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Delineating the inner bladder surface using uniform contractions from the outer surface under variable bladder

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Accurately delineating the inner bladder (IB) surface is crucial for radiotherapy. A variable volume bladder wall (BW) model best approximates IB position during varying bladder filling conditions, improving dose reconstruction.

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Area of Science:

  • Medical Physics
  • Radiotherapy
  • Medical Imaging

Background:

  • Accurate delineation of the inner bladder (IB) surface is essential for precise dose calculation in intensity-modulated radiotherapy (IMRT) for prostate cancer.
  • Variations in bladder filling between planning and treatment scans can lead to significant geometric uncertainties.

Purpose of the Study:

  • To evaluate different methods for delineating the inner bladder (IB) surface by uniformly contracting the outer bladder (OB) surface.
  • To compare these methods under assumptions of constant bladder wall (BW) thickness, constant volume, or variable volume.

Main Methods:

  • Utilized planning CT scans from 14 prostate IMRT patients.
  • Compared manual IB delineations against IB surfaces generated using uniform contractions (2.5-mm, patient-specific) and wall volume methods (constant and variable).
  • Assessed accuracy using geometric and dosimetric indices.

Main Results:

  • Constant contraction methods significantly overestimated IB volume in cases of variable bladder filling.
  • Methods assuming constant or variable wall volume achieved mean IB surface differences of ≤2 mm.
  • The variable wall volume method showed minimal mean dose-volume histogram (DVH) differences (<1 cm³).

Conclusions:

  • The variable volume bladder wall (BW) model offers the most accurate approximation of the inner bladder (IB) surface under varying filling conditions.
  • This research provides a practical equation for accurate hollow BW delineation on serial imaging for dose reconstruction.