Deep learning-based optimization of field geometry for total marrow irradiation delivered with volumetric modulated arc therapy.

Journal: Medical physics
Published Date: Apr 18, 2024

Abstract

BACKGROUND: Total marrow (lymphoid) irradiation (TMI/TMLI) is a radiotherapy treatment used to selectively target the bone marrow and lymph nodes in conditioning regimens for allogeneic hematopoietic stem cell transplantation. A complex field geometry is needed to cover the large planning target volume (PTV) of TMI/TMLI with volumetric modulated arc therapy (VMAT). Five isocenters and ten overlapping fields are needed for the upper body, while, for patients with large anatomical conformation, two specific isocenters are placed on the arms. The creation of a field geometry is clinically challenging and is performed by a medical physicist (MP) specialized in TMI/TMLI.

Authors

  • Nicola Lambri
    IRCCS Humanitas Research Hospital, Medical Physics Unit of Radiotherapy and Radiosurgery Department, via Manzoni, Rozzano, Milan, Italy.
  • Giorgio Longari
    Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
  • Daniele Loiacono
    Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
  • Ricardo Coimbra Brioso
    Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
  • Leonardo Crespi
    Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
  • Carmela Galdieri
    Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
  • Francesca Lobefalo
    Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan-Rozzano, Italy.
  • Giacomo Reggiori
    Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
  • Roberto Rusconi
    Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
  • Stefano Tomatis
    Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan-Rozzano, Italy.
  • Luisa Bellu
    Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
  • Stefania Bramanti
    Department of Oncology and Hematology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
  • Elena Clerici
    Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
  • Chiara De Philippis
    Department of Oncology and Hematology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
  • Damiano Dei
    Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
  • Pierina Navarria
    Department of Radiotherapy and Radiosurgery, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy.
  • Carmelo Carlo-Stella
    Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
  • Ciro Franzese
    Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
  • Marta Scorsetti
    Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan-Rozzano, Italy.
  • Pietro Mancosu
    Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan-Rozzano, Italy.

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