anand
          Neylon, John
          Min, Yugang
          Armstrong, Tess
          Sheng, Ke
          Staton, Robert J
          Pukala, Jason
          Pham, Andrew
          Low, Daniel A
          Lee, Steve P
          Steinberg, Michael
          Manon, Rafael
          Chen, Allen M
          Kupelian, Patrick
      sug:
        subj:
          Head and Neck Neoplasms Radiography
          Head and Neck Neoplasms Radiotherapy
          Parotid Gland Radiation Effects
          Parotid Gland Radiography
          Radiotherapy, Computer-Assisted Methods
          Radiotherapy, Conformal Methods
          Ethmoid Sinus
          Pilot Studies
          Human
          Nasopharyngeal Neoplasms Radiography
          Nasopharyngeal Neoplasms Radiotherapy
          Body Regions Radiation Effects
          Body Regions Radiography
          Paranasal Sinus Neoplasms Radiography
          Paranasal Sinus Neoplasms Radiotherapy
          Radiation Dosage
          Tomography, X-Ray Computed Methods
          Tongue Neoplasms Radiography
          Tongue Neoplasms Radiotherapy
          Pharyngeal Neoplasms Radiography
          Pharyngeal Neoplasms Radiotherapy
      ab: Purpose: The purpose of this study was to systematically monitor anatomic variations and their dosimetric consequences during intensity modulated radiation therapy (IMRT) for head and neck (H&N) cancer by using a graphics processing unit (GPU)-based deformable image registration (DIR) framework. Methods and Materials: Eleven IMRT H&N patients undergoing IMRT with daily megavoltage computed tomography (CT) and weekly kilovoltage CT (kVCT) scans were included in this analysis. Pretreatment kVCTs were automatically registered with their corresponding planning CTs through a GPU-based DIR framework. The deformation of each contoured structure in the H&N region was computed to account for nonrigid change in the patient setup. The Jacobian determinant of the planning target volumes and the surrounding critical structures were used to quantify anatomical volume changes. The actual delivered dose was calculated accounting for the organ deformation. The dose distribution uncertainties due to registration errors were estimated using a landmark-based gamma evaluation. Results: Dramatic interfractional anatomic changes were observed. During the treatment course of 6 to 7 weeks, the parotid gland volumes changed up to 34.7%, and the center-of-mass displacement of the 2 parotid glands varied in the range of 0.9 to 8.8 mm. For the primary treatment volume, the cumulative minimum and mean and equivalent uniform doses assessed by the weekly kVCTs were lower than the planned doses by up to 14.9% (P=.14), 2% (P=.39), and 7.3% (P=.05), respectively. The cumulative mean doses were significantly higher than the planned dose for the left parotid (P=.03) and right parotid glands (P=.006). The computation including DIR and dose accumulation was ultrafast (∼45 seconds) with registration accuracy at the subvoxel level. Conclusions: A systematic analysis of anatomic variations in the H&N region and their dosimetric consequences is critical in improving treatment efficacy. Nearly real-time assessment of anatomic and dosimetric variations is feasible using the GPU-based DIR framework. Clinical implementation of this technology may enable timely plan adaptation and improved outcome.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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