Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator
Background and Purpose: Online adaptive radiotherapy for fractionated intracranial stereotactic radiosurgery (FSRS) on a magnetic resonance linear accelerator (MR-L) has the potential to allow for real-time adjustments of anatomical changes during radiotherapy treatment. This study investigates the...
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Elsevier
2025-01-01
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| Series: | Physics and Imaging in Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631625000077 |
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| author | Karen Chin Snyder Salim M. Siddiqui Parag Parikh Kundan Thind |
| author_facet | Karen Chin Snyder Salim M. Siddiqui Parag Parikh Kundan Thind |
| author_sort | Karen Chin Snyder |
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| description | Background and Purpose: Online adaptive radiotherapy for fractionated intracranial stereotactic radiosurgery (FSRS) on a magnetic resonance linear accelerator (MR-L) has the potential to allow for real-time adjustments of anatomical changes during radiotherapy treatment. This study investigates the dosimetric improvements of an online-adaptive MR-L workflow and validates the dosimetry utilizing an MR-visible phantom. Methods and materials: Twenty-six cases previously treated with a conventional C-arm linear accelerator (CA-L) were replanned to determine optimal optimization constraints and objectives for achieving comparable MR-L plans. The optimization methodology was subsequently applied to simulate an online adaptive workflow on an MR phantom, incorporating target volumes from five previously treated patients that required offline adaptation. Plan quality and normal brain dose statistics were evaluated and compared to the offline adapted CA-L plans. Results: No significant difference was observed between the CA-L and MR-L target coverage. The normal brain dose for MR-L plans increased with target volume more rapidly than for CA-L plans. However, some outliers achieved equivalent normal brain doses, indicating potential benefits of MRIgRT for specific superficial volumes located in the frontal, occipital lobes, and cerebellum. End-to-end validation with simulated adaptive workflow on a MR phantom utilizing target volumes that previously required adaption showed acceptable difference of <2.5 % between measured and planned target dose. Conclusion: The study shows promising results for an online adaptive workflow for the treatment of intracranial FSRS on a low-field MR-L. |
| format | Article |
| id | doaj-art-c1729214e03844c0a4b1beddc0d857f0 |
| institution | Kabale University |
| issn | 2405-6316 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj-art-c1729214e03844c0a4b1beddc0d857f02025-01-24T04:45:24ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162025-01-0133100702Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear acceleratorKaren Chin Snyder0Salim M. Siddiqui1Parag Parikh2Kundan Thind3Corresponding author.; Department of Radiation Oncology, Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI 48202, United StatesDepartment of Radiation Oncology, Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI 48202, United StatesDepartment of Radiation Oncology, Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI 48202, United StatesDepartment of Radiation Oncology, Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI 48202, United StatesBackground and Purpose: Online adaptive radiotherapy for fractionated intracranial stereotactic radiosurgery (FSRS) on a magnetic resonance linear accelerator (MR-L) has the potential to allow for real-time adjustments of anatomical changes during radiotherapy treatment. This study investigates the dosimetric improvements of an online-adaptive MR-L workflow and validates the dosimetry utilizing an MR-visible phantom. Methods and materials: Twenty-six cases previously treated with a conventional C-arm linear accelerator (CA-L) were replanned to determine optimal optimization constraints and objectives for achieving comparable MR-L plans. The optimization methodology was subsequently applied to simulate an online adaptive workflow on an MR phantom, incorporating target volumes from five previously treated patients that required offline adaptation. Plan quality and normal brain dose statistics were evaluated and compared to the offline adapted CA-L plans. Results: No significant difference was observed between the CA-L and MR-L target coverage. The normal brain dose for MR-L plans increased with target volume more rapidly than for CA-L plans. However, some outliers achieved equivalent normal brain doses, indicating potential benefits of MRIgRT for specific superficial volumes located in the frontal, occipital lobes, and cerebellum. End-to-end validation with simulated adaptive workflow on a MR phantom utilizing target volumes that previously required adaption showed acceptable difference of <2.5 % between measured and planned target dose. Conclusion: The study shows promising results for an online adaptive workflow for the treatment of intracranial FSRS on a low-field MR-L.http://www.sciencedirect.com/science/article/pii/S2405631625000077MRIgRTAdaptive radiotherapyIntracranial FSRSLow-field MR-LWorkflow |
| spellingShingle | Karen Chin Snyder Salim M. Siddiqui Parag Parikh Kundan Thind Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator Physics and Imaging in Radiation Oncology MRIgRT Adaptive radiotherapy Intracranial FSRS Low-field MR-L Workflow |
| title | Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator |
| title_full | Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator |
| title_fullStr | Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator |
| title_full_unstemmed | Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator |
| title_short | Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator |
| title_sort | adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low field magnetic resonance linear accelerator |
| topic | MRIgRT Adaptive radiotherapy Intracranial FSRS Low-field MR-L Workflow |
| url | http://www.sciencedirect.com/science/article/pii/S2405631625000077 |
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