(P038) An MRI-Based Online Adaptive Replanning Tool

Publication
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OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

The online tool is developed to perform three different plan adaptation strategies-simple, moderate, and complex-based on the degree of the interfractional variations.

Ozgur Ates, PhD, Ergun E. Ahunbay, PhD, Guang-Pei Chen, PhD, JingQiao Zhang, PhD, J. Frank Wilson, MD, X. Allen Li, PhD; Medical College of Wisconsin

BACKGROUND: MR-Linac, an integration of a magnetic resonance imaging (MRI) scanner with a Linac, has many advantages, such as excellent soft tissue and tumor contrast, allowing us to deliver MRI-based online-replanned radiation treatment (RT) with real-time tumor motion tracking. In this work, we introduce an online adaptive replanning tool to address interfractional changes in tumor and organs at risk (OARs), based on the synthetic CT converted from the pretreatment MRI.

METHODS AND DISCUSSION: The online tool is developed to perform three different plan adaptation strategies-simple, moderate, and complex-based on the degree of the interfractional variations. The simple strategy is designed for situations in which translational shift is the dominant interfractional change, where the adaptive plan is generated by shifting all beam apertures based on the rigid registration of the planning and daily images and by optimizing all beam weights based on the dose map from the original plan. The simple strategy requires no segmentation and can be performed quickly. The moderate strategy will use the previously developed segment aperture morphing (SAM) algorithm to account for the changes, including target deformation, which requires delineation of the target. The complex strategy is a general solution to fully address interfractional variations; this approach requires segmentation of target and OARs. In this strategy, the adaptive plan is generated by the SAM and warm-start optimization (WSO) algorithms.

A software tool is developed to perform a comprehensive pretreatment and posttreatment delivery quality assurance, including segmentation verification, plan check, and delivery validation. The entire procedure takes 4 minutes for the simple strategy, 6 minutes for the moderate strategy, and 10 minutes for the complex strategy. The adaptive plans developed from the three techniques have shown to be comparable with those generated from the full-blown reoptimization plans based on daily images.

Proceedings of the 98th Annual Meeting of the American Radium Society -americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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