The use of in-vivo dosimetry to identify head and neck cancer patients needing adaptive radiotherapy

Yawo A C Fiagan; Evy Bossuyt; Daan Nevens; Melanie Machiels; Ibrahim Chiairi; Ines Joye; Meijnders Paul; Thierry Gevaert; Dirk Verellen

doi:10.1016/j.radonc.2023.109676

The use of in-vivo dosimetry to identify head and neck cancer patients needing adaptive radiotherapy

Yawo A C Fiagan, Evy Bossuyt, Daan Nevens, Melanie Machiels, Ibrahim Chiairi, Ines Joye, Meijnders Paul, Thierry Gevaert, Dirk Verellen

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Abstract

BACKGROUND AND PURPOSE: Head and neck cancer (HNC) patients experiencing anatomical changes during their radiotherapy (RT) course may benefit from adaptive RT (ART). We investigated the sensitivity of an electronic portal imaging device (EPID)-based in-vivo dosimetry (EIVD) system to detect patients that require ART and identified its limitations.

MATERIALS AND METHODS: A retrospective study was conducted for 182 HNC patients: laryngeal cancer without elective lymph nodes (group A), postoperative RT (group B) and primary RT including elective lymph nodes (group C). The effect of anatomical changes on the dose distribution and volumetric changes was quantified. The receiver operating characteristic curve was used to obtain the optimal cut-off value for the gamma passing rate (%GP) with a dose difference of 3% and a distance to agreement of 3 mm.

RESULTS: Fifty HNC patients receiving ART were analyzed: 1 in group A, 10 in group B and 39 in group C. Failed fractions (FFs) occurred in 1/1, 6/10 and 23/39 cases before ART in group A, B and C respectively. In the four cases in group B without FFs, only minor dosimetric changes were observed. One of the cases in group C without FFs had significant dosimetric changes (false negative). Three cases received ART because of clinical reasons that cannot be detected by EIVD. The optimal cut-off value for the %GP was 95%/95.2% for old/new generation machines respectively.

CONCLUSION: EIVD combined with 3D imaging techniques can be synergistic in the detection of anatomical changes in HNC patients who benefit from ART.

Original language	English
Article number	109676
Number of pages	6
Journal	Radiotherapy and Oncology
Volume	184
Early online date	20 Apr 2023
DOIs	https://doi.org/10.1016/j.radonc.2023.109676
Publication status	Published - Jul 2023

Bibliographical note

Funding Information:
The research is supported by the Islamic Development Bank (IsDB) as the primary funder, the Iridium Netwerk and VUB. The authors would like to acknowledge the radiation oncologists, radiation therapists, and medical physicists of Iridium Netwerk for their cooperation.

Funding Information:
The research is supported by the Islamic Development Bank (IsDB) as the primary funder, the Iridium Netwerk and VUB. The authors would like to acknowledge the radiation oncologists, radiation therapists, and medical physicists of Iridium Netwerk for their cooperation. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors have an on-going scientific collaboration with Sun Nuclear Corporation.

Publisher Copyright:
© 2023 The Author(s)

Copyright:
Copyright 2023 Elsevier B.V., All rights reserved.

Keywords

Adaptive radiotherapy
Automated in-vivo dosimetry
Head and Neck cancer

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@article{772b1079d0f74272a5f4566d285b80ca,

title = "The use of in-vivo dosimetry to identify head and neck cancer patients needing adaptive radiotherapy",

abstract = "BACKGROUND AND PURPOSE: Head and neck cancer (HNC) patients experiencing anatomical changes during their radiotherapy (RT) course may benefit from adaptive RT (ART). We investigated the sensitivity of an electronic portal imaging device (EPID)-based in-vivo dosimetry (EIVD) system to detect patients that require ART and identified its limitations.MATERIALS AND METHODS: A retrospective study was conducted for 182 HNC patients: laryngeal cancer without elective lymph nodes (group A), postoperative RT (group B) and primary RT including elective lymph nodes (group C). The effect of anatomical changes on the dose distribution and volumetric changes was quantified. The receiver operating characteristic curve was used to obtain the optimal cut-off value for the gamma passing rate (%GP) with a dose difference of 3% and a distance to agreement of 3 mm.RESULTS: Fifty HNC patients receiving ART were analyzed: 1 in group A, 10 in group B and 39 in group C. Failed fractions (FFs) occurred in 1/1, 6/10 and 23/39 cases before ART in group A, B and C respectively. In the four cases in group B without FFs, only minor dosimetric changes were observed. One of the cases in group C without FFs had significant dosimetric changes (false negative). Three cases received ART because of clinical reasons that cannot be detected by EIVD. The optimal cut-off value for the %GP was 95%/95.2% for old/new generation machines respectively.CONCLUSION: EIVD combined with 3D imaging techniques can be synergistic in the detection of anatomical changes in HNC patients who benefit from ART.",

keywords = "Adaptive radiotherapy, Automated in-vivo dosimetry, Head and Neck cancer",

author = "{A C Fiagan}, Yawo and Evy Bossuyt and Daan Nevens and Melanie Machiels and Ibrahim Chiairi and Ines Joye and Meijnders Paul and Thierry Gevaert and Dirk Verellen",

