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Related Experiment Video

Updated: Jun 15, 2026

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Published on: June 7, 2015

Radiobiologically equivalent deformable dose mapping for re-irradiation planning: Implementation, robustness, and

Juan A García-Alvarez¹, Eric Paulson¹, Kristofer Kainz¹

¹Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, United States.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology

|January 24, 2025

Summary

This study introduces a new radiotherapy re-irradiation planning workflow. The bias-dose guided plans (BDGPs) improve organ at risk sparing and target coverage compared to manual plans.

Keywords:

Bias dose Deformable dose mapping Deformable dose uncertainty Deformable image registration Equivalent dose in 2 Gy fractions Re-irradiation

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Published on: March 24, 2022

Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Planning

Background:

Re-irradiation in radiotherapy requires specialized tools for optimal re-treatment planning.
Complexities include managing fractionation size, anatomical changes, and cumulative doses.

Purpose of the Study:

To present a robust workflow for radiotherapy re-irradiation planning.
To improve organ at risk (OAR) sparing and target coverage in re-treatment scenarios.

Main Methods:

Developed an automated workflow using MIM® Software and Elekta® Monaco® treatment planning system.
Deformably mapped prior doses, converted to equivalent dose in 2 Gy fractions (EQD2), and accumulated.
Created MIM extensions for dose mapping uncertainty estimation and EQD2 conversion for bias optimization.

Main Results:

Bias-dose guided plans (BDGPs) showed a median reduction in OAR cumulative EQD2 of 240 cGy (p=0.002).
BDGPs enabled higher target coverage compared to manually optimized plans (MOPs) that de-escalated dose.
Dose mapping uncertainties led to OAR cumulative EQD2 increments of 10-730 cGy.

Conclusions:

Introduced an efficient re-irradiation planning workflow using commercial software.
Voxel-level bias dose guidance enhances OAR sparing and maximizes target dose coverage.
Workflow tools support informed clinical decision-making in re-irradiation.