Abstract
This study aimed to develop a new method to quantitatively analyze body shape changes in patients during radiotherapy without additional radiation exposure using an optical surface tracking system. This method’s accuracy was evaluated using a cubic phantom with a known shift. Surface images of three-dimensionally printed phantoms, which simulated the head and neck shapes of real patients before and after treatment, were used to create a deformation surface area histogram. The near-maximum deformation value covering an area of 2 cm2 in the surface image (Def-2cm2) was calculated. A volumetric modulated arc therapy (VMAT) plan was also created on the pre-treatment phantom, and the dose distribution was recalculated on the post-treatment phantom to compare the dose indices. Surface images of four patients were analyzed to evaluate Def-2cm2 and examine whether this method can be used in clinical cases. Experiments with the cubic phantom resulted in a mean deformation error of 0.08 mm. With head and neck phantoms, the Def-2cm2 value was 17.5 mm, and the dose that covered 95% of the planning target volume in the VMAT plan decreased by 11.7%, indicating that deformation of the body surface may affect the dose distribution. Although analysis of the clinical data showed no clinically relevant deformation in any of the cases, slight skin sagging and respiratory changes in the body surface were observed. The proposed method can quantitatively and accurately evaluate the deformation of a body surface. This method is expected to be used to make decisions regarding modifications to treatment plans.
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References
Nutting C, Morden J, Harrington K, Urbano T, Bhide S, Clark C, et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): A phase 3 multicentre randomised controlled trial. Lancet Oncol. 2011;12:127–36.
Hunt M, Zelefsky M, Wolden S, Chui C, LoSasso T, Rosenzweig K, et al. Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer. Int J Radiat Oncol Biol Phys. 2001;49:623–32.
Hong T, Tomé W, Chappell R, Chinnaiyan P, Mehta M, Harari P. The impact of daily setup variations on head-and-neck intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2005;61:779–88.
Kawamorita R, Yamada K, Nakajima T, Okuno Y, Ogura M. Changes in regional body volume and gross tumor volume affect dose distribution during IMRT for head and neck cancer. J Jpn Soc Ther Radiol Oncol. 2006;18:199–207.
Tsujita N, Yamaguchi S, Murakami R, Hattori T, Maruyama M, Nakaguchi Y, et al. Impact of setup error and anatomical change on dose distribution during conventional radiation therapy. J Radiol Technol. 2011;67:1559–64.
Bhide S, Davies M, Burke K, McNair H, Hansen V, Barbachano Y, et al. Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: a prospective observational study. Int J Radiat Oncol Biol Phys. 2010;76:1360–8.
Burela N, Soni T, Patni N, Natarajan T. Adaptive intensity-modulated radiotherapy in head-and-neck cancer: a volumetric and dosimetric study. J Cancer Res Ther. 2019;15:533–8.
Hansen E, Bucci M, Quivey J, Weinberg V, Xia P. Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2006;64:355–62.
Yan H, Zhen X, Cerviño L, Jiang S, Jia X. Progressive cone beam CT dose control in image-guided radiation therapy. Med Phys. 2013;40:6.
Dawson L, Sharpe M. Image-guided radiotherapy: rationale, benefits, and limitations. Lancet Oncol. 2006;7:848–58.
Hoisak J, Pawlicki T. The role of optical surface imaging systems in radiation therapy. Semin Radiat Oncol. 2018;28:185–93.
Carl G, Reitz D, Schönecker S. Optical surface scanning for patient positioning in radiation therapy: a prospective analysis of 1902 fractions. Technol Cancer Res Treat. 2018;17:1–9.
Stieler F, Wenz F, Shi M, Lohr F. A novel surface imaging system for patient positioning and surveillance during radiotherapy: a phantom study and clinical evaluation. Strahlenther Onkol. 2013;189:938–44.
Walter F, Freislederer P, Belka C, Heinz C, Söhn M, Roeder F. Evaluation of daily patient positioning for radiotherapy with a commercial 3D surface-imaging system (Catalyst™). Radiat Oncol. 2016;11:154.
