Initial Results from Multiple Irradiations of an Anthropomorphic - PowerPoint PPT Presentation

Dec 08, 2023 •143 likes •326 views

Initial Results from Multiple Irradiations of an Anthropomorphic Spine Phantom Andrea Molineu, Nadia Hernandez, Paola Alvarez, David Followill, Geoffrey Ibbott Spine phantom heart esophagus lung lung PTV spinal bone cord Treatment Plan

Initial Results from Multiple Irradiations of an Anthropomorphic Spine Phantom Andrea Molineu, Nadia Hernandez, Paola Alvarez, David Followill, Geoffrey Ibbott
Spine phantom heart esophagus lung lung PTV spinal bone cord
Treatment Plan • 6 Gy to at least 90% of PTV • Min PTV dose at least 5.25 Gy Normal Volume Volume Max Point structure Max (Gy) Dose (Gy) <0.35 cc 3.75 Spinal Cord 5.25 <1.2 cc 2.63 Heart <15 cc 6.00 8.25 Esophagus <5 cc 4.46 6.00 Skin <10 cc 8.63 9.75 Whole Lung 1000 cc 2.78
Representative Treatment Plan
Criteria • TLD ±7% • Film (axial and sagittal planes) 85% meet 5%/3mm • Plan DVH must comply with protocol
Good Agreement PTV OAR Cord/bone Measurement Plan
Good Agreement Measurement 100% passing Gamma
Cord/bone Plan Poor Agreement PTV OAR Measurement
Poor Agreement Measurement 100% 26% passing passing Gamma
Overall results • 41 irradiations at 35 institutions • 17 irradiations failed • 1 failed TLD criteria only • 8 failed gamma criteria only • 8 failed both TLD and gamma
All Results Axial Sagittal PTV Heart Gamma Gamma mean 0.99 1.02 85 86 std dev 0.05 0.17 16.4 14.6 range 0.88 - 1.15 0.67 - 1.51 22 - 100 42 - 99
Passing Results Axial Sagittal PTV Heart Gamma Gamma mean 0.99 1.02 94 94 std dev 0.03 0.12 4.6 5.1 range 0.93 - 1.03 0.67 - 1.18 85 - 100 85 - 99
Results by Machine Criteria Failed Irradiations Passes Machine Manufacturer TLD Gamma Dose and Gamma Dose CyberKnife 5 2 1 0 2 Elekta 6 2 0 2 2 Novalis 13 10 0 1 2 Siemens 2 1 0 1 0 TomoTherapy 2 1 0 1 0 Varian 13 8 0 3 2 total 41 24 1 8 8
Results by TPS Criteria Failed Irradiations Passes TPS Algorithm TLD Dose and Gamma Dose Gamma 1 1 0 0 0 Monte Carlo CyberKnife 4 1 1 0 2 raytracing 12 7 0 4 1 AAA Eclipse 2 1 0 0 1 pencil beam 2 1 0 1 0 Hi-Art superposition 4 2 0 1 1 Monte Carlo iPlan 8 7 0 0 1 pencil beam 5 3 0 1 1 Pinnacle convolution 3 1 0 1 1 XiO superposition 41 24 1 8 8 total
Results by Algorithm Criteria Failed Algorithm Irradiations Passes Dose and Dose Gamma Gamma 12 7 0 4 1 AAA superposition/ 10 5 0 3 2 convolution Monte Carlo 5 3 0 1 1 pencil beam 10 8 0 0 2 4 1 1 0 2 raytracing 41 24 1 8 8 total
Conclusions •Challenging credentialing process •Treatment couch should be considered in these treatments •Cannot make generalizations with regard to machine, TPS, or algorithm
Thank you. The investigation was supported by PHS grants CA10953 and CA81647 awarded by the NCI, DHHS.

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