ALERT‐RA: an aperture library‐enabled real‐time respiratory motion adaptive framework for 4D‐VMAT
Notice bibliographique
Résumé
PURPOSE: To develop a framework for robust optimization of real-time respiratory motion adaptive VMAT treatment plans, and to evaluate the robustness of resulting plans to variations in tumor trajectory during delivery. METHODS: The proposed framework is called aperture library-enabled real-time robust adaptation (ALERT-RA). A patient-specific library of optimized MLC apertures is defined for each combination of gantry angle and respiratory phase. The method assumes that the tumor is tracked in real-time throughout delivery, and the aperture corresponding to the current phase and gantry angle will be delivered. The aperture library is optimized by considering all possible tumor trajectories determined by a probabilistic respiratory motion model. Plan robustness to trajectory variations was evaluated by sampling a trajectory, and determining the corresponding dose, from the respiratory model for each fraction. The cumulative dose of the full treatment course was simulated 50 times. Percentile dose-volume histograms (PDVHs) were computed from these simulated treatments. The resulting plan quality and robustness of this method were compared to other previously published motion 4D-VMAT methods, including: an optimized tracking approach that assumes reproducible tumor motion, conformal tracking with aperture deformation, and a motion-encompassing method. Two fractionation schemes were tested to determine the possible effect on robustness: a conventional fractionation of 66 Gy in 33 fractions, and an SBRT course with 60 Gy in 5 fractions. RESULTS: When considering target coverage, the ALERT-RA method was found to produce a plan which was more robust than those produced using the optimized or conformal tracking methods. Using the PDVH analysis, the 5th and 95th percentiles of the prescription dose volume for the conventionally fractioned plan were found to be (respectively) 79% and 82% for the optimized tracking approach, 81% and 83% for the conformal tracking approach, and 92% and 97% using the new ALERT-RA method. The motion-encompassing plan was slightly more robust than the ALERT-RA plan, with 5th and 95th percentiles at 94% and 95%, respectively. This came at a cost of higher dose to OARs, with the volume of lung receiving 5 Gy or more equal to 48% for the motion-encompassing plan versus 44% for the ALERT-RA plan. For the SBRT plan, the conformal tracking plan was similarly not robust, with 5th and 95th percentiles of the prescription dose volume equal to 88% and 89%. The optimized tracking SBRT plan gave values of 93% and 95%, and the motion-encompassing plan 94% and 95%, while the ALERT-RA gave values of 93% and 96%. The volume of lung receiving 20 Gy or more was slightly higher for the optimized tracking and motion-encompassing plans compared to the ALERT-RA plan, at 15%, 15%, and 14%, respectively. CONCLUSIONS: Compared to other motion-adaptive VMAT approaches, the ALERT-RA algorithm is capable of delivering high-quality plans which are robust to variations in tumor motion trajectories.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».