Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy

Aims: This study evaluated the influence of high dose (HD) vertex numbers and its placement on equivalent uniform dose (EUD) and peak-to-valley dose ratio (PVDR) in lattice radiotherapy (LRT). Settings and Design: One hundred and eighty-eight RapidArc (RA) plans were created for a cohort of 15 patie...

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Main Authors: A. T. Bhagyalakshmi, Velayudham Ramasubramanian
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Medical Physics
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Online Access:https://journals.lww.com/10.4103/jmp.jmp_97_24
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author A. T. Bhagyalakshmi
Velayudham Ramasubramanian
author_facet A. T. Bhagyalakshmi
Velayudham Ramasubramanian
author_sort A. T. Bhagyalakshmi
collection DOAJ
description Aims: This study evaluated the influence of high dose (HD) vertex numbers and its placement on equivalent uniform dose (EUD) and peak-to-valley dose ratio (PVDR) in lattice radiotherapy (LRT). Settings and Design: One hundred and eighty-eight RapidArc (RA) plans were created for a cohort of 15 patients. Materials and Methods: RA plans were created with zero to eight HD vertices to analyze their relationship with EUD. Eight lattices were systematically and optimally placed (by avoiding proximity to organs at risks [OARs]) to study the impact of vertex placement. Variations in PVDR were assessed using PVDR1 (mean dose to HD vertices by the difference of mean doses to planning target volume [PTV] and HD vertices) and PVDR2 (D10/D90 of PTV in composite plans) across 38 RA plans with HD vertex doses of 9 Gy, 12 Gy, 15 Gy, and 18 Gy. PVDR3 (product of PVDR1 and PVDR2) was evaluated for its variation with peak dose. Statistical Analysis Used: Hypothesis testing between vertex placements was performed using a two-tailed Student’s t-test. Results: EUD values ranged from 32.88 Gy to 40.63 Gy. In addition, statistical analysis revealed significant associations (P = 0.0074) between the placement patterns of HD vertices, both in systematic and optimized arrangements. The PVDR and D10/D90 product values were 1.6, 1.8, 2.1, and 2.3 for peak doses of 9 Gy, 12 Gy, 15 Gy, and 18 Gy, respectively. Conclusions: The addition of one HD vertex increased EUD, emphasizing the impact of individual vertex increments on outcomes. Systematic and optimized vertex placements enhance EUD, with optimized placement yielding better doses to PTV and OARs. PVDR3 offers superior dose reporting for LRT compared to PVDR1 and PVDR2.
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spelling doaj-art-ea73d393f7c541fab5ccba8bf73ba4cf2025-01-07T07:19:03ZengWolters Kluwer Medknow PublicationsJournal of Medical Physics0971-62031998-39132024-12-0149449350110.4103/jmp.jmp_97_24Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice RadiotherapyA. T. BhagyalakshmiVelayudham RamasubramanianAims: This study evaluated the influence of high dose (HD) vertex numbers and its placement on equivalent uniform dose (EUD) and peak-to-valley dose ratio (PVDR) in lattice radiotherapy (LRT). Settings and Design: One hundred and eighty-eight RapidArc (RA) plans were created for a cohort of 15 patients. Materials and Methods: RA plans were created with zero to eight HD vertices to analyze their relationship with EUD. Eight lattices were systematically and optimally placed (by avoiding proximity to organs at risks [OARs]) to study the impact of vertex placement. Variations in PVDR were assessed using PVDR1 (mean dose to HD vertices by the difference of mean doses to planning target volume [PTV] and HD vertices) and PVDR2 (D10/D90 of PTV in composite plans) across 38 RA plans with HD vertex doses of 9 Gy, 12 Gy, 15 Gy, and 18 Gy. PVDR3 (product of PVDR1 and PVDR2) was evaluated for its variation with peak dose. Statistical Analysis Used: Hypothesis testing between vertex placements was performed using a two-tailed Student’s t-test. Results: EUD values ranged from 32.88 Gy to 40.63 Gy. In addition, statistical analysis revealed significant associations (P = 0.0074) between the placement patterns of HD vertices, both in systematic and optimized arrangements. The PVDR and D10/D90 product values were 1.6, 1.8, 2.1, and 2.3 for peak doses of 9 Gy, 12 Gy, 15 Gy, and 18 Gy, respectively. Conclusions: The addition of one HD vertex increased EUD, emphasizing the impact of individual vertex increments on outcomes. Systematic and optimized vertex placements enhance EUD, with optimized placement yielding better doses to PTV and OARs. PVDR3 offers superior dose reporting for LRT compared to PVDR1 and PVDR2.https://journals.lww.com/10.4103/jmp.jmp_97_24equivalent uniform dosehigh doselattice therapypeak to-valley dose ratioplacement pattern
spellingShingle A. T. Bhagyalakshmi
Velayudham Ramasubramanian
Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy
Journal of Medical Physics
equivalent uniform dose
high dose
lattice therapy
peak to-valley dose ratio
placement pattern
title Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy
title_full Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy
title_fullStr Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy
title_full_unstemmed Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy
title_short Impact of Number and Placement of High-dose Vertices on Equivalent Uniform Dose and Peak-to-valley Ratio for Lattice Radiotherapy
title_sort impact of number and placement of high dose vertices on equivalent uniform dose and peak to valley ratio for lattice radiotherapy
topic equivalent uniform dose
high dose
lattice therapy
peak to-valley dose ratio
placement pattern
url https://journals.lww.com/10.4103/jmp.jmp_97_24
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