SU-E-T-334: Dosimetric Impacts of Organ at Risk (OAR) Contour Errors in Prostate Volumetric Modulated Arc Therapy (VMAT) Planning: A Sensitivity Study




To investigate the dosimetric impacts of OAR contour errors in prostate VMAT planning with a sensitivity analysis method.


Ten randomly selected prostate VMAT patients were used to simulate OAR contour error in rectum and bladder. For each OAR 12 even spaced contour control points were selected in every three slices. For each simulation, only one of the control points was simulated to move inwards or outwards by up to 6 voxels and coordinates of adjacent voxels to that moving control point were moved accordingly with a 3D-spline smooth function. An in-house software was used to predict OARs dosimetric endpoints based on geometric relationship between PTV and OAR. In this study, the V75, V70, V65, V60 of rectum and V80, V75, V70, V65 of bladder with and without perturbed contours were calculated and compared.


The percentage of OAR dose volume difference around the reference OAR contours were plotted as iso-error lines overlaid on CT images. The significant difference was shown in OAR contours adjacent to the PTV where high dose gradient exists. When one of the 12 points adjacent to the PTV moved up to 6 voxels, maximum errors of 1.99%, 2.46%, 2.89%, and 3.19% were found in V75, V70, V65, and V60 of the rectum, and 1.59%, 1.67%, 1.87%, and 1.90% were found in V80, V75, V70, and V65 of the bladder, respectively.


We can quantify the dosimetric impact of OAR contouring error by evaluating the percentage of OAR dose volume changes in prostate VMAT planning. For the adaptive radiation therapy, the iso-error lines can provide the planner a guideline that which portion of contour needed to be checked carefully because dosimetric sensitivity of contour errors are different for different part of contours.