Dosimetric Benefits and Practical Pitfalls of Daily Online Adaptive MRI-Guided Stereotactic Radiation Therapy for Pancreatic Cancer Nancy El-Bared, MD,

Slides:

Advertisements

Similar presentations

Two-and-a-half-year clinical experience with the world's first magnetic resonance image guided radiation therapy system Benjamin W. Fischer-Valuck, MD,

Advertisements

Management of independent motion between multiple targets in lung cancer radiation therapy Feng Liu, PhD, An Tai, PhD, Ergun Ahunbay, PhD, Elizabeth.

Intensity modulated radiation therapy for definitive treatment of paraortic relapse in patients with endometrial cancer Shervin M. Shirvani, MD, Ann.

Abscopal effect in recurrent colorectal cancer treated with carbon-ion radiation therapy: 2 case reports Daniel K. Ebner, BS, Tadashi Kamada, MD, PhD,

Incorporating big data into treatment plan evaluation: Development of statistical DVH metrics and visualization dashboards Charles S. Mayo, PhD, John.

Automatic treatment planning improves the clinical quality of head and neck cancer treatment plans Christian Rønn Hansen, Anders Bertelsen, Irene Hazell,

Dosimetric analysis of varying cord planning organ at risk volume in spine stereotactic body radiation therapy Dawn Owen, MD, PhD, Charles S. Mayo, PhD,

Detection of late radiation damage on left atrial fibrosis using cardiac late gadolinium enhancement magnetic resonance imaging Y. Jessica Huang, PhD,

Gastric lymph node contouring atlas: A tool to aid in clinical target volume definition in 3- dimensional treatment planning for gastric cancer Jennifer.

Chad G. Rusthoven, MD, Christine F. Lauro, MD, Brian D

Effect of variations in atelectasis on tumor displacement during radiation therapy for locally advanced lung cancer Nathan Tennyson, MD, Elisabeth Weiss,

Pain Control by Image-Guided Radiosurgery for Solitary Spinal Metastasis Samuel Ryu, MD, Ryan Jin, MD, Jian-Yue Jin, PhD, Qing Chen, PhD, Jack Rock, MD,

Dosimetric and Economic Comparison of Interstitial High-Dose-Rate Brachytherapy to Stereotactic Body Radiation Therapy for Liver Lesions Brian A. Hrycushko,

Tumour-Targeted Treatment Intensification for Prostate Cancer Using Magnetic Resonance Imaging Guidance Jessy Abed, RTT, MHScMRS, Jenny Lee, MMath, Tim.

Impact of magnetic resonance imaging on computed tomography-based treatment planning and acute toxicity for prostate cancer patients treated with intensity.

Hippocampal-sparing and target volume coverage in treating 3 to 10 brain metastases: A comparison of Gamma Knife, single-isocenter VMAT, CyberKnife, and.

Volume 199, Issue 1, (January 2018)

Intensity modulated radiation therapy for definitive treatment of paraortic relapse in patients with endometrial cancer Shervin M. Shirvani, MD, Ann.

Should we irradiate a brain tumor in a patient with parkinsonism

RTOG 0631 phase 2/3 study of image guided stereotactic radiosurgery for localized (1- 3) spine metastases: Phase 2 results Samuel Ryu, MD, Stephanie L.

HPV-related nasopharyngeal and cervical cancer in a married couple in North America Daniel B. Vanderbilt, MD, PhD, Quoc-Anh Ho, MD, Uma Goyal, MD, Robert.

Clinical evaluation of interfractional variations for whole breast radiotherapy using 3- dimensional surface imaging Amish P. Shah, PhD, Tomas Dvorak,

Radiotherapeutic Management of Non–Small Cell Lung Cancer in the Minimal Resource Setting Danielle Rodin, MD, Surbhi Grover, MD, MPH, Melody J. Xu, MD,

European Urology Oncology

Severe Local Toxicity after Lung Stereotactic Body Radiation Therapy: Lesional Abscess Leading to Bronchocutaneous Fistula Requiring Surgical Marsupialization

Dawn Owen, MD, PhD, Nadia N. Laack, MD, MSc, Charles S

Gastric perforation following stereotactic body radiation therapy of hepatic metastasis from colon cancer Matthew J. Furman, MD, Giles F. Whalen, MD,

Postoperative Proton Therapy in the Management of Stage III Thymoma

Automatic treatment planning improves the clinical quality of head and neck cancer treatment plans Christian Rønn Hansen, Anders Bertelsen, Irene Hazell,

Brenda G. Clark, PhD, Robert J

Fatal complications after stereotactic body radiation therapy for central lung tumors abutting the proximal bronchial tree Justin M. Haseltine, BSE,

Safety of differential radiation dosing in lymph node positive necks treated with IMRT Stephen Sozio, MBS, Zorimar Rivera-Núñez, PhD, Omar Mahmoud, MD,

Recommendations for MRI-based contouring of gross tumor volume and organs at risk for radiation therapy of pancreatic cancer H.D. Heerkens, MD, W.A.

