Influence of eye movement on lens dose and optic nerve target coverage during craniospinal irradiation

Bianca A W Hoeben; Enrica Seravalli; Amber M L Wood; Mirjam Bosman; Witold P Matysiak; John H Maduro; Astrid L H M W van Lier; Matteo Maspero; Gijsbert H Bol; Geert O Janssens

doi:10.1016/j.ctro.2021.08.009

Influence of eye movement on lens dose and optic nerve target coverage during craniospinal irradiation

Bianca A W Hoeben^*, Enrica Seravalli, Amber M L Wood, Mirjam Bosman, Witold P Matysiak, John H Maduro, Astrid L H M W van Lier, Matteo Maspero, Gijsbert H Bol, Geert O Janssens

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Guided Treatment in Optimal Selected Cancer Patients (GUTS)

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Purpose: Optic nerves are part of the craniospinal irradiation (CSI) target volume. Modern radiotherapy techniques achieve highly conformal target doses while avoiding organs-at-risk such as the lens. The magnitude of eye movement and its influence on CSI target- and avoidance volumes are unclear. We aimed to evaluate the movement-range of lenses and optic nerves and its influence on dose distribution of several planning techniques.

Methods: Ten volunteers underwent MRI scans in various gaze directions (neutral, left, right, cranial, caudal). Lenses, orbital optic nerves, optic discs and CSI target volumes were delineated. 36-Gy cranial irradiation plans were constructed on synthetic CT images in neutral gaze, with Volumetric Modulated Arc Therapy, pencil-beam scanning proton therapy, and 3D-conventional photons. Movement-amplitudes of lenses and optic discs were analyzed, and influence of gaze direction on lens and orbital optic nerve dose distribution.

Results: Mean eye structures' shift from neutral position was greatest in caudal gaze; -5.8 +/- 1.2 mm (+/- SD) for lenses and 7.0 +/- 2.0 mm for optic discs. In 3D-conventional plans, caudal gaze decreased Mean Lens Dose (MLD). In VMAT and proton plans, eye movements mainly increased MLD and diminished D98 orbital optic nerve (D98OON) coverage; mean MLD increased up to 5.5 Gy [total Delta MLD range -8.1 to 10.0 Gy], and mean D98OON decreased up to 3.3 Gy [total Delta D98OON range -13.6 to 1.2 Gy]. VMAT plans optimized for optic disc Internal Target Volume and lens Planning organ-at-Risk Volume resulted in higher MLD over gaze directions. D98OON became >= 95% of prescribed dose over 95/100 evaluated gaze directions, while all-gaze bilateral D98OON significantly changed in 1 of 10 volunteers.

Conclusion: With modern CSI techniques, eye movements result in higher lens doses and a mean detriment for orbital optic nerve dose coverage of

Originele taal-2	English
Pagina's (van-tot)	28-33
Aantal pagina's	6
Tijdschrift	Clinical and Translational Radiation Oncology
Volume	31
DOI's	https://doi.org/10.1016/j.ctro.2021.08.009
Status	Published - 1-nov.-2021

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10.1016/j.ctro.2021.08.009Licentie: CC BY

Influence of eye movement on lens dose and optic nerve target coverage during craniospinal irradiationFinal publisher's version, 1,77 MBLicentie: CC BY

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Hoeben, B. A. W., Seravalli, E., Wood, A. M. L., Bosman, M., Matysiak, W. P., Maduro, J. H., van Lier, A. L. H. M. W., Maspero, M., Bol, G. H., & Janssens, G. O. (2021). Influence of eye movement on lens dose and optic nerve target coverage during craniospinal irradiation. Clinical and Translational Radiation Oncology, 31, 28-33. https://doi.org/10.1016/j.ctro.2021.08.009

