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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
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Automatic planning for functional lung avoidance radiotherapy based on function-guided beam angle selection and plan

Tianyu Xiong1, Guangping Zeng1, Zhi Chen1

  • 1Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China, People's Republic of China.

Physics in Medicine and Biology
|July 3, 2024
PubMed
Summary
This summary is machine-generated.

A new automatic planning framework for functional lung avoidance radiotherapy (AP-FLART) effectively redirects radiation dose away from high-function lungs to low-function lungs. This approach ensures high-quality treatment plans with improved lung sparing and patient outcomes.

Keywords:
automatic planningbeam angle selectionfunctional lung avoidance radiotherapyplan optimization

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Planning

Background:

  • Lung cancer radiotherapy requires precise dose delivery to minimize damage to healthy lung tissue.
  • Functional lung avoidance radiotherapy (FLART) aims to spare functional lung regions, but manual planning is complex and time-consuming.
  • Existing methods lack automated solutions for incorporating lung function into radiotherapy planning.

Purpose of the Study:

  • To develop and evaluate a fully automatic planning framework for functional lung avoidance radiotherapy (AP-FLART).
  • To integrate lung function information for dose redirection from high functional lung (HFL) to low functional lung (LFL).
  • To assess the effectiveness of AP-FLART in generating both contour-based (cFLART) and voxel-based (vFLART) plans.

Main Methods:

  • Developed AP-FLART integrating dosimetric score-based beam angle selection and meta-optimization plan optimization.
  • Incorporated lung function data from SPECT perfusion scans for dose redirection guidance.
  • Applied AP-FLART to 18 lung cancer patient cases, generating conventional RT (ConvRT), cFLART, and vFLART plans for comparison with manual and automatic ConvRT plans.

Main Results:

  • Automatic ConvRT plans matched the quality of manual plans.
  • cFLART plans significantly reduced HFL mean dose (1.13 Gy), V20 (2.01%), and V5 (6.66%) compared to automatic ConvRT.
  • vFLART plans showed decreased lung functionally weighted mean dose (0.64 Gy), fV20 (0.90%), and fV5 (5.07%) compared to automatic ConvRT, with all dose constraints satisfied.

Conclusions:

  • AP-FLART effectively redirects radiation dose from HFL to LFL without compromising conventional dose metrics.
  • The framework produces high-quality, labor-free, and consistent FLART plans.
  • AP-FLART has the potential to advance FLART research and clinical application through automated, precise treatment planning.