Search of an ideal location of isocenter in intensity-modulated radiotherapy treatment plans: A dosimetrical approach

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Date
2019-01
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Publisher
Wolters Kluwer India Pvt. Ltd.
Abstract
Aim: The aim of this study is to identify an ideal location of isocenter in intensity-modulated radiotherapy (IMRT) treatment plans. Materials and Methods: A total of 28 clinical target volumes and 4 English capital letters (C, L, T, and H) target volumes were considered in this study. Two IMRT treatment plans were generated for each target volume in the ECLIPSETM treatment planning system (TPS), first one with isocenter automatically placed (ISOAUTO) by TPS and the second one with geometric center-based isocenter (ISOGEOM). The geometric center of a cuboid volume, which was formed encompassing around the target volume in sagittal, transverse, and frontal planes, is considered as the geometric center of the target volume as well as the isocenter (ISOGEOM) of the IMRT plans. While performing the IMRT treatment plans using the beam angle optimization and dose volume optimization, the normal tissue objectives and target volume objectives were kept similar in both the plans. The dosimetrical parameters between the two groups of plans were compared. Results: The distance between ISOGEOM and ISOAUTO ranged from 0.16 cm to 3.04 cm with a mean and median of 0.85 cm and 0.69 cm, respectively. The ISOGEOM-based IMRT plans exhibited statistically significant advantages in total monitor units reduction (100% of cases, P ≤ 0.001), total number of field reduction (66% of cases, P ≤ 0.001), and reduction of patient mean dose (69% of cases, P ≤ 0.001) over ISOAUTO-based IMRT plans. The conformity index, homogeneity index and target mean dose were comparable between both group of plans. Conclusion: Significant dosimetrical advantages may be observed, when the geometric centroid of target volume is considered as isocenter of IMRT treatment plan.
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Keywords
Conformity index, homogeneity index, intensity-modulated radiotherapy, isocenter
Citation
Mandal Abhijit, Asthana Anupam Kumar, Pradhan Satyajit, Shahi Uday Pratap, Choudhary Sunil. Search of an ideal location of isocenter in intensity-modulated radiotherapy treatment plans: A dosimetrical approach. Journal of Cancer Research and Therapeutics. 2019 Jan; 15(1): 211-215