title: Target volume coverage and dose to organs at risk in prostate cancer patients. Dose calculation on daily cone-beam CT data sets.
abstract: OBJECTIVE
  On the basis of correct Hounsfield unit to electron density calibration, cone-beam computed tomography (CBCT) data provide the opportunity for retrospective dose recalculation in the patient. Therefore, the consequences of translational positioning corrections and of morphological changes in the patient anatomy can be quantified for prostate cancer patients.
  
  
  METHODS
  The organs at risk were newly contoured on the CBCT data sets of 7 patients so as to evaluate the actual applied dose. The daily dose to the planning target volume (PTV) was recalculated with and without the translation data, which result from the real patient repositioning.
  
  
  RESULTS
  A CBCT-based dose recalculation with uncertainties less than 3 % is possible. The deviations between the planning CT and the CBCT without the translational positioning correction vector show an average dose difference of - 8 % inside the PTV. An inverse proportional relation between the mean bladder dose and the actual volume of the bladder could be established. The daily applied dose to the rectum is about 1-54 % higher than predicted by the planning CT.
  
  
  CONCLUSIONS
  A dose calculation based on CBCT data is possible. The daily positioning correction of the patient is necessary to avoid an underdosage in the PTV. The new contouring of the organs at risk - the bladder and rectum - allows a better appraisal to be made of the total applied dose to these organs.
authors.affiliation: Klinik für Strahlentherapie, Universitätsklinikum Gießen-Marburg GmbH, Klinikstr. 33, 35392, Gießen, Germany, petra.huettenrauch@kmub.thm.de.
authors.forename: P
authors.initials: P
authors.lastname: Hüttenrauch
authors.forename: M
authors.initials: M
authors.lastname: Witt
authors.forename: D
authors.initials: D
authors.lastname: Wolff
authors.forename: S
authors.initials: S
authors.lastname: Bosold
authors.forename: R
authors.initials: R
authors.lastname: Engenhart-Cabillic
authors.forename: J
authors.initials: J
authors.lastname: Sparenberg
authors.forename: H
authors.initials: H
authors.lastname: Vorwerk
authors.forename: K
authors.initials: K
authors.lastname: Zink
mesh_terms: D002138:Calibration; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods*; D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D058958:Organs at Risk; D056888:Patient Positioning / Q000295:instrumentation / Q000379:methods; D019047:Phantoms, Imaging; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000295:instrumentation / Q000379:methods*; D012007:Rectum / Q000528:radiation effects*; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000528:radiation effects*