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Analysis of the cause of dose delivery errors due to changes in abdominal gas volume during MRgART pancreatic cancer  

Ha, Min Yong (Department of Radiation Oncology, Seoul National University Hospital)
Son, Sang Jun (Department of Radiation Oncology, Seoul National University Hospital)
Kim, Chan Yong (Department of Radiation Oncology, Seoul National University Hospital)
Lee, Je Hee (Department of Radiation Oncology, Seoul National University Hospital)
Publication Information
The Journal of Korean Society for Radiation Therapy / v.32, no., 2020 , pp. 73-83 More about this Journal
Abstract
Purpose: The purpose of this study is to confirm the matching of the electron density between tissue and gas due to variation of abdominal gas volume in MRgART (Magnetic Resonance-guided Adaptive Radiation Therapy) for pancreatic cancer patients, and to confirm the effect on the dose change and treatment time. Materials and Methods: We compared the PTV and OAR doses of the initial plan and the AGC(Abdominal gas correction) plans to one pancreatic cancer patient who treated with MRgART using the ViewRay MRIdian System (Viewray, USA) at this clinic. In the 4fx AGC plans, Beam ON(%) according to the patient's motion error was checked to confirm the effect of abdominal gas volume on treatment time. Results: Comparing the Initial plan with the average value of AGC plan, the dose difference was -7 to 0.1% in OAR and decreased by 0.16% on average, and in PTV, the dose decreased by 4.5% to 5.5% and decreased by 5.1% on average. In Adaptive treatment, as the abdominal gas volume increased, the Beam ON(%) decreased. Conclusion: Abdominal gas volume variation causes dose change due to inaccurate electron density matching between tissue and gas. In addition, if the abdominal gas volume increases, the Beam ON(%) decreases, and the treatment time may increase due to the motion error of the patient. Therefore, in MRgART, it is necessary to check the electron density matching and minimize the variability of the abdominal gas.
Keywords
ViewRay; MRgART; Electron density; abdominal gas;
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