Positron Emission Tomography Guided Dose Painting by Numbers of Lung Cancer: Alanine Dosimetry in an Anthropomorphic Phantom

Overview

Journal Phys Imaging Radiat Oncol

Specialty Oncology

Date 2022 Mar 4

PMID 35243040

Authors

Iosif Papoutsis

Ingerid Skjei Knudtsen

Erlend Peter Skaug Sande

Bernt Louni Rekstad

Michel Ollers

Wouter van Elmpt

Marius Rothe Arnesen

Eirik Malinen

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Dose painting by numbers (DPBN) require a high degree of dose modulation to fulfill the image-based voxel wise dose prescription. The aim of this study was to assess the dosimetric accuracy of F-fluoro-2-deoxy-glucose positron emission tomography(F-FDG-PET)-based DPBN in an anthropomorphic lung phantom using alanine dosimetry.

Materials And Methods: A linear dose prescription based on F-FDG-PET image intensities within the gross tumor volume (GTV) of a lung cancer patient was employed. One DPBN scheme with low dose modulation (Scheme A; minimum/maximum fraction dose to the GTV 2.92/4.26 Gy) and one with a high modulation (Scheme B; 2.81/4.52 Gy) were generated. The plans were transferred to a computed tomograpy (CT) scan of a thorax phantom based on CT images of the patient. Using volumetric modulated arc therapy (VMAT), DPBN was delivered to the phantom with embedded alanine dosimeters. A plan was also delivered to an intentionally misaligned phantom. Absorbed doses at various points in the phantom were measured by alanine dosimetry.

Results: A pointwise comparison between GTV doses from prescription, treatment plan calculation and VMAT delivery showed high correspondence, with a mean and maximum dose difference of <0.1 Gy and 0.3 Gy, respectively. No difference was found in dosimetric accuracy between scheme A and B. The misalignment caused deviations up to 1 Gy between prescription and delivery.

Conclusion: DPBN can be delivered with high accuracy, showing that the treatment may be applied correctly from a dosimetric perspective. Still, misalignment may cause considerable dosimetric erros, indicating the need for patient immobilization and monitoring.

Citing Articles

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PMID: 36272949 PMC: 10068574. DOI: 10.1016/j.zemedi.2022.09.001.

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