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Evaluation of Delivery Analysis to Detect Intrafractional Motion during Tomotherapy

International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2019年第4期8卷 225-235页

作者： kazuo tarutani Masao Tanooka Keisuke Sano Okada Wataru Masayuki Fujiwara Koichiro Yamakado Department of Radiology Hyogo College of Medicine Nishinomiya Japan Japan Organization of Occupational Health and Safety Kansai Rousai Hospital Amagasaki Japan Department of Radiotherapy Takarazuka City Hospital Takarazuka Japan

The purpose of this study was to investigate the ability of a management system (Delivery Analysis: DA) to detect intrafractional motion during intensity-modulated radiation therapy (IMRT) in tomotherapy mode. Tomotherapy has made it possible to manage internal movements during treatment using software DA, which quantifies using the information of the passing dose obtained during the radiation treatment of patients. First, three treatment plans for the test were created (lumbar spine, prostate, and femur). Second, a pelvis phantom was moved in the X, Y, and Z directions, and a sinogram was acquired. The magnitudes of the movements were 3 mm, 5 mm, and 10 mm, respectively. Finally, the ability of DA to detect the motion was evaluated by comparing the sinogram obtained by moving the phantom with a reference sinogram obtained without movement. The sensitivity of DA could be detected with a shift amount of 3 mm (gamma analysis tolerance 0.3 mm/0.3%). The average gamma analysis of each direction at 0.3 mm/0.3% tolerance at each treatment site was 96.1% for the prostate, 93.5% for the lumbar spine, and 94.4% for the femur. Additionally, the average gamma pass rate results for the pelvic phantom in the X, Y, Z directions for a 10 mm shift were 96.2%, 96.3%, and 95.9%, respectively. DA is a powerful tool with high detection sensitivity and ability to detect body movement during treatment.

关键词： Delivery Analysis (DA) Tomotherapy Sinogram Intra-Fraction Motion Quality Assurance (QA)

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Feasibility of Estimating Patient-Specific Dose Verification Results Directly from Linear Accelerator Log Files in Volumetric Modulated Arc Therapy

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2016年第4期5卷 317-328页

作者： Kengo Kosaka Masao Tanooka Hiroshi Doi Hiroyuki Inoue kazuo tarutani Hitomi Suzuki Yasuhiro Takada Masayuki Fujiwara Norihiko Kamikonya Shozo Hirota Department of Radiology Hyogo College of Medicine Nishinomiya Japan Department of Radiological Technology Hyogo College of Medicine College Hospital Nishinomiya Japan

The feasibility of estimating patient-specific dose verification results directly from linear accelerator (linac) log files has been investigated for prostate cancer patients who undergo volumetric modulated arc therapy (VMAT). Twenty-six patients who underwent VMAT in our facility were consecutively selected. VMAT plans were created using Monaco treatment planning system and were transferred to an Elekta linac. During the beam delivery, dynamic machine parameters such as positions of the multi-leaf collimator and the gantry were recorded in the log files;subsequently, root mean square (rms) values of control errors, speeds and accelerations of the above machine parameters were calculated for each delivery. Dose verification was performed for all the plans using a cylindrical phantom with diodes placed in a spiral array. The gamma index pass rates were evaluated under 3%/3 mm and 2%/2 mm criteria with a dose threshold of 10%. Subsequently, the correlation coefficients between the gamma index pass rates and each of the above rms values were calculated. Under the 2%/2 mm criteria, significant negative correlations were found between the gamma index pass rates and the rms gantry angle errors (r = 0.64, p < 0.001) as well as the pass rates and the rms gantry accelerations (r = 0.68, p < 0.001). On the other hand, the rms values of the other dynamic machine parameters did not significantly correlate with the gamma index pass rates. We suggest that the VMAT quality assurance (QA) results can be directly estimated from the log file thereby providing potential to simplify patient-specific prostate VMAT QA procedure.

关键词： Radiotherapy VMAT Log File Patient Specific QA Correlation Gamma Index

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Usability of Deformable Image Registration for Adaptive Radiotherapy in Head and Neck Cancer and an Automatic Prediction of Replanning

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第1期6卷 10-20页

作者： Masao Tanooka Hiroshi Doi Toshihisa Ishida Kazuhiro Kitajima Tsukasa Wakayama Toshiyuki Sakai Hiroyuki Inoue Noriko Kotoura Kengo Kosaka kazuo tarutani Masayuki Fujiwara Norihiko Kamikonya Department of Radiological Technology Hyogo College of Medicine College Hospital Nishinomiya Japan Department of Radiology Hyogo College of Medicine Hyogo Nishinomiya Japan

Deformable image registration (DIR) has been an important component in adaptive radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice similarity coefficient (DSC) and to determine the optimal timing of replanning. A total of 22 patients who underwent volume modulated arc therapy (VMAT) for head and neck (H&N) cancers were prospectively analyzed. The planning target volume (PTV) was to receive a total of 70 Gy in 33 fractions. A second planning CT scan (rescan) was performed at the 15th fraction. The DSC was calculated for each structure on both CT scans. The continuous variables to predict the need for replanning were assessed. The optimal cut-off value was determined using receiver operating characteristic (ROC) curve analysis. In the correlation between body weight loss and DSC of each structure, weight loss correlated negatively with DSC of the whole face (rs = -0.45) and the face surface (rs = -0.51). Patients who required replanning tended to have experienced rapid weight loss. The threshold DSC was 0.98 and 0.60 in the whole face and the face surface, respectively. Patients who showed low DSC in the whole face and the face surface required replanning at a significantly high rate (P < 0.05 and P < 0.01). Weight loss correlated with DSC in both the whole face and the face surface (P < 0.05 and P < 0.05). The DSC values in the face predicted the need for replanning. In addition, weight loss tended to correlate with DSC. DIR during ART was found to be a useful tool for replanning.

关键词： Deformable Image Registration Adaptive Radiotherapy Head and Neck Can-cer Dice Similarity Coefficient Volume Modulated Arc Therapy

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