Advanced Dose Calculation Algorithm in Superficial Brachytherapy - the Impact of Tissue Inhomogeneity on Treatment Plan Dosimetry

Overview

Journal J Contemp Brachytherapy

Date 2021 Sep 6

PMID 34484359

Citations 1

Authors

Marta Szlag

Sylwia Kellas-Sleczka

Piotr Wojcieszek

Magdalena Stankiewicz

Agnieszka Cholewka

Agnieszka Pruefer

Tomasz Krzysztofiak

Piotr Lelek

Malgorzata Stapor-Fudzinska

Krzysztof Slosarek

Affiliations

Soon will be listed here.

Abstract

Purpose: Given tissue inhomogeneity and lack of backscatter media, superficial brachytherapy necessitates more accurate dosimetry than TG-43 formalism. However, the introduction of modern model-based dose calculation algorithms into clinical practice should be carefully evaluated. The aim of this work was to compare dose distributions calculated with TG-43 and advanced collapsed cone engine (ACE) algorithms for individual multi-catheter moulds, and investigate the impact of target size and the lack of bolus to differences between plans.

Material And Methods: Eleven treatment plans for individual mould multi-catheter high-dose-rate brachytherapy (IMM HDR) were selected for retrospective analysis. All treatment plans were initially calculated with TG-43 formula and re-calculated using ACE algorithm. Plan re-calculation with ACE was repeated for each plan in order to assess the impact of bolus. To evaluate differences between TG-43 and ACE dose distributions, dose-volume histogram (DVH) parameters for each ROI were compared. D (maximal point dose), D, and D were calculated for each risk's organ (OARs) and for external contour. For clinical target volume (CTV), D, D, D, CTV coverage (CTV-V), and dose delivered to reference point were compared between the plans.

Results: A significantly lower values ( < 0.05) of CTV parameters were observed for treatment plans calculated with ACE algorithm comparing to TG-43. Further analysis showed that differences between CTV-V for ACE and TG-43 plans depended on CTV volume. Dosimetric parameters for OARs were significantly lower in ACE plans than those of TG-43. Only D for external and D for both eye lenses in ACE plans were insignificantly different comparing to TG-43 plans.

Conclusions: Results show that differences between dosimetric parameters are statistically significant. However, their clinical relevance is still undetermined. Careful re-evaluation of the clinical results based on long-term research on TG-43 is necessary to safely introduce modern algorithms to clinical practice.

Citing Articles

Comparison of image registration methods in patients with non-melanoma skin cancer treated with superficial brachytherapy.

Szlag M, Stankiewicz M, Kellas-Sleczka S, Stapor-Fudzinska M, Cholewka A, Pruefer A Phys Imaging Radiat Oncol. 2024; 31:100631.

PMID: 39262679 PMC: 11387206. DOI: 10.1016/j.phro.2024.100631.

References

Boman E, Satherley T, Schleich N, Paterson D, Greig L, Louwe R . The validity of Acuros BV and TG-43 for high-dose-rate brachytherapy superficial mold treatments. Brachytherapy. 2017; 16(6):1280-1288. DOI: 10.1016/j.brachy.2017.08.010. View

Mikell J, Klopp A, Gonzalez G, Kisling K, Price M, Berner P . Impact of heterogeneity-based dose calculation using a deterministic grid-based Boltzmann equation solver for intracavitary brachytherapy. Int J Radiat Oncol Biol Phys. 2012; 83(3):e417-22. PMC: 3955059. DOI: 10.1016/j.ijrobp.2011.12.074. View

Beaulieu L, Carlsson Tedgren A, Carrier J, Davis S, Mourtada F, Rivard M . Report of the Task Group 186 on model-based dose calculation methods in brachytherapy beyond the TG-43 formalism: current status and recommendations for clinical implementation. Med Phys. 2012; 39(10):6208-36. DOI: 10.1118/1.4747264. View

Jacob D, Lamberto M, Lawrence L, Mourtada F . Clinical transition to model-based dose calculation algorithm: A retrospective analysis of high-dose-rate tandem and ring brachytherapy of the cervix. Brachytherapy. 2017; 16(3):624-629. DOI: 10.1016/j.brachy.2017.02.008. View

Granero D, Perez-Calatayud J, Vijande J, Ballester F, Rivard M . Limitations of the TG-43 formalism for skin high-dose-rate brachytherapy dose calculations. Med Phys. 2014; 41(2):021703. DOI: 10.1118/1.4860175. View

Hofbauer J, Kirisits C, Resch A, Xu Y, Sturdza A, Potter R . Impact of heterogeneity-corrected dose calculation using a grid-based Boltzmann solver on breast and cervix cancer brachytherapy. J Contemp Brachytherapy. 2016; 8(2):143-9. PMC: 4873554. DOI: 10.5114/jcb.2016.59352. View

Guinot J, Rembielak A, Perez-Calatayud J, Rodriguez-Villalba S, Skowronek J, Tagliaferri L . GEC-ESTRO ACROP recommendations in skin brachytherapy. Radiother Oncol. 2018; 126(3):377-385. DOI: 10.1016/j.radonc.2018.01.013. View

Zwierzchowski G, Bieleda G, Skowronek J, Mazur M . Film based verification of calculation algorithms used for brachytherapy planning-getting ready for upcoming challenges of MBDCA. J Contemp Brachytherapy. 2016; 8(4):326-35. PMC: 5018527. DOI: 10.5114/jcb.2016.61828. View

Szlag M, Wojcieszek P, Kellas-Sleczka S, Krysiak K, Cholewka A, Stapor-Fudzinska M . Individual multi-catheter mould technique in high-dose-rate brachytherapy - personalized approach in treating multifocal angiosarcoma of the face. J Contemp Brachytherapy. 2019; 11(4):337-342. PMC: 6737578. DOI: 10.5114/jcb.2019.87144. View

10.

Delishaj D, Rembielak A, Manfredi B, Ursino S, Pasqualetti F, Laliscia C . Non-melanoma skin cancer treated with high-dose-rate brachytherapy: a review of literature. J Contemp Brachytherapy. 2017; 8(6):533-540. PMC: 5241375. DOI: 10.5114/jcb.2016.64112. View

11.

Paiva Fonseca G, Carlsson Tedgren A, Reniers B, Nilsson J, Persson M, Yoriyaz H . Dose specification for ¹⁹²Ir high dose rate brachytherapy in terms of dose-to-water-in-medium and dose-to-medium-in-medium. Phys Med Biol. 2015; 60(11):4565-79. DOI: 10.1088/0031-9155/60/11/4565. View

12.

Vijande J, Ballester F, Ouhib Z, Granero D, Pujades-Claumarchirant M, Perez-Calatayud J . Dosimetry comparison between TG-43 and Monte Carlo calculations using the Freiburg flap for skin high-dose-rate brachytherapy. Brachytherapy. 2012; 11(6):528-35. DOI: 10.1016/j.brachy.2011.11.005. View

13.

Ma Y, Vijande J, Ballester F, Carlsson Tedgren A, Granero D, Haworth A . A generic TG-186 shielded applicator for commissioning model-based dose calculation algorithms for high-dose-rate Ir brachytherapy. Med Phys. 2017; 44(11):5961-5976. DOI: 10.1002/mp.12459. View