Adaptive replanning using cone beam CT for deformation of original CT simulation. Issue 2 (26th October 2021)

• Record Type: Journal Article
• Authors: Bojechko, Casey; Hua, Patricia; Sumner, Whitney; Guram, Kripa; Atwood, Todd; Sharabi, Andrew
• Is Part Of: Journal of medical radiation sciences. Volume 69:Issue 2(2022)
• Page Start: 267
• Page End: 272
• Publication Date: 2021-10-26
• Subjects: Adaptive radiotherapy (ART) < radiation therapy -- deformable registration < radiation therapy -- general < discipline -- head and neck < clinical site -- medical imaging < general -- palliative < general -- radiotherapy (radiation therapy) < discipline; Radiology, Medical -- Periodicals; Radiology, Medical -- Australia -- Periodicals; Radiology, Medical -- New Zealand -- Periodicals; Radiotherapy -- Periodicals; Diagnostic imaging -- Periodicals; 616
• DOI: 10.1002/jmrs.549
• Languages: English
• ISSNs: 2051-3895

Abstract

Abstract: Background: During a course of radiation therapy, anatomical changes such as a decrease in tumour size or weight loss can trigger the need for repeating a computed tomography (CT) simulation scan in order to generate a new treatment plan. This adaptive approach requires a separate appointment for an additional CT scan which generates additional burden, cost, and radiation exposure for patients. Case Presentation: Here, we present a case of a head and neck cancer patient who required palliative radiation for a large neck mass. During treatment, he had a remarkable response which required a replan due to rapid tumour downsizing. In this case, we used a novel technique to avoid repeating the planning CT simulation by using a mid‐treatment high‐quality cone beam CT (CBCT) to deform the secondary image (plan CT) of the original planning CT and generate a new adapted treatment plan. Conclusion: This is the first report to our knowledge using a Halcyon CBCT to deform the original planning CT in order to generate a new radiation treatment plan, and this novel technique represents a new potential method of adaptive replanning for select patients. Abstract : Adaptive radiation therapy utilising treatment plans that are modified daily or weekly during a course of radiation is an emerging new technology. Here we report one of the first examples of a novel technique using a mid‐treatment high‐quality cone beam CT (CBCT) to deform the image registration of the original planning CT and generate a new adapted treatment plan without repeating CT simulation. Adaptive radiation therapy techniques have the potential to further improve the quality of radiation treatment delivery