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Evaluation of daily dose accumulation with deformable image registration method using helical tomotherapy images for nasopharyngeal carcinoma

Published online by Cambridge University Press:  09 June 2020

Warit Thongsuk Open the ORCID record for Warit Thongsuk [Opens in a new window] ,
Wannapha Nobnop Open the ORCID record for Wannapha Nobnop [Opens in a new window] ,
Imjai Chitapanarux Open the ORCID record for Imjai Chitapanarux [Opens in a new window]  and
Somsak Wanwilairat Open the ORCID record for Somsak Wanwilairat [Opens in a new window]
Warit Thongsuk
Affiliation:
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Wannapha Nobnop*
Affiliation:
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Imjai Chitapanarux
Affiliation:
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Somsak Wanwilairat
Affiliation:
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*
Author for correspondence: Wannapha Nobnop, Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Rd., Sriphum50200, Chiang Mai, Thailand. Tel: +66 53935456. E-mail: pung435@yahoo.com
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Abstract

Aim:

Nasopharyngeal carcinoma (NPC) patients may have anatomical variations during their radiotherapy treatment course. In this study, we determine the daily accumulated dose by the deformable image registration (DIR) process for comparing with the planned dose and explore the number of fractions which the daily accumulated dose significantly changed from the planned dose.

Methods:

The validation of the DIR process in MIM software has been tested. One hundred and sixty-five daily megavoltage computed tomography (MVCT) images of NPC patients who were treated by helical tomotherapy were exported to MIM software to determine the daily accumulated dose and then compared with the planned dose.

Results:

The MIM software illustrated the acceptable validation for clinical application. The accumulated dose (D50%) of the planning target volume (PTV70) showed a decrease from the planned dose with an average of 0.5 ± 0.27% at the end of the treatment and was significantly different from the planned dose after the second fraction of the treatment (p-value = 0.008). In contrast, the accumulated dose of organ at risk (OAR) tended to increase from the planned dose and was significantly different after the fifth fraction (left parotid), the twelfth fraction (right parotid) and the second fraction (spinal cord).

Findings:

The inter-fractional anatomic changes cause the actual dose to be different from the planned dose. The dose differences and the number of fractions were varied in each target and OAR. The dose accumulation explored the necessary information for the radiation oncologist to consider adaptive treatment strategies to increase the efficiency of treatment.

Keywords

deformable image registrationdose accumulationhelical tomotherapynasopharyngeal carcinoma
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 273 - 278
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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