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An extended dose-volume model in high dose-rate brachytherapy: Using mean-tail-dose to reduce tumor underdosage
Linköping University, Department of Mathematics, Optimization . Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0001-7191-5206
Linköping University, Department of Mathematics, Optimization . Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0003-2094-7376
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska University Hospital, Stockholm, Sweden.
2019 (English)In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 46, no 6, p. 2556-2566Article in journal (Refereed) Published
Abstract [en]

Purpose High dose-rate brachytherapy is a method of radiotherapy for cancer treatment in which the radiation source is placed within the body. In addition to give a high enough dose to a tumor, it is also important to spare nearby healthy organs [organs at risk (OAR)]. Dose plans are commonly evaluated using the so-called dosimetric indices; for the tumor, the portion of the structure that receives a sufficiently high dose is calculated, while for OAR it is instead the portion of the structure that receives a sufficiently low dose that is of interest. Models that include dosimetric indices are referred to as dose-volume models (DVMs) and have received much interest recently. Such models do not take the dose to the coldest (least irradiated) volume of the tumor into account, which is a distinct weakness since research indicates that the treatment effect can be largely impaired by tumor underdosage even to small volumes. Therefore, our aim is to extend a DVM to also consider the dose to the coldest volume. Methods An improved DVM for dose planning is proposed. In addition to optimizing with respect to dosimetric indices, this model also takes mean dose to the coldest volume of the tumor into account. Results Our extended model has been evaluated against a standard DVM in ten prostate geometries. Our results show that the dose to the coldest volume could be increased, while also computing times for the dose planning were improved. Conclusion While the proposed model yields dose plans similar to other models in most aspects, it fulfils its purpose of increasing the dose to cold tumor volumes. An additional benefit is shorter solution times, and especially for clinically relevant times (of minutes) we show major improvements in tumour dosimetric indices.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019. Vol. 46, no 6, p. 2556-2566
Keywords [en]
cold volumes, CVaR, dose-volume model, dosimetric index, dwell time optimization, EUD, mean-tail-dose, TCP
National Category
Computational Mathematics Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-157356DOI: 10.1002/mp.13533ISI: 000471277705311PubMedID: 30972758Scopus ID: 2-s2.0-85065984130OAI: oai:DiVA.org:liu-157356DiVA, id: diva2:1323730
Funder
Swedish Research Council, VR-NT 2015-04543Swedish Cancer Society, CAN 2015/618
Note

Funding agencies:  Swedish Research Council [VR-NT 2015-04543]; Swedish Cancer Foundation [CAN 2015/618]

Available from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-07-15Bibliographically approved

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Morén, BjörnLarsson, TorbjörnCarlsson Tedgren, Åsa

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Computational MathematicsRadiology, Nuclear Medicine and Medical Imaging

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