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An adaptive radiotherapy planning strategy for bladder cancer using deformation vector fields.

Anne Vestergaard1, Jesper Folsted Kallehauge2, Jørgen Breede Baltzer Petersen1

  • 1Department of Medical Physics, Aarhus University Hospital, Denmark.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|August 25, 2014
PubMed
Summary

Deformable image registration-based adaptive radiotherapy (ART) for bladder cancer significantly reduces planning target volume (PTV) compared to manual delineation ART. This DVF-based ART offers superior normal tissue sparing potential in bladder irradiation.

Keywords:
ARTAdaptiveBladder cancerDeformation vector fieldsNormal tissue sparingPlan selection

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Oncology

Background:

  • Adaptive radiotherapy (ART) shows promise for bladder cancer treatment due to significant inter-fractional variations.
  • Current clinical ART methods rely on manual bladder delineation for plan library creation.

Purpose of the Study:

  • To compare a clinically applied manual delineation ART (Clin-ART) with a novel DVF-based ART method.
  • To evaluate the effectiveness of DVF-based ART in reducing planning target volume (PTV) for bladder cancer.

Main Methods:

  • Thirteen bladder cancer patients undergoing daily cone beam CT (CBCT) were included.
  • Clin-ART used manual bladder delineations, while DVF-based ART utilized deformation vector fields (DVFs) from image registration.
  • Volume ratios (VRs) of course-averaged PTV to non-adaptive PTV were calculated for both strategies.

Main Results:

  • Both Clin-ART and DVF-based ART significantly reduced the course-averaged PTV compared to non-adaptive radiotherapy.
  • DVF-based ART demonstrated a lower VR (0.65) than Clin-ART (0.73), indicating greater PTV reduction (p<0.01).

Conclusions:

  • DVF-based ART offers significant normal tissue sparing potential in bladder cancer treatment.
  • This advanced ART strategy surpasses the efficacy of current clinically applied methods, including manual delineation ART.