Evaluation of multi-institutional end-to-end testing for post-operative spine stereotactic body radiation therapy.
End-to-end test
Impact of metal hardware
Multi-institutional phantom study
Post-operative spine SBRT
SABR
Journal
Physics and imaging in radiation oncology
ISSN: 2405-6316
Titre abrégé: Phys Imaging Radiat Oncol
Pays: Netherlands
ID NLM: 101704276
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
06
05
2020
revised:
18
08
2020
accepted:
22
09
2020
entrez:
18
1
2021
pubmed:
19
1
2021
medline:
19
1
2021
Statut:
epublish
Résumé
Post-operative spine stereotactic body radiation therapy (SBRT) represents a significant challenge as there are many restrictions on beam geometry to avoid metal hardware as it surrounds the target volume. In this study, an international multi-institutional end-to-end test using an in-house spine phantom was developed and executed. The aim was to evaluate the impact of titanium spine hardware on planned and delivered dose for post-operative spine SBRT. Five centers performed simulation, planning and irradiation of the spine phantom, with/without titanium metal hardware (MB/B), following our pre-specified protocol. The doses were calculated using the centers' treatment planning system (TPS) and measured with radiophotoluminescent glass dosimeters (RPLDs) embedded within each phantom. The dose differences between the RPLD measured and calculated doses in the target region were within ± 5% for both phantoms studied. Differences greater than 5% were observed for the spinal cord and the out-of-the target regions due to steeper dose gradient regions that are created in these plans. Dose measurements within ± 3% were observed between RPLDs that were embedded in MB and B inserts. For the spinal cord and the out-of-target regions surrounded by metal hardware, the dose measured using RPLDs was within 3% different near the titanium screws compared to the dose measured near only the metal rods. We have successfully performed the first multi-institutional end-to-end dose analysis using an in-house phantom built specifically for post-operative spine SBRT. The differences observed between the measured and planned doses in the presence of metal hardware were clinically insignificant.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Post-operative spine stereotactic body radiation therapy (SBRT) represents a significant challenge as there are many restrictions on beam geometry to avoid metal hardware as it surrounds the target volume. In this study, an international multi-institutional end-to-end test using an in-house spine phantom was developed and executed. The aim was to evaluate the impact of titanium spine hardware on planned and delivered dose for post-operative spine SBRT.
MATERIALS AND METHODS
METHODS
Five centers performed simulation, planning and irradiation of the spine phantom, with/without titanium metal hardware (MB/B), following our pre-specified protocol. The doses were calculated using the centers' treatment planning system (TPS) and measured with radiophotoluminescent glass dosimeters (RPLDs) embedded within each phantom.
RESULTS
RESULTS
The dose differences between the RPLD measured and calculated doses in the target region were within ± 5% for both phantoms studied. Differences greater than 5% were observed for the spinal cord and the out-of-the target regions due to steeper dose gradient regions that are created in these plans. Dose measurements within ± 3% were observed between RPLDs that were embedded in MB and B inserts. For the spinal cord and the out-of-target regions surrounded by metal hardware, the dose measured using RPLDs was within 3% different near the titanium screws compared to the dose measured near only the metal rods.
CONCLUSION
CONCLUSIONS
We have successfully performed the first multi-institutional end-to-end dose analysis using an in-house phantom built specifically for post-operative spine SBRT. The differences observed between the measured and planned doses in the presence of metal hardware were clinically insignificant.
Identifiants
pubmed: 33458345
doi: 10.1016/j.phro.2020.09.005
pii: S2405-6316(20)30055-5
pmc: PMC7807765
doi:
Types de publication
Journal Article
Langues
eng
Pagination
61-68Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Arjun Sahgal has received honorarium for past educational seminars from Medtronic and Elekta AB and research grants from Elekta AB. Dr. Arjun Sahgal has participated on the medical advisory board for Varian Medical Systems and Merck. Dr. Arjun Sahgal has received honorarium for past educational seminars from Accuray and Medtronic.
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