Trofimov A, Nguyen P, Efstathiou J, Wang Y, Lu H, Engelsman M, et al. Interfractional variations in the setup of pelvic bony anatomy and soft tissue, and their implications on the delivery of proton therapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2011;80:928–37.
Swinnen A, Öllers M, Loon Ong C, Verhaegen F. The potential of an optical surface tracking system in non-coplanar single isocenter treatments of multiple brain metastases. J Appl Clin Medical Phys. 2020;21:63–72.
Rusinkiewicz S, Levoy M. Efficient variants of the ICP algorithm. In: Proceedings Third International Conference on 3-D Digital Imaging and Modeling. IEEE, Quebec City, QC, Canada. 2001; p. 145–152. https://doi.org/10.1109/IM.2001.924423
Brock K, Sharpe M, Dawson L, Kim S, Jaffray D. Accuracy of finite element model-based multi-organ deformable image registration. Med Phys. 2005;32:1647–59.
Heinzerling J, Hampton C, Robinson M, Bright M, Moeller B, Ruiz J, et al. Use of surface-guided radiation therapy in combination with IGRT for setup and intrafraction motion monitoring during stereotactic body radiation therapy treatments of the lung and abdomen. J Appl Clin Medical Phys. 2020;21:48–55.
Matsumoto Y, Fukumitsu N, Ishikawa H, Nakai K, Sakurai H. A critical review of radiation therapy: From particle beam therapy (proton, carbon, and bnct) to beyond. J Pers Med. 2021;11:8.
Batin E, Depauw N, MacDonald S, Lu H. Can surface imaging improve the patient setup for proton postmastectomy chest wall irradiation? Pract Radiat Oncol. 2016;6:e235–41.
Georg P, Lang S, Dimopoulos J, Dörr W, Sturdza A, Berger D, et al. Dose-volume histogram parameters and late side effects in magnetic resonance image-guided adaptive cervical cancer brachytherapy. Int J Radiat Oncol Biol Phys. 2011;79:356–62.
Georg P, Pötter R, Georg D, Lang S, Dimopoulos J, Sturdza A, et al. Dose effect relationship for late side effects of the rectum and urinary bladder in magnetic resonance image-guided adaptive cervix cancer brachytherapy. Int J Radiat Oncol Biol Phys. 2012;82:653–7.
Schultheiss T. The Radiation Dose-Response of the Human Spinal Cord. Int J Radiat Oncol Biol Phys. 2008;71:1455–9.
McCunniff A, Lliang M. Radiation tolerance of the cervical spinal cord. Int J Radiat Oncol Biol Phys. 1989;16:675–8.
Nieder C, Grosu A, Andratschke N, Molls M. Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. Int J Radiat Oncol Biol Phys. 2006;66:1446–9.
Yaparpalvi R, Hong L, Mah D, Shen J, Mutyala S, Spierer M, et al. ICRU reference dose in an era of intensity-modulated radiation therapy clinical trials: Correlation with planning target volume mean dose and suitability for intensity-modulated radiation therapy dose prescription. Radiother Oncol. 2008;89:347–52.
Zhao L, Zhou S, Balter P, Shen C, Gomez D, Welsh J, et al. Planning target volume d95 and mean dose should be considered for optimal local control for stereotactic ablative radiation therapy. Int J Radiat Oncol Biol Phys. 2016;95:1226–35.
Zhao B, Maquilan G, Jiang S, Schwartz D. Minimal mask immobilization with optical surface guidance for head and neck radiotherapy. J Appl Clin Medical Phys. 2018;19:17–24.
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All procedures performed in studies involving human participants followed the ethical standards of the Institutional Review Board and with 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Formal consent was not required for this study at our institution. This study did not include animal studies.
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Sato, K., Kanai, T., Lee, S.H. et al. Development of a quantitative analysis method for assessing patient body surface deformation using an optical surface tracking system. Radiol Phys Technol 15, 367–378 (2022). https://doi.org/10.1007/s12194-022-00676-0
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DOI: https://doi.org/10.1007/s12194-022-00676-0