Effect of region extraction and assigned mass-density values on the accuracy of dose calculation with magnetic resonance-based volumetric arc therapy planning
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This study aimed to verify the validity of generating treatment plans for volumetric arc therapy (VMAT) for prostate cancer using magnetic resonance (MR) imaging with a dose calculation algorithm in Acuros XB (Eclipse version 13.6; Varian Medical Systems, Palo Alto, CA, USA) based on deterministically solving the linear Boltzmann transport equations. Four different classes were applied to prostate MR images: MRW (all water equivalent); MRW+B (water and bone); MRS+B (soft tissue and bone); and MRS+B+G (soft tissue, bone, and rectal gas). Each of these regions was assigned a mass density for calculating doses. The assigned mass-density values were then altered in three ways. Using initial planning and optimization parameters, MR-based VMAT plans were generated and compared with corresponding forward-calculated computed tomography-based plans for doses to the target volumes and organs at risk using dose-volume histograms and γ analyses. In the MRW plans, the mean doses for TVs were overestimated by approximately 1.3%. The MRW+B plans revealed reduced differences within 0.5%. Further segmentation (MRS+B) did not result in substantial improvement. Dose deviations affected by the changes in the mass densities assigned to soft tissue were as small as approximately 1.0%, whereas larger deviations were revealed in bone and rectal gas, especially those with > 5% error. Assignment of accurate mass-density values acquired from MR images is needed for MR-based radiation treatment planning. Multiple MR sequences should be acquired for segmentation and mass-density conversion purposes. Segmented MR-based VMAT planning is feasible with a density assignment method using Acuros XB.
KeywordsDose calculation MR image VMAT Boltzmann transport equations Segmentation
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.
All procedures involving human participants were performed in accordance with the ethics committee of the authors’ institution, and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study did not involve animals.
Informed consent was obtained from all participants included in this study.
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