Evaluation of the impact of dental artefacts on intensity-modulated radiotherapy planning for the head and neck.
AffiliationNorth Western Medical Physics, Christie Hospital NHS Foundation Trust, Manchester, UK. Gareth.Webster@physics.cr.man.ac.uk
MetadataShow full item record
AbstractBACKGROUND AND PURPOSE: High density materials create severe artefacts in the computed tomography (CT) scans used for radiotherapy dose calculations. Increased use of intensity-modulated radiotherapy (IMRT) to treat oropharyngeal cancers raises concerns over the accuracy of the resulting dose calculation. This work quantifies their impact and evaluates a simple corrective technique. MATERIALS AND METHODS: Fifteen oropharyngeal patients with severe artefacts were retrospectively planned with IMRT using two different CT/density look-up tables. Each plan was recalculated using a corrected CT dataset to evaluate the dose distribution delivered to the patient. Plan quality in the absence of dental artefacts was similarly assessed. A range of dosimetric and radiobiological parameters were compared pre- and post-correction. RESULTS: Plans using a standard CT/density look-up table (density 1.8 g/cm(3)) revealed inconsistent inter-patient errors, mostly within clinical acceptance, although potentially significantly reducing target coverage for individual patients. Using an extended CT/density look-up table (density 10.0 g/cm(3)) greatly reduced the errors for 13/15 patients. In 2/15 patients with residual errors the CTV extended into the severely affected region and could be corrected by applying a simple manual correction. CONCLUSIONS: Use of an extended CT/density look-up table together with a simple manual bulk density correction reduces the impact of dental artefacts on head and neck IMRT planning to acceptable levels.
CitationEvaluation of the impact of dental artefacts on intensity-modulated radiotherapy planning for the head and neck. 2009, 93 (3):553-8 Radiother Oncol
JournalRadiotherapy and Oncology
- Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer.
- Authors: Hansen EK, Bucci MK, Quivey JM, Weinberg V, Xia P
- Issue date: 2006 Feb 1
- The impact of dental metal artifacts on head and neck IMRT dose distributions.
- Authors: Kim Y, Tomé WA, Bal M, McNutt TR, Spies L
- Issue date: 2006 May
- Dental amalgam artifact: Adverse impact on tumor visualization and proton beam treatment planning in oral and oropharyngeal cancers.
- Authors: Richard P, Sandison G, Dang Q, Johnson B, Wong T, Parvathaneni U
- Issue date: 2015 Nov-Dec
- Adequate margins for random setup uncertainties in head-and-neck IMRT.
- Authors: Astreinidou E, Bel A, Raaijmakers CP, Terhaard CH, Lagendijk JJ
- Issue date: 2005 Mar 1
- Treatment plan comparison between helical tomotherapy and MLC-based IMRT using radiobiological measures.
- Authors: Mavroidis P, Ferreira BC, Shi C, Lind BK, Papanikolaou N
- Issue date: 2007 Jul 7