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    Suitability of propagated contours for adaptive replanning for head and neck radiotherapy

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    Authors
    Nash, D.
    Palmer, A. L.
    van Herk, Marcel
    McWilliam, Alan
    Vasquez Osorio, Eliana
    Affiliation
    Department of Medical Physics, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Purpose: Adaptive radiotherapy relies on rapid recontouring for replanning. Contour propagation offers workflow efficiencies, but the impact of using unedited propagated OAR contours directly during re-optimisation is unclear. Methods: Plans for ten head and neck patients were created on the planning CT scan. OAR contours for the spinal cord, brainstem, parotids and larynx were then propagated to five shading-corrected CBCTs equally spaced throughout treatment using five commercial packages. Two reference contours were created on the CBCTs by (1) a clinician and (2) a geometric consensus from the propagated contours. Treatment plans were re-optimised on each CBCT for each set of contours, and the DVH statistic differences to the reference contours were calculated. The spread of DVH statistic differences between the 5th and 95th percentiles was quantified. Results: The spread of DVH statistic differences was 3.7 Gy compared to the clinician contour and 3.3 Gy compared to the consensus contour for the brainstem (and PRV) and 2.4 Gy and 2 Gy for the spinal cord (and PRV), across all 5 auto-contouring solutions. The parotids and larynx showed differences of 3.7 Gy compared to the clinician and 0.9 Gy to the consensus contour, with the larger difference for the clinician possibly caused by uncertainty in the clinician standard due to poor image quality on the CBCTs. Conclusions: Propagated OAR contours can be used safely for adaptive radiotherapy replanning, however, where organ doses are close to clinical tolerance then the contours should be reviewed for accuracy regardless of the propagation software used.
    Citation
    Nash D, Palmer AL, van Herk M, McWilliam A, Vasquez Osorio E. Suitability of propagated contours for adaptive replanning for head and neck radiotherapy. Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). 2022 Sep 18;102:66-72. PubMed PMID: 36126469. Epub 2022/09/21. eng.
    Journal
    Physica Medica
    URI
    http://hdl.handle.net/10541/625626
    DOI
    10.1016/j.ejmp.2022.09.002
    PubMed ID
    36126469
    Additional Links
    https://dx.doi.org/10.1016/j.ejmp.2022.09.002
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ejmp.2022.09.002
    Scopus Count
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