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Inverse vs. forward breast IMRT planning

Mihai, A; Rakovitch, E; Sixel, K; Woo, T; Cardoso, M; Bell, C; Ruschin, Mark LU and Pignol, JP (2005) In Medical Dosimetry 30(3). p.149-154
Abstract
Breast intensity-modulated radiation therapy (IMRT) improves dose distribution homogeneity within the whole breast. Previous publications report the use of inverse or forward dose optimization algorithms. Because the inverse technique is not widely available in commercial treatment planning systems, it is important to compare the 2 algorithms. The goal of this work is to compare them on a prospective cohort of 30 patients. Dose distributions were evaluated on differential dose-volume histograms using the volumes receiving more than 105% (V-105) and 110% (V-110) of the prescribed dose, and on the maximum dose (D-max) or hot spot and the sagittal dose gradient (SDG) being the gradient between the dose on inframammary crease and the dose... (More)
Breast intensity-modulated radiation therapy (IMRT) improves dose distribution homogeneity within the whole breast. Previous publications report the use of inverse or forward dose optimization algorithms. Because the inverse technique is not widely available in commercial treatment planning systems, it is important to compare the 2 algorithms. The goal of this work is to compare them on a prospective cohort of 30 patients. Dose distributions were evaluated on differential dose-volume histograms using the volumes receiving more than 105% (V-105) and 110% (V-110) of the prescribed dose, and on the maximum dose (D-max) or hot spot and the sagittal dose gradient (SDG) being the gradient between the dose on inframammary crease and the dose prescribed. The data were analyzed using Wilcoxon signed rank test. The inverse planning significantly improves the V-105 (mean value 9.7% vs. 14.5%, p = 0.002), and the V-110 (mean value 1.4% vs. 3.2%, p = 0.006). However, the SDG is not statistically significantly different for either algorithm. Looking at the potential impact on skin acute reaction, although there is a significant reduction of V-110 using an inverse algorithm, it is unlikely this 1.6% volume reduction will present a significant clinical advantage over a forward algorithm. Both algorithms are equivalent in removing the hot spots on the inframammary fold, where acute skin reactions occur more frequently using a conventional wedge technique. Based on these results, we recommend that both forward and inverse algorithms should be considered for breast IMRT planning. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
inverse IMRT, breast cancer, adjuvant radiotherapy, forward IMRT
in
Medical Dosimetry
volume
30
issue
3
pages
149 - 154
publisher
Elsevier
external identifiers
  • pmid:16112466
  • wos:000235834700005
  • scopus:23844493207
ISSN
1873-4022
DOI
10.1016/j.meddos.2005.03.004
language
English
LU publication?
yes
id
7c3b4afe-2777-4f88-848f-45e98160f189 (old id 208563)
date added to LUP
2007-08-15 13:04:32
date last changed
2017-08-13 03:40:29
@article{7c3b4afe-2777-4f88-848f-45e98160f189,
  abstract     = {Breast intensity-modulated radiation therapy (IMRT) improves dose distribution homogeneity within the whole breast. Previous publications report the use of inverse or forward dose optimization algorithms. Because the inverse technique is not widely available in commercial treatment planning systems, it is important to compare the 2 algorithms. The goal of this work is to compare them on a prospective cohort of 30 patients. Dose distributions were evaluated on differential dose-volume histograms using the volumes receiving more than 105% (V-105) and 110% (V-110) of the prescribed dose, and on the maximum dose (D-max) or hot spot and the sagittal dose gradient (SDG) being the gradient between the dose on inframammary crease and the dose prescribed. The data were analyzed using Wilcoxon signed rank test. The inverse planning significantly improves the V-105 (mean value 9.7% vs. 14.5%, p = 0.002), and the V-110 (mean value 1.4% vs. 3.2%, p = 0.006). However, the SDG is not statistically significantly different for either algorithm. Looking at the potential impact on skin acute reaction, although there is a significant reduction of V-110 using an inverse algorithm, it is unlikely this 1.6% volume reduction will present a significant clinical advantage over a forward algorithm. Both algorithms are equivalent in removing the hot spots on the inframammary fold, where acute skin reactions occur more frequently using a conventional wedge technique. Based on these results, we recommend that both forward and inverse algorithms should be considered for breast IMRT planning.},
  author       = {Mihai, A and Rakovitch, E and Sixel, K and Woo, T and Cardoso, M and Bell, C and Ruschin, Mark and Pignol, JP},
  issn         = {1873-4022},
  keyword      = {inverse IMRT,breast cancer,adjuvant radiotherapy,forward IMRT},
  language     = {eng},
  number       = {3},
  pages        = {149--154},
  publisher    = {Elsevier},
  series       = {Medical Dosimetry},
  title        = {Inverse vs. forward breast IMRT planning},
  url          = {http://dx.doi.org/10.1016/j.meddos.2005.03.004},
  volume       = {30},
  year         = {2005},
}