note = "Funding Information: The research is supported by the Islamic Development Bank (IsDB) as the primary funder, the Iridium Netwerk and VUB. The authors would like to acknowledge the radiation oncologists, radiation therapists, and medical physicists of Iridium Netwerk for their cooperation. Funding Information: The research is supported by the Islamic Development Bank (IsDB) as the primary funder, the Iridium Netwerk and VUB. The authors would like to acknowledge the radiation oncologists, radiation therapists, and medical physicists of Iridium Netwerk for their cooperation. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors have an on-going scientific collaboration with Sun Nuclear Corporation. Publisher Copyright: {\textcopyright} 2023 The Author(s) Copyright: Copyright 2023 Elsevier B.V., All rights reserved.",

year = "2023",

month = jul,

doi = "10.1016/j.radonc.2023.109676",

language = "English",

volume = "184",

journal = "Radiotherapy and Oncology",

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publisher = "Elsevier Ireland Ltd",

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T1 - The use of in-vivo dosimetry to identify head and neck cancer patients needing adaptive radiotherapy

AU - A C Fiagan, Yawo

AU - Bossuyt, Evy

AU - Nevens, Daan

AU - Machiels, Melanie

AU - Chiairi, Ibrahim

AU - Joye, Ines

AU - Paul, Meijnders

AU - Gevaert, Thierry

AU - Verellen, Dirk

N1 - Funding Information: The research is supported by the Islamic Development Bank (IsDB) as the primary funder, the Iridium Netwerk and VUB. The authors would like to acknowledge the radiation oncologists, radiation therapists, and medical physicists of Iridium Netwerk for their cooperation. Funding Information: The research is supported by the Islamic Development Bank (IsDB) as the primary funder, the Iridium Netwerk and VUB. The authors would like to acknowledge the radiation oncologists, radiation therapists, and medical physicists of Iridium Netwerk for their cooperation. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors have an on-going scientific collaboration with Sun Nuclear Corporation. Publisher Copyright: © 2023 The Author(s) Copyright: Copyright 2023 Elsevier B.V., All rights reserved.

PY - 2023/7

Y1 - 2023/7

N2 - BACKGROUND AND PURPOSE: Head and neck cancer (HNC) patients experiencing anatomical changes during their radiotherapy (RT) course may benefit from adaptive RT (ART). We investigated the sensitivity of an electronic portal imaging device (EPID)-based in-vivo dosimetry (EIVD) system to detect patients that require ART and identified its limitations.MATERIALS AND METHODS: A retrospective study was conducted for 182 HNC patients: laryngeal cancer without elective lymph nodes (group A), postoperative RT (group B) and primary RT including elective lymph nodes (group C). The effect of anatomical changes on the dose distribution and volumetric changes was quantified. The receiver operating characteristic curve was used to obtain the optimal cut-off value for the gamma passing rate (%GP) with a dose difference of 3% and a distance to agreement of 3 mm.RESULTS: Fifty HNC patients receiving ART were analyzed: 1 in group A, 10 in group B and 39 in group C. Failed fractions (FFs) occurred in 1/1, 6/10 and 23/39 cases before ART in group A, B and C respectively. In the four cases in group B without FFs, only minor dosimetric changes were observed. One of the cases in group C without FFs had significant dosimetric changes (false negative). Three cases received ART because of clinical reasons that cannot be detected by EIVD. The optimal cut-off value for the %GP was 95%/95.2% for old/new generation machines respectively.CONCLUSION: EIVD combined with 3D imaging techniques can be synergistic in the detection of anatomical changes in HNC patients who benefit from ART.

AB - BACKGROUND AND PURPOSE: Head and neck cancer (HNC) patients experiencing anatomical changes during their radiotherapy (RT) course may benefit from adaptive RT (ART). We investigated the sensitivity of an electronic portal imaging device (EPID)-based in-vivo dosimetry (EIVD) system to detect patients that require ART and identified its limitations.MATERIALS AND METHODS: A retrospective study was conducted for 182 HNC patients: laryngeal cancer without elective lymph nodes (group A), postoperative RT (group B) and primary RT including elective lymph nodes (group C). The effect of anatomical changes on the dose distribution and volumetric changes was quantified. The receiver operating characteristic curve was used to obtain the optimal cut-off value for the gamma passing rate (%GP) with a dose difference of 3% and a distance to agreement of 3 mm.RESULTS: Fifty HNC patients receiving ART were analyzed: 1 in group A, 10 in group B and 39 in group C. Failed fractions (FFs) occurred in 1/1, 6/10 and 23/39 cases before ART in group A, B and C respectively. In the four cases in group B without FFs, only minor dosimetric changes were observed. One of the cases in group C without FFs had significant dosimetric changes (false negative). Three cases received ART because of clinical reasons that cannot be detected by EIVD. The optimal cut-off value for the %GP was 95%/95.2% for old/new generation machines respectively.CONCLUSION: EIVD combined with 3D imaging techniques can be synergistic in the detection of anatomical changes in HNC patients who benefit from ART.

KW - Adaptive radiotherapy

KW - Automated in-vivo dosimetry

KW - Head and Neck cancer

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JO - Radiotherapy and Oncology

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M1 - 109676

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The use of in-vivo dosimetry to identify head and neck cancer patients needing adaptive radiotherapy

Abstract

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