دورية أكاديمية
Uterus motion analysis for radiotherapy planning optimization. The innovative contribution of on-board hybrid MR imaging
| العنوان: | Uterus motion analysis for radiotherapy planning optimization. The innovative contribution of on-board hybrid MR imaging |
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| المؤلفون: | Angela Romano, Claudio Votta, Matteo Nardini, Giuditta Chiloiro, Giulia Panza, Luca Boldrini, Davide Cusumano, Elena Galofaro, Lorenzo Placidi, Marco Valerio Antonelli, Gabriele Turco, Rosa Autorino, Maria Antonietta Gambacorta |
| المصدر: | Clinical and Translational Radiation Oncology, Vol 47, Iss , Pp 100808- (2024) |
| بيانات النشر: | Elsevier, 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Medical physics. Medical radiology. Nuclear medicine LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | Locally advanced cervical cancer, Magnetic resonance guided radiation therapy, Organ motion, Adaptive radiotherapy, Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Introduction: Organ motion (OM) and volumetric changes pose challenges in radiotherapy (RT) for locally advanced cervical cancer (LACC). Magnetic Resonance-guided Radiotherapy (MRgRT) combines improved MRI contrast with adaptive RT plans for daily anatomical changes. Our goal was to analyze cervico-uterine structure (CUS) changes during RT to develop strategies for managing OM. Materials and methods: LACC patients received chemoradiation by MRIdian system with a simultaneous integrated boost (SIB) protocol. Prescription doses of 55–50.6 Gy at PTV1 and 45–39.6 Gy at PTV2 were given in 22 and 25 fractions. Daily MRI scans were co-registered with planning scans and CUS changes were assessed.Six PTVs were created by adding 0.5, 0.7, 1, 1.3, 1.5, and 2 cm margins to the CUS, based on the simulation MRI. Adequate margins were determined to include 95 % of the CUSs throughout the entire treatment in 95 % of patients. Results: Analysis of 15 LACC patients and 372 MR scans showed a 31 % median CUS volume decrease. Asymmetric margins of 2 cm cranially, 0.5 cm caudally, 1.5 cm posteriorly, 2 cm anteriorly, and 1.5 cm on both sides were optimal for PTV, adapting to CUS variations. Post-14th fraction, smaller margins of 0.7 cm cranially, 0.5 cm caudally, 1.3 cm posteriorly, 1.3 cm anteriorly, and 1.3 cm on both sides sufficed. Conclusion: CUS mobility varies during RT, suggesting reduced PTV margins after the third week. MRgRT with adaptive strategies optimizes dose delivery, emphasizing the importance of streamlined IGRT with reduced PTV margins using a tailored MRgRT workflow with hybrid MRI-guided systems. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2405-6308 |
| العلاقة: | http://www.sciencedirect.com/science/article/pii/S2405630824000855Test; https://doaj.org/toc/2405-6308Test |
| DOI: | 10.1016/j.ctro.2024.100808 |
| الوصول الحر: | https://doaj.org/article/2523e9bd0f7640ad8f79a0bb592360e5Test |
| رقم الانضمام: | edsdoj.2523e9bd0f7640ad8f79a0bb592360e5 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 24056308 |
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| DOI: | 10.1016/j.ctro.2024.100808 |