Feasibility Study of an Efficient Plan Pool Adaptive Radiotherapy Technology Based on Low-dose Computed Tomography...

Area of Science:

• Radiation Oncology
• Medical Physics
• Cancer Treatment

Background:

• Online adaptive radiotherapy (oART) presents workflow complexities and increased workloads for radiation oncologists and physicists.
• A need exists for efficient, low-dose, image-guided adaptive radiotherapy solutions for cervical cancer.
• This study explores a plan-pool adaptive radiotherapy (plan-pool ART) workflow for improved efficiency and dosimetric outcomes.

Purpose of the Study:

• To evaluate the feasibility and performance of a plan-pool ART workflow for cervical cancer.
• To assess the efficiency and dosimetric benefits of plan-pool ART for tumors and organs at risk (OARs).
• To compare plan-pool ART with image-guided radiotherapy (IGRT) and triggered oART (trigger-oART).

Main Methods:

• Developed a plan-pool ART framework using daily low-dose computed tomography (LDCT) synthesized to restorative CT (RCT) images.
• Utilized a support vector machine (SVM) model to predict the need for oART fractions.
• Compared IGRT, plan-pool ART, and trigger-oART by simulating treatments for 5 cervical cancer cases.

Main Results:

• The oART classification model demonstrated high predictive performance (AUC 0.98).
• Plan-pool ART reduced oART execution frequency (1.4 vs. 3.0 for trigger-oART) and optimized dosimetry.
• Plan-pool ART decreased mean bladder and rectum doses compared to IGRT, with comparable target coverage.

Conclusions:

• Plan-pool ART is a feasible technology for cervical cancer radiotherapy.
• This approach ensures reliable target dose coverage and reduces OAR doses.
• Plan-pool ART offers a promising, efficient, and clinically beneficial solution for adaptive radiotherapy.