根治性前列腺切除术后磁共振成像引导的前列腺床立体定向放射治疗的点内几何和剂量/体积计量变化

Yu Gao , Stephanie Yoon , Ting Martin Ma , Yingli Yang , Ke Sheng , Daniel A. Low , Leslie Ballas , Michael L. Steinberg , Amar U Kishan , Minsong Cao
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引用次数: 0

摘要

背景和目的磁共振成像(MRI)引导的立体定向体放射治疗(SBRT)在前列腺癌根治术后的前列腺床治疗中引起了越来越多的关注。本研究的目的是评估接受这种治疗的患者的分段内解剖学和剂量/体积指标的变化。每个分段(共 75 个分段)均采集了治疗前和治疗后的 MRI 图像。所有图像都对临床靶体积(CTV)、膀胱、直肠和直肠壁进行了轮廓分析。计算每个结构的体积变化、豪斯多夫距离、平均一致距离(MDA)和戴斯相似系数(DSC)。记录中位值和四分位间范围(IQR)。结果 膀胱的体积变化最大,中位体积增加了 48.9%(IQR 28.9-76.8%),中位 MDA 为 5.1 毫米(IQR 3.4-7.1毫米)。小灶内 CTV 体积保持稳定,中位体积变化率为 1.2 %(0.0-4.8 %)。DSC为0.97(IQR 0.94-0.99)。在剂量/体积指标方面,除了膀胱热点增加、膀胱V32.5 Gy和平均剂量减少外,没有观察到统计学意义上的显著变化。CTV的V95%从99.9%(IQR 98.8-100%)变为99.6%(IQR 93.9-100%)。
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Intra-fractional geometric and dose/volume metric variations of magnetic resonance imaging-guided stereotactic radiotherapy of prostate bed after radical prostatectomy

Background and purpose

Magnetic Resonance Imaging (MRI)-guided Stereotactic body radiotherapy (SBRT) treatment to prostate bed after radical prostatectomy has garnered growing interests. The aim of this study is to evaluate intra-fractional anatomic and dose/volume metric variations for patients receiving this treatment.

Materials and methods

Nineteen patients who received 30–34 Gy in 5 fractions on a 0.35T MR-Linac were included. Pre- and post-treatment MRIs were acquired for each fraction (total of 75 fractions). The Clinical Target Volume (CTV), bladder, rectum, and rectal wall were contoured on all images. Volumetric changes, Hausdorff distance, Mean Distance to Agreement (MDA), and Dice similarity coefficient (DSC) for each structure were calculated. Median value and Interquartile range (IQR) were recorded. Changes in target coverage and Organ at Risk (OAR) constraints were compared and evaluated using Wilcoxon rank sum tests at a significant level of 0.05.

Results

Bladder had the largest volumetric changes, with a median volume increase of 48.9 % (IQR 28.9–76.8 %) and a median MDA of 5.1 mm (IQR 3.4–7.1 mm). Intra-fractional CTV volume remained stable with a median volume change of 1.2 % (0.0–4.8 %). DSC was 0.97 (IQR 0.94–0.99). For the dose/volume metrics, there were no statistically significant changes observed except for an increase in bladder hotspot and a decrease of bladder V32.5 Gy and mean dose. The CTV V95% changed from 99.9 % (IQR 98.8–100 %) to 99.6 % (IQR 93.9–100 %).

Conclusion

Despite intra-fractional variations of OARs, CTV coverage remained stable during MRI-guided SBRT treatments for the prostate bed.

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来源期刊
Physics and Imaging in Radiation Oncology
Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation
CiteScore
5.30
自引率
18.90%
发文量
93
审稿时长
6 weeks
期刊最新文献
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