0 67

Cited 0 times in

Integration of rotatable tandem applicator to conventional ovoid applicator toward complete framework of intensity modulated brachytherapy (IMBT) for cervical cancer

Authors
 Hojin Kim  ;  Youngmoon Goh  ;  Dong Wook Kim  ;  Jin Sung Kim  ;  Young Kyung Lim 
Citation
 PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS, Vol.91 : 131-139, 2021-11 
Journal Title
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS
ISSN
 1120-1797 
Issue Date
2021-11
MeSH
Brachytherapy* ; Female ; Humans ; Monte Carlo Method ; Neoplasm Recurrence, Local ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Uterine Cervical Neoplasms* / radiotherapy
Keywords
Intensity modulated brachytherapy (IMBT) ; Intra-cavitary brachytherapy (ICBT) ; Inverse planning ; Plan optimization ; Rotating shield
Abstract
A new tandem applicator with tungsten shield for Ir-192 radiation source used in intra-cavitary brachytherapy (ICBT) enabled intensity modulated brachytherapy (IMBT) in cervical cancer treatment through fluence-modulation by rotating shield. Our previous work employed group-wise and element-wise sparsity constraints for plan optimization of tandem applicator to minimizes the number of activated angles and source dwell points for delivery efficiency. It, however, did not incorporate the ovoid applicators into the optimizing process, which is generally used to prevent cancer recurrence. To integrate ovoid applicators to the new tandem applicator, this work proposed a comprehensive framework that modifies 1) dose deposition matrix for inverse planning, and 2) plan optimizing algorithm. The dose deposition matrix was newly formulated by the Monte-Carlo simulated dose distribution for 10 positions of ovoid applicators, followed by combining those with tandem-associated dose deposition matrix. The plan optimizing algorithm decomposed entire elements into tandem and ovoid applicators, which were governed by different constraints adaptive to specified plan objectives. The integrated framework was compared against conventional ICBT, and IMBT with tandem only for three patients with asymmetric dose distributions. Integrated IMBT framework resulted in the most optimal plans. Including fluence-modulation by rotating-shield outperformed conventional ICBT in dose sparing to critical organs. Adopting ovoid applicators to the optimization yielded more conformal dose distribution around inferior, laterally expanded region of target volume. The resulting plans reduced D5cc and D2cc by 30.9% and 27.8% for critical organs over conventional ICBT, and by 20.6% and 21.5% for target volume over IMBT with tandem only.
Full Text
https://www.sciencedirect.com/science/article/pii/S1120179721003367
DOI
10.1016/j.ejmp.2021.10.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Wook(김동욱) ORCID logo https://orcid.org/0000-0002-5819-9783
Kim, Jinsung(김진성) ORCID logo https://orcid.org/0000-0003-1415-6471
Kim, Hojin(김호진) ORCID logo https://orcid.org/0000-0002-4652-8682
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187259
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links