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  • [Scientific Reports] Verification of rebuild-up effect on superficial cardiac lesion of ventricular tachycardia using 3-D printed phantom in volumetric-modulated arc therapy planning

    [Scientific Reports] Verification of rebuild-up effect on superficial cardiac lesion of ventricular tachycardia using 3-D printed phantom in volumetric-modulated arc therapy planning

    건국대 / 노시원, 신준봉, 이정우*

  • 출처
    Scientific Reports
  • 등재일
    2022
  • 저널이슈번호
    12, Article number: 2270
  • 내용

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    Abstract
    The aim of the study was to evaluate dose distributions on the superficial cardiac lesion surrounded by low-density lungs. Volumetric modulated arc therapy (VMAT) technique was applied to optimize the dose distribution using the anisotropic analytic algorithm (AAA) and Acuros XB algorithm (AXB) using the 3-D printed cardiac phantom. We used four full and half arcs with 6-MV and 15-MV photons to investigate the rebuild-up effect near the planning target volume (PTV). Depending on the calculation algorithm (AAA vs. AXB) for full arcs plans, V95 of PTV differed by 27% for 6-MV and 29% for 15-MV, and D95 for 6-MV and 15-MV shows 24% and 30%, respectively. The maximum doses in the AXB plans on PTV were 5.1% higher than those in AAA plans at 6-MV, and 3.8% higher at 15-MV. In addition, half arcs treatment plans showed a very similar tendency with full arcs plans. Film dosimetry showed significant differences from the planned results in the AAA plans. Particularly, the dose mismatch occurred between the cardiac PTV and the left lung interface. In the case of 6-MV plans calculated by AAA, the maximum dose increased from 4.1 to 7.7% in the PTV. Furthermore, it showed that 50% of the width of dose profiles was reduced by 1.3 cm in the 6-MV plan. Conversely, in the case of the plans using the AXB algorithm, the maximum dose increased by 2.0–5.0%. In contrast to the AAA algorithm, the dose patterns at the interface demonstrated a good agreement with the plans. Dose fluctuation on the interface between superficial cardiac lesions and low-density lungs can lead to an error in the estimation of accurate dose delivery for the case of VT SBRT.

  • 연구소개
    본 논문은 3차원 프린팅 기술을 이용하여 심장을 구현하고 체적조절호형방사선치료(VMAT)로 심실빈맥(ventricular tarchycardia) 표재성 심장변변(superficial cardiac lesion)을 치료 시 발생할 수 있는 선량오류를 조사한 연구로써 저밀도 폐조직을 투과 후 선량재상승효과(rebuild-up)를 규명한 실측을 통해 입증한 매우 가치 있는 연구이다. 치료계획장치의 선량계산 알고리즘에 의한 잠재적인 선량분포의 오류를 3차원 프린팅 기술과 라디오크로믹 필름을 사용하였다는 것이 독창적이다.
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