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Main Authors: Ma, Tianjun, Guo, Bingqi, Balik, Salim, Qi, Peng, Magnelli, Anthony, Videtic, Gregory M M., Stephans, Kevin L, Zhuang, Tingliang
Format: Preprint
Published: 2025
Subjects:
Online Access:https://arxiv.org/abs/2501.18153
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author Ma, Tianjun
Guo, Bingqi
Balik, Salim
Qi, Peng
Magnelli, Anthony
Videtic, Gregory M M.
Stephans, Kevin L
Zhuang, Tingliang
author_facet Ma, Tianjun
Guo, Bingqi
Balik, Salim
Qi, Peng
Magnelli, Anthony
Videtic, Gregory M M.
Stephans, Kevin L
Zhuang, Tingliang
contents Purpose: To investigate the impact of delivery techniques and planning parameters on interplay effect in lung SBRT. Methods: A dynamic virtual patient model containing normal structures and a tumor with adjustable sizes, locations, and 3D breathing motion was utilized. SBRT plans were developed using both step-and-shoot IMRT and VMAT with different planning parameters (energy, isocenter location, PTV margin, and PTV dose heterogeneity). 4D doses were calculated by simulating synchronized delivery of SBRT to the virtual patient model with random initial positions of tumor motion. The expected dose (average) and the standard deviation of the 4D doses were obtained. The relative difference between the expected GTV minimal/mean (GTVMin/GTVMean) dose and the planned ITVMin/ITVMean dose (denoted by %E/P), and between the GTVMin and the prescription dose (DRx) were computed. Results: The %E/P for GTVMean was significantly lower for IMRT than VMAT (0.5% +/- 7.7% v.s. 3.5% +/- 5.0%, p=0.04). The expected GTVMin was lower than DRx in 9.4% of all IMRT plans versus 3.1% in VMAT. The worst-case scenario, 4D GTVMin was 14.1% lower than the ITVMin. Choices of PTV margin or dose heterogeneity to be achieved in PTV can result in significant difference (p<0.05) in motion interplay depending on delivery techniques. Conclusion: Motion interplay may cause the expected GTVMin to be less than the planned ITV minimal dose and DRx for both IMRT and VMAT plans. The differences between the expected GTV dose and the ITV dose depended on the delivery technique and planning parameters. Overall, VMAT is less prone to motion interplay than IMRT.
format Preprint
id arxiv_https___arxiv_org_abs_2501_18153
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Volumetric modulated arc therapy or step-shoot IMRT? A 4D dosimetry study of motion effect in lung SBRT using a dynamic virtual patient model
Ma, Tianjun
Guo, Bingqi
Balik, Salim
Qi, Peng
Magnelli, Anthony
Videtic, Gregory M M.
Stephans, Kevin L
Zhuang, Tingliang
Medical Physics
Purpose: To investigate the impact of delivery techniques and planning parameters on interplay effect in lung SBRT. Methods: A dynamic virtual patient model containing normal structures and a tumor with adjustable sizes, locations, and 3D breathing motion was utilized. SBRT plans were developed using both step-and-shoot IMRT and VMAT with different planning parameters (energy, isocenter location, PTV margin, and PTV dose heterogeneity). 4D doses were calculated by simulating synchronized delivery of SBRT to the virtual patient model with random initial positions of tumor motion. The expected dose (average) and the standard deviation of the 4D doses were obtained. The relative difference between the expected GTV minimal/mean (GTVMin/GTVMean) dose and the planned ITVMin/ITVMean dose (denoted by %E/P), and between the GTVMin and the prescription dose (DRx) were computed. Results: The %E/P for GTVMean was significantly lower for IMRT than VMAT (0.5% +/- 7.7% v.s. 3.5% +/- 5.0%, p=0.04). The expected GTVMin was lower than DRx in 9.4% of all IMRT plans versus 3.1% in VMAT. The worst-case scenario, 4D GTVMin was 14.1% lower than the ITVMin. Choices of PTV margin or dose heterogeneity to be achieved in PTV can result in significant difference (p<0.05) in motion interplay depending on delivery techniques. Conclusion: Motion interplay may cause the expected GTVMin to be less than the planned ITV minimal dose and DRx for both IMRT and VMAT plans. The differences between the expected GTV dose and the ITV dose depended on the delivery technique and planning parameters. Overall, VMAT is less prone to motion interplay than IMRT.
title Volumetric modulated arc therapy or step-shoot IMRT? A 4D dosimetry study of motion effect in lung SBRT using a dynamic virtual patient model
topic Medical Physics
url https://arxiv.org/abs/2501.18153