Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy

Janid P. Blanco Kiely; B. M. White; S. Vennarini; A. Dimofte; L. Lin; G. Freedman; S. Both

doi:10.1007/978-3-319-19387-8_98

Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy

Janid P. Blanco Kiely, B. M. White, S. Vennarini, A. Dimofte, L. Lin, G. Freedman, S. Both

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

Abstract

The dosimetric impact of accurately delineating the left anterior descending artery (LAD) was investigated for routine treatment planning deep inspiration breath-hold (DIBH) CT where cardiac motion was not accounted for. The LAD was contoured in the routine DIBH CT images by an expert radiologist in a population of 10 patients with cancer of the left breast. The motion blurring of the LAD in the DIBH CT images was extracted from the contoured LAD to create a corrected LAD volume. This was used to compare the maximum and mean LAD dose over 3D conformal radiotherapy (3DCRT), uniform scattering (US) proton, and pencil beam scanning (PBS) proton plans. Using a corrected LAD volume reduced the maximum dose LAD DVH indicator by 2% (3DCRT), 4% (US), and 25% (PBS). A corrected LAD volume increased the mean dose LAD DVH indicator by 25% (3DCRT), 61% (US), and 35% (PBS). In terms of absolute dose the impact of contouring on LAD is higher for photon therapy due to the higher doses delivered using this modality. Overall, the results demonstrate that the LAD volume could potentially be the source of inconsistencies in correlation between dose and radiation-induced cardiac toxicity when uncompensated motion is present in the treatment planning images.

Original language	English (US)
Title of host publication	World Congress on Medical Physics and Biomedical Engineering, 2015
Editors	David A. Jaffray
Publisher	Springer Verlag
Pages	405-408
Number of pages	4
ISBN (Print)	9783319193878
DOIs	https://doi.org/10.1007/978-3-319-19387-8_98
State	Published - 2015
Externally published	Yes
Event	World Congress on Medical Physics and Biomedical Engineering, 2015 - Toronto, Canada Duration: Jun 7 2015 → Jun 12 2015

Publication series

Name	IFMBE Proceedings
Volume	51
ISSN (Print)	1680-0737

Other

Other	World Congress on Medical Physics and Biomedical Engineering, 2015
Country/Territory	Canada
City	Toronto
Period	6/7/15 → 6/12/15

Keywords

Breast cancer
Cardiac toxicity
DIBH CT
LAD

ASJC Scopus subject areas

Bioengineering
Biomedical Engineering

Access to Document

10.1007/978-3-319-19387-8_98

Cite this

Blanco Kiely, J. P., White, B. M., Vennarini, S., Dimofte, A., Lin, L., Freedman, G., & Both, S. (2015). Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy. In D. A. Jaffray (Ed.), World Congress on Medical Physics and Biomedical Engineering, 2015 (pp. 405-408). (IFMBE Proceedings; Vol. 51). Springer Verlag. https://doi.org/10.1007/978-3-319-19387-8_98

Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy. / Blanco Kiely, Janid P.; White, B. M.; Vennarini, S. et al.
World Congress on Medical Physics and Biomedical Engineering, 2015. ed. / David A. Jaffray. Springer Verlag, 2015. p. 405-408 (IFMBE Proceedings; Vol. 51).

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

Blanco Kiely, JP, White, BM, Vennarini, S, Dimofte, A, Lin, L, Freedman, G & Both, S 2015, Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy. in DA Jaffray (ed.), World Congress on Medical Physics and Biomedical Engineering, 2015. IFMBE Proceedings, vol. 51, Springer Verlag, pp. 405-408, World Congress on Medical Physics and Biomedical Engineering, 2015, Toronto, Canada, 6/7/15. https://doi.org/10.1007/978-3-319-19387-8_98

Blanco Kiely JP, White BM, Vennarini S, Dimofte A, Lin L, Freedman G et al. Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy. In Jaffray DA, editor, World Congress on Medical Physics and Biomedical Engineering, 2015. Springer Verlag. 2015. p. 405-408. (IFMBE Proceedings). doi: 10.1007/978-3-319-19387-8_98

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abstract = "The dosimetric impact of accurately delineating the left anterior descending artery (LAD) was investigated for routine treatment planning deep inspiration breath-hold (DIBH) CT where cardiac motion was not accounted for. The LAD was contoured in the routine DIBH CT images by an expert radiologist in a population of 10 patients with cancer of the left breast. The motion blurring of the LAD in the DIBH CT images was extracted from the contoured LAD to create a corrected LAD volume. This was used to compare the maximum and mean LAD dose over 3D conformal radiotherapy (3DCRT), uniform scattering (US) proton, and pencil beam scanning (PBS) proton plans. Using a corrected LAD volume reduced the maximum dose LAD DVH indicator by 2% (3DCRT), 4% (US), and 25% (PBS). A corrected LAD volume increased the mean dose LAD DVH indicator by 25% (3DCRT), 61% (US), and 35% (PBS). In terms of absolute dose the impact of contouring on LAD is higher for photon therapy due to the higher doses delivered using this modality. Overall, the results demonstrate that the LAD volume could potentially be the source of inconsistencies in correlation between dose and radiation-induced cardiac toxicity when uncompensated motion is present in the treatment planning images.",

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AB - The dosimetric impact of accurately delineating the left anterior descending artery (LAD) was investigated for routine treatment planning deep inspiration breath-hold (DIBH) CT where cardiac motion was not accounted for. The LAD was contoured in the routine DIBH CT images by an expert radiologist in a population of 10 patients with cancer of the left breast. The motion blurring of the LAD in the DIBH CT images was extracted from the contoured LAD to create a corrected LAD volume. This was used to compare the maximum and mean LAD dose over 3D conformal radiotherapy (3DCRT), uniform scattering (US) proton, and pencil beam scanning (PBS) proton plans. Using a corrected LAD volume reduced the maximum dose LAD DVH indicator by 2% (3DCRT), 4% (US), and 25% (PBS). A corrected LAD volume increased the mean dose LAD DVH indicator by 25% (3DCRT), 61% (US), and 35% (PBS). In terms of absolute dose the impact of contouring on LAD is higher for photon therapy due to the higher doses delivered using this modality. Overall, the results demonstrate that the LAD volume could potentially be the source of inconsistencies in correlation between dose and radiation-induced cardiac toxicity when uncompensated motion is present in the treatment planning images.

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Dosimetric impact of accurately delineating of the left anterior descending artery in photon and proton radiotherapy

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