Abstract
We investigated delivered dose and dose accumulation features in the dose tracking
module of RayStation version 11B before potential integration into the spine stereotactic
radiosurgery (SSRS) program at our institution. End-to-end testing with a rigid Rando
phantom was performed, and 10 retrospective clinical cases were selected for evaluation.
Pre-treatment cone beam CTs (pCBCT) were corrected for Hounsfield unit (HU) integrity
and contours were rigidly copied from the reference plan. We then calculated the delivered
dose to the corrected cone beam CT (cCBCT). A deformable image registration (DIR)
was generated between cCBCT and reference planning CT (rCT) using controlling region
of interests. Deformed delivered dose to the rCT was summed to generate the accumulated
dose for multiple fractions. The end-to-end tests of the phantom study revealed an
improvement of cCBCT HU information by > 100 HU compared to the pCBCT. When compared
to the reference plan, the delivered dose and deformed delivered dose were within
1.0% for the GTV and CTV and 3.0% for the spinal cord, respectively. Nearly all 10
clinical cases demonstrated delivered dose and accumulated dose deviations < 3.0%
from the reference plan. However, 2 patients rendered delivered dose deviations between
3.0% and 4.0%, showing the effectiveness of the module. The dose tracking module in
RayStation version 11B could potentially be utilized to aid clinical decision-making
for external body shape change or positional deviation in SSRS for rigid target and
critical structures. Evaluation before clinical application under one's specific practice
is required, and results must be carefully analyzed specially near the high dose gradient
area.
Keywords
Abbreviations:
SSRS (Spine stereotactic radiosurgery), pCBCT (pre-treatment cone beam CT), OARs (organs at risk), rCT (reference CT), 6DOF (six degree of freedom), HU (Hounsfield unit), OIS (oncology information system), cCBCT (corrected CBCT), DIR (deformable image registration), GTV (gross tumor volume), CTV (clinical tumor volume), ROI (region of interest), D95% (dose to 95% of the target volume), D1% (dose to 1% of the target volume), D1cc (and dose to 1 cm3), D0.03cc (and dose to 0.03 cm3 of volume), DVH (dose volume histogram)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 26, 2022
Accepted:
September 10,
2022
Received in revised form:
July 27,
2022
Received:
February 14,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of American Association of Medical Dosimetrists.