Should we irradiate a brain tumor in a patient with parkinsonism

Use of standardized uptake value thresholding for target volume delineation in pediatric Hodgkin lymphoma Amanda J. Walker, MD, Alin Chirindel, MD, Robert.

Emma Hedin, Anna Bäck, Roumiana Chakarova

Phantom Verification of AAA and Acuros Dose Calculations for Lung Cancer: Do Tumor Size and Regression Matter? Satomi Shiraishi, PhD, Luis E. Fong de.

VMAT radiation-induced nausea and vomiting in adjuvant breast cancer radiotherapy: The incidental effect of low-dose bath exposure G. Lazzari, A. Terlizzi,

Stereotactic Ablative Radiotherapy for Centrally Located Early Stage Non–Small-Cell Lung Cancer: What We Have Learned Joe Y. Chang, MD, PhD, Andrea Bezjak,

Eliminating Daily Shifts, Tattoos, and Skin Marks: Streamlining Isocenter Localization With Treatment Plan Embedded Couch Values for External Beam Radiation.

Half-Body Irradiation With Tomotherapy for Pain Palliation in Metastatic Breast Cancer Carlo Furlan, MD, Marco Trovo, MD, Annalisa Drigo, ScD, MPh, Elvira.

Action Levels on Dose and Anatomic Variation for Adaptive Radiation Therapy Using Daily Offline Plan Evaluation: Preliminary Results Baoshe Zhang, PhD,

Physics and Imaging in Radiation Oncology

Prophylactic Cranial Irradiation (PCI) versus Active MRI Surveillance for Small Cell Lung Cancer: The Case for Equipoise Chad G. Rusthoven, MD, Brian.

Stereotactic body radiation therapy and 3-dimensional conformal radiotherapy for stage I non-small cell lung cancer: A pooled analysis of biological equivalent.

Intramedullary Reactive Fibrosis as Mimic of Prostate Cancer Bone Metastasis on 11C- Choline Positron Emission and Computed Tomography Tyler Trump, BS,

Kiran Devisetty, MD, Joseph K. Salama, MD Journal of Thoracic Oncology

Efficacy of fiducial marker-based image-guided radiation therapy in prostate tomotherapy and potential dose coverage improvement using a patient positioning.

ITV-Based Robust Optimization for VMAT Planning of Stereotactic Body Radiation Therapy of Lung Cancer Xiaoying Liang, PhD, Dandan Zheng, PhD, Maria Mamalui-Hunter,

Defining Optimal Comorbidity Measures for Patients With Early-Stage Non-small cell lung cancer Treated With Stereotactic Body Radiation Therapy Todd.

Concurrent chemotherapy and intensity modulated radiation therapy in the treatment of anal cancer: A retrospective review from a large academic center

Feasibility of stereotactic body radiotherapy for locally-advanced non-small cell lung cancer Katrina Woodford, Vanessa Panettieri, Trieumy Tran Le,

Effect of Daily and Every Other Day Stereotactic Body Radiation Therapy Schedules on Treatment-Related Fatigue in Patients With Hepatocellular Carcinoma

Clinical and radiobiological evaluation of a method for planning target volume generation dependent on organ-at-risk exclusions in magnetic resonance.

Khaled Adil, MD, Marija Popovic, PhD, Fabio L. Cury, MD, Sergio L

Stereotactic Body Radiation Therapy for Primary Lung Cancers >3 Centimeters John J. Cuaron, MD, Ellen D. Yorke, PhD, Amanda Foster, BA, Meier Hsu, MS,

Hemithoracic Radiotherapy After Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma: A Dosimetric Comparison of Two Well-Described Techniques

Nicholas Trakul, MD, PhD, Jeremy P

Stereotactic Body Radiation Therapy for the Treatment of Primary Cardiac Angiosarcoma Causing Hemodynamic Instability Prashant Gabani, MD, Benjamin W.

