RAdiotherapy Dose Accumulation Routine (RADAR)-A novel dose accumulation script with built-in uncertainty Journal Article

  


Authors: Mechalakos, J. G.; Hu, Y. C.; Kuo, L.; Zhang, L.; Shah, N.; Ballangrud, A.; Cervino, L.; Yorke, E.; Liu, Y.; Zhang, P.
Article Title: RAdiotherapy Dose Accumulation Routine (RADAR)-A novel dose accumulation script with built-in uncertainty
Abstract: Purpose: To incorporate uncertainty into dose accumulation for reirradiation. Methods and Materials: The RAdiotherapy Dose Accumulation Routine (RADAR) script for the Eclipse treatment planning system (Varian Medical Systems) is described, and the voxel-wise ellipsoid search algorithm is introduced as a means of incorporating uncertainty. RADAR is first demonstrated on a test patient reirradiated to the spine, illustrating the effect of the uncertainty algorithm. A summary of initial evaluation testing conducted by 11 users, each of whom ran a separate spine reirradiation case, follows. Finally, RADAR run times are reported for various conditions. Results: In the demonstration case in which a 3-mm ellipsoid search was used, the maximum RADAR 2-Gy equivalent (EQD2) accumulated spinal cord dose increased from 7244 to 12,689 cGy because the ellipsoid search pulled dose from closer to the adjacent target structure. When the ellipsoid search was restricted to voxels within the spinal cord, the maximum accumulated cord dose was reduced to 6523 cGy and did not exceed the sum of the maximum EQD2 spinal cord doses of the individual plans (6730 cGy). In the evaluation cases, the RADAR EQD2 maximum dose for the spinal cord increased by an average of 31.6% with uncertainty applied compared to a conventional dose accumulation and decreased by an average of 16.7% compared to a conventional dose accumulation when the uncertainty calculation was restricted to voxels within the spinal cord. RADAR run times vary depending on the number of plans added and the type of uncertainty used. Conclusions: RADAR offers a novel way to directly account for uncertainty in dose accumulation through a voxel-wise ellipsoid search algorithm. EQD2 dose accumulation with and without dose discounts is also available. © 2024 American Society for Radiation Oncology
Keywords: controlled study; intensity modulated radiation therapy; radiotherapy dosage; algorithms; algorithm; spinal cord; radiotherapy planning, computer-assisted; stereotactic body radiation therapy; radiation dose distribution; esophagus; uncertainty; radiological parameters; cauda equina; procedures; re-irradiation; organs at risk; radiation dose reduction; humans; human; article; radiotherapy planning system; x-ray computed tomography; radiotherapy dose accumulation routine
Journal Title: Practical Radiation Oncology
Volume: 15
Issue: 2
ISSN: 1879-8519
Publisher: Elsevier Inc.  
Date Published: 2025-03-01
Start Page: 187
End Page: 195
Language: English
DOI: 10.1016/j.prro.2024.10.006
PUBMED: 39447864
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85209242601&doi=10.1016%2fj.prro.2024.10.006&partnerID=40&md5=109a52bac3ac311c401e897c39204461
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is James Mechalakos -- Source: Scopus
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MSK Authors
  1. Li Cheng Kuo
    65 Kuo
  2. Pengpeng Zhang
    179 Zhang
  3. Ase M Ballangrud-Popovic
    104 Ballangrud-Popovic
  4. James G Mechalakos
    165 Mechalakos
  5. Ellen D Yorke
    451 Yorke
  6. Yu-Chi Hu
    120 Hu
  7. Niral Minesh Shah
    10 Shah
  8. Yilin Liu
    20 Liu
  9. Lei Zhang
    32 Zhang
  10. Laura Isabel Cervino Arriba
    142 Cervino Arriba
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