Journal of Medical Physics
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ORIGINAL ARTICLE
Year : 2022  |  Volume : 47  |  Issue : 4  |  Page : 344-351

Comparison of three commercial methods of cone-beam computed tomography-based dosimetric analysis of head-and-neck patients with weight loss


Department of Oncology, University of Alberta; Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta, Canada

Correspondence Address:
Dr. Satyapal Rathee
Department of Oncology, University of Alberta and Department of Medical Physics, Cross Cancer Institute, 11560 University Ave, Edmonton, Alberta T6G 1Z2
Canada
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmp.jmp_7_22

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Purpose: This investigation compares three commercial methods of cone-beam computed tomography (CBCT)-based dosimetric analysis to a method based on repeat computed tomography (CT). Materials and Methods: Seventeen head-and-neck patients treated in 2020, and with a repeat CT, were included in the analyses. The planning CT was deformed to anatomy in repeat CT to generate a reference plan. Two of the CBCT-based methods generated test plans by deforming the planning CT to CBCT of fraction N using VelocityAI™ and SmartAdapt®. The third method compared directly calculated doses on the CBCT for fraction 1 and fraction N, using PerFraction™. Maximum dose to spinal cord (Cord_dmax) and dose to 95% volume (D95) of planning target volumes (PTVs) were used to assess “need to replan” criteria. Results: The VelocityAI™ method provided results that most accurately matched the reference plan in “need to replan” criteria using either Cord_dmax or PTV D95. SmartAdapt® method overestimated the change in Cord_dmax (6.77% vs. 3.85%, P < 0.01) and change in cord volume (9.56% vs. 0.67%, P < 0.01) resulting in increased false positives in “need to replan” criteria, and performed similarly to VelocityAI™ for D95, but yielded more false negatives. PerFraction™ method underestimated Cord_dmax, did not perform any volume deformation, and missed all “need to replan” cases based on cord dose. It also yielded high false negatives using the D95 PTV criteria. Conclusions: The VelocityAI™-based method using fraction N CBCT is most similar to the reference plan using repeat CT; the other two methods had significant differences.


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