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Reconstructed Rectal Wall Dose Map-Based Verification of Rectal Dose Sparing Effect According to Rectum Definition Methods and Dose Perturbation by Air Cavity in Endo-Rectal Balloon

J Park

J Park1,2,3*, H Park4 , J Lee5 , S Kang3,6 , M Lee3,6 , B Lee7,8 , T Suh3,6 , (1) Dept. of Pediatrics and (2) Molecular Imaging Program at Stanford, Stanford University, Stanford, CA, USA (3) Research Institute of Biomedical Engineering, The Catholic University of Korea, Seoul, Korea (4) Dept. of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea (5) Konkuk University Medical Center, Seoul, Korea (6) Dept. of Biomedical Engineering, The Catholic University of Korea, Seoul, Korea (7) Dept. of Bio-Convergence Engineering, Korea University, Seoul, Korea (8) Dept. of Radiation Oncology, Sun Medical Center, Daejeon, Korea


SU-E-T-280 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: Dosimetric effect and discrepancy according to the rectum definition methods and dose perturbation by air cavity in an endo-rectal balloon (ERB) were verified using rectal-wall (Rwall) dose maps considering systematic errors in dose optimization and calculation accuracy in intensity-modulated radiation treatment (IMRT) for prostate cancer patients.
Methods:When the inflated ERB having average diameter of 4.5 cm and air volume of 100 cc is used for patient, Rwall doses were predicted by pencil-beam convolution (PBC), anisotropic analytic algorithm (AAA), and AcurosXB (AXB) with material assignment function. The errors of dose optimization and calculation by separating air cavity from the whole rectum (Rwhole) were verified with measured rectal doses. The Rwall doses affected by the dose perturbation of air cavity were evaluated using a featured rectal phantom allowing insert of rolled-up gafchromic films and glass rod detectors placed along the rectum perimeter. Inner and outer Rwall doses were verified with reconstructed predicted rectal wall dose maps. Dose errors and extent at dose levels were evaluated with estimated rectal toxicity.
Results:While AXB showed insignificant difference of target dose coverage, Rwall doses underestimated by up to 20% in dose optimization for the Rwhole than Rwall at all dose range except for the maximum dose. As dose optimization for Rwall was applied, the Rwall doses presented dose error less than 3% between dose calculation algorithm except for overestimation of maximum rectal dose up to 5% in PBC. Dose optimization for Rwhole caused dose difference of Rwall especially at intermediate doses.
Conclusion:Dose optimization for Rwall could be suggested for more accurate prediction of rectal wall dose prediction and dose perturbation effect by air cavity in IMRT for prostate cancer.

Funding Support, Disclosures, and Conflict of Interest: This research was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (MSIP) (Grant No. 200900420)

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