Cone beam CT based dose calculation in the thorax region

Pulmonary Atelectasis after Stereotactic Ablative Radiotherapy for a Central Lung Tumor Sashendra Senthi, MBChB, FRANZCR, Eric F Ullmann, MD, Suresh.

Individual lymph nodes: “See it and Zap it”

Impact of Tumor Size on Local Control and Pneumonitis After Stereotactic Body Radiation Therapy for Lung Tumors Sean M. Parker, BS, R. Alfredo Siochi,

Todd J. Carpenter, MD, Kenneth E. Rosenzweig, MD

Clinical implementation of magnetic resonance imaging guided adaptive radiotherapy for localized prostate cancer Shyama U. Tetar, Anna M.E. Bruynzeel,

Technical Innovations and Patient Support in Radiation Oncology

Clinical and Translational Radiation Oncology

Evaluation of plan adaptation strategies for stereotactic radiotherapy of lymph node oligometastases using online magnetic resonance image guidance Dennis.

Volumetric and dosimetric comparison of two delineation guidelines for the radiation treatment of laryngeal squamous cell carcinoma C. Bondue, S. Racadot,

Justin D. Blasberg, MD, Scott J. Belsley, MD, Gary S

Presentation transcript:

Dosimetric Benefits and Practical Pitfalls of Daily Online Adaptive MRI-Guided Stereotactic Radiation Therapy for Pancreatic Cancer Nancy El-Bared, MD, Lorraine Portelance, MD, Benjamin O. Spieler, MD, Deukwoo Kwon, PhD, Kyle R. Padgett, PhD, Karen M. Brown, CMD, Eric A. Mellon, MD, PhD Practical Radiation Oncology Volume 9, Issue 1, Pages e46-e54 (January 2019) DOI: 10.1016/j.prro.2018.08.010 Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 1 Dot plots demonstrate nonadaptive (NA) and adaptive (A) fraction target volume and organ-at-risk doses for 10 patients treated with 5-fraction stereotactic body radiation therapy. Red vertical lines in each figure indicate the objective doses. For each NA and A plan, plotted are planning target volume (PTV) at 100% isodose (PTV100) (prescription 90%) (A), bowel maximum dose (goal Dmax 38 Gy) (B), stomach V33 Gy (volume receiving 33 Gy or more; goal V33 Gy <1 cm3) (C), stomach maximum dose (goal Dmax 38 Gy) (D), duodenum V33Gy (goal V33 Gy <1 cm3) (E), and duodenum maximum dose (goal Dmax 38 Gy) (F). Each patient's fraction is represented by a different color as per the legend. The results of this figure are summarized in Table 2. At a glance, adaptive plans always put the prescription dose (90%) into the PTV (A) and they put less dose into stomach and duodenum (fewer dots to the left of the red line in C-F). However they can put more dose into the bowel (B, more dots to the right of the red line) because of large interfraction variability of the large bowel and tendency not to weight the large bowel as strongly in the optimizer objectives when it was not initially at risk. Practical Radiation Oncology 2019 9, e46-e54DOI: (10.1016/j.prro.2018.08.010) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 2 The stomach (green) is much larger between a single patient's (patient 2 in Figs 1 and 3) planning magnetic resonance imaging (MRI) (A) and third fraction setup MRI (B). Additional contours shown: liver (blue), duodenum (yellow), spinal canal (dark blue), kidneys (pink), bowel loops (orange), and gross tumor volume (red). Practical Radiation Oncology 2019 9, e46-e54DOI: (10.1016/j.prro.2018.08.010) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 3 Stomach volume observed for the planning magnetic resonance imaging (MRI) (fraction 0) and the 5 subsequent treatment setup MRI scans (A). Plotted against change in stomach volume (%) are changes in: planning target volume at 100% isodose (PTV100) (B), stomach V33 Gy (volume receiving 33 Gy or more) (C), stomach maximum dose (Dmax) (D), duodenum V33 Gy (E), and duodenum Dmax (F). Practical Radiation Oncology 2019 9, e46-e54DOI: (10.1016/j.prro.2018.08.010) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 4 Plan 20 Gy isodose line comparison between a nonadaptive and an adaptive fraction where the spinal canal 20 Gy dose objective was violated. The nonadaptive plan (A) demonstrates that the spinal canal (blue contour) is not within the 20 Gy isodose line (red), whereas the adaptive plan (B) isodose line has been shifted to include the entire spinal canal. Planning target volume is contoured in magenta. Practical Radiation Oncology 2019 9, e46-e54DOI: (10.1016/j.prro.2018.08.010) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions