Dose Tracking Accuracy of the Dose on the Treatment Day using Cone-beam Computed Tomography for Radiation Therapy of Prostate Cancer: Pilot Study
Keywords:
CBCT, Dose tracking, Prostate cancer, VMATAbstract
Background: The benefit of cone-beam computed tomography (CBCT) is not only for pretreatment setup verification, but also their potential in providing the three-dimensional anatomical information to present the organ deformation and daily actual dose distribution. Objective: This study aimed to investigate the dose tracking on the treatment day for 5 volumetric modulated arc therapy (VMAT) prostate cancer patients using CBCT-based dose calculation. Materials and methods: The CBCT HU to electron density calibration curve was firstly generated. Then, the accuracy of CBCT-based dose calculation (DCBCT) was verified by comparing with dose measurements on CIRS pelvic phantom using IC (0.13cc) and Gafchromic EBT3 film. Velocity 3.2.0 deformable image registration (DIR) software was applied to map organ contours from planning CT (PCT) to the fractionated CBCT and modified by the radiation oncologist. Isodose distribution on CBCT images was calculated and variation of the organ volume as well as the dosimetric parameters following the QUANTEC-guideline for the planning target volume (PTV) and organ at risks were collected and analyzed. Results: Point dose and dose distribution difference in phantom, between the measurements and DCBCT, 2.28% and 87.7% (3%/3mm) gamma passing rate was presented. In clinical investigation, the volume ratio of CBCT/PCT for PTV, bladder and rectum were found to be 1.04, 1.11 and 0.91. DCBCT was found to be deviated from DPCT about -8.26% for D95% of PTV, 1.12% and 9.12% for Dmean and V70Gy of bladder, 6.60%, and 7.10%, for Dmean and V70Gy of rectum, respectively. Conclusion: Dose tracking on treatment day using CBCT-based dose calculation and DIR to guide organ contouring is found to be feasible and adequate to predict the actual dose delivery to the VMAT prostate cancer.
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