Quantitative analysis of motion-induced dose uncertainty and robust optimization in liver lattice radiotherapy: a comparative study.
- 1Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
- 2Department of Radiotherapy Physics & Technology, West China Hospital, Sichuan University, Chengdu, China.
Abstract
The precise delivery of high doses to lattice vertices in liver lattice radiotherapy (LRT) can be compromised by respiratory motion.This study aimed to quantitatively characterize the dosimetric impact of respiratory motion on liver LRT and to assess the potential of four-dimensional (4D) robust optimization in mitigating motion-induced uncertainties. Twenty-one patients with bulky liver tumors underwent 4D computed tomography scanning. Three lattice target volumes (LTVs) were generated using varied lattice geometries defined by vertex sizes and spacing. Conventional and 4D robust plans were generated on average intensity projection images. Four-dimensional dose distributions were reconstructed via deformable image registration-based dose accumulation across all respiratory phases. Dosimetric parameters of LTVs and organs at risk (OARs) were compared between static three-dimensional (3D) and dynamic 4D scenarios. Spearman correlation coefficients were calculated to quantify the relationship between motion amplitudes and dosimetric variations. Respiratory motion introduced substantial dose degradation in conventional plans. Specifically, LTV Dmin and D98, which represent the minimum dose and the dose covering 98% of the structure, decreased by up to 12.71% and 9.45%, respectively. Motion amplitude was strongly correlated with dose deviations (r>0.7). In contrast, 4D robust plans significantly improved dose stability, with discrepancies in Dmin and D98 between 3D and 4D dose metrics reduced to within 1.4%. Robust optimization led to a significant decrease in the conformity index (CI) in 3D scenarios, but the CI of these robust plans significantly improved in 4D evaluations (P<0.01). Furthermore, under 4D evaluation, robust plans maintained clinically acceptable target conformity, with no statistically significant differences observed compared to conventional plans in most configurations. OAR doses remained within clinically acceptable limits for both conventional and robust plans. Liver LRT is highly sensitive to respiratory motion, resulting in notable target dose deterioration under conventional planning. Four-dimensional robust optimization demonstrated the ability to address motion-induced uncertainties and facilitate robust target coverage while maintaining favorable conformity in 4D scenarios through necessary high-dose volume expansion. These findings highlight the importance of integrating motion-aware optimization and patient-specific motion management strategies in clinical LRT planning.
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BibTeX
@article{dai2026quantitative,
title = {{Quantitative analysis of motion-induced dose uncertainty and robust optimization in liver lattice radiotherapy: a comparative study.}},
author = {Guyu Dai and Shuokai Jia and Junchen Shi and Weige Wei and Xi Zhou and Xiangbin Zhang and Qing Xiao and Hang Yu and Yanmei Hao and Yuwei Xia and Linsen Zhou and Guangjun Li and Sen Bai},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = oct,
doi = {10.21037/qims-2026-1467},
url = {https://europepmc.org/article/MED/42997925},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Quantitative analysis of motion-induced dose uncertainty and robust optimization in liver lattice radiotherapy: a comparative study.
AU - Guyu Dai
AU - Shuokai Jia
AU - Junchen Shi
AU - Weige Wei
AU - Xi Zhou
AU - Xiangbin Zhang
AU - Qing Xiao
AU - Hang Yu
AU - Yanmei Hao
AU - Yuwei Xia
AU - Linsen Zhou
AU - Guangjun Li
AU - Sen Bai
PY - 2026
DA - 2026/10/20
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-1467
UR - https://europepmc.org/article/MED/42997925
AB - The precise delivery of high doses to lattice vertices in liver lattice radiotherapy (LRT) can be compromised by respiratory motion.This study aimed to quantitatively characterize the dosimetric impact of respiratory motion on liver LRT and to assess the potential of four-dimensional (4D) robust optimization in mitigating motion-induced uncertainties. Twenty-one patients with bulky liver tumors underwent 4D computed tomography scanning. Three lattice target volumes (LTVs) were generated using varied lattice geometries defined by vertex sizes and spacing. Conventional and 4D robust plans were generated on average intensity projection images. Four-dimensional dose distributions were reconstructed via deformable image registration-based dose accumulation across all respiratory phases. Dosimetric parameters of LTVs and organs at risk (OARs) were compared between static three-dimensional (3D) and dynamic 4D scenarios. Spearman correlation coefficients were calculated to quantify the relationship between motion amplitudes and dosimetric variations. Respiratory motion introduced substantial dose degradation in conventional plans. Specifically, LTV Dmin and D98, which represent the minimum dose and the dose covering 98% of the structure, decreased by up to 12.71% and 9.45%, respectively. Motion amplitude was strongly correlated with dose deviations (r>0.7). In contrast, 4D robust plans significantly improved dose stability, with discrepancies in Dmin and D98 between 3D and 4D dose metrics reduced to within 1.4%. Robust optimization led to a significant decrease in the conformity index (CI) in 3D scenarios, but the CI of these robust plans significantly improved in 4D evaluations (P<0.01). Furthermore, under 4D evaluation, robust plans maintained clinically acceptable target conformity, with no statistically significant differences observed compared to conventional plans in most configurations. OAR doses remained within clinically acceptable limits for both conventional and robust plans. Liver LRT is highly sensitive to respiratory motion, resulting in notable target dose deterioration under conventional planning. Four-dimensional robust optimization demonstrated the ability to address motion-induced uncertainties and facilitate robust target coverage while maintaining favorable conformity in 4D scenarios through necessary high-dose volume expansion. These findings highlight the importance of integrating motion-aware optimization and patient-specific motion management strategies in clinical LRT planning.
SN - 2223-4292
SN - 2223-4306
ER -