@article{5035122eb02f4bd8b7a1fb575b2dfcca,

title = "Influence of eye movement on lens dose and optic nerve target coverage during craniospinal irradiation",

abstract = "Purpose: Optic nerves are part of the craniospinal irradiation (CSI) target volume. Modern radiotherapy techniques achieve highly conformal target doses while avoiding organs-at-risk such as the lens. The magnitude of eye movement and its influence on CSI target- and avoidance volumes are unclear. We aimed to evaluate the movement-range of lenses and optic nerves and its influence on dose distribution of several planning techniques.Methods: Ten volunteers underwent MRI scans in various gaze directions (neutral, left, right, cranial, caudal). Lenses, orbital optic nerves, optic discs and CSI target volumes were delineated. 36-Gy cranial irradiation plans were constructed on synthetic CT images in neutral gaze, with Volumetric Modulated Arc Therapy, pencil-beam scanning proton therapy, and 3D-conventional photons. Movement-amplitudes of lenses and optic discs were analyzed, and influence of gaze direction on lens and orbital optic nerve dose distribution.Results: Mean eye structures' shift from neutral position was greatest in caudal gaze; -5.8 +/- 1.2 mm (+/- SD) for lenses and 7.0 +/- 2.0 mm for optic discs. In 3D-conventional plans, caudal gaze decreased Mean Lens Dose (MLD). In VMAT and proton plans, eye movements mainly increased MLD and diminished D98 orbital optic nerve (D98OON) coverage; mean MLD increased up to 5.5 Gy [total Delta MLD range -8.1 to 10.0 Gy], and mean D98OON decreased up to 3.3 Gy [total Delta D98OON range -13.6 to 1.2 Gy]. VMAT plans optimized for optic disc Internal Target Volume and lens Planning organ-at-Risk Volume resulted in higher MLD over gaze directions. D98OON became >= 95% of prescribed dose over 95/100 evaluated gaze directions, while all-gaze bilateral D98OON significantly changed in 1 of 10 volunteers.Conclusion: With modern CSI techniques, eye movements result in higher lens doses and a mean detriment for orbital optic nerve dose coverage of",

keywords = "Craniospinal irradiation, VMAT, 3D-conventional, Proton, Lens, Optic nerve, RADIOTHERAPY, GERMINOMA, CATARACT, ANGLE",

author = "Hoeben, {Bianca A W} and Enrica Seravalli and Wood, {Amber M L} and Mirjam Bosman and Matysiak, {Witold P} and Maduro, {John H} and {van Lier}, {Astrid L H M W} and Matteo Maspero and Bol, {Gijsbert H} and Janssens, {Geert O}",

note = "{\textcopyright} 2021 The Author(s).",

year = "2021",

month = nov,

day = "1",

doi = "10.1016/j.ctro.2021.08.009",

language = "English",

volume = "31",

pages = "28--33",

journal = "Clinical and Translational Radiation Oncology",

issn = "2405-6308",

publisher = "Elsevier",

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TY - JOUR

T1 - Influence of eye movement on lens dose and optic nerve target coverage during craniospinal irradiation

AU - Hoeben, Bianca A W

AU - Seravalli, Enrica

AU - Wood, Amber M L

AU - Bosman, Mirjam

AU - Matysiak, Witold P

AU - Maduro, John H

AU - van Lier, Astrid L H M W

AU - Maspero, Matteo

AU - Bol, Gijsbert H

AU - Janssens, Geert O

PY - 2021/11/1

Y1 - 2021/11/1

N2 - Purpose: Optic nerves are part of the craniospinal irradiation (CSI) target volume. Modern radiotherapy techniques achieve highly conformal target doses while avoiding organs-at-risk such as the lens. The magnitude of eye movement and its influence on CSI target- and avoidance volumes are unclear. We aimed to evaluate the movement-range of lenses and optic nerves and its influence on dose distribution of several planning techniques.Methods: Ten volunteers underwent MRI scans in various gaze directions (neutral, left, right, cranial, caudal). Lenses, orbital optic nerves, optic discs and CSI target volumes were delineated. 36-Gy cranial irradiation plans were constructed on synthetic CT images in neutral gaze, with Volumetric Modulated Arc Therapy, pencil-beam scanning proton therapy, and 3D-conventional photons. Movement-amplitudes of lenses and optic discs were analyzed, and influence of gaze direction on lens and orbital optic nerve dose distribution.Results: Mean eye structures' shift from neutral position was greatest in caudal gaze; -5.8 +/- 1.2 mm (+/- SD) for lenses and 7.0 +/- 2.0 mm for optic discs. In 3D-conventional plans, caudal gaze decreased Mean Lens Dose (MLD). In VMAT and proton plans, eye movements mainly increased MLD and diminished D98 orbital optic nerve (D98OON) coverage; mean MLD increased up to 5.5 Gy [total Delta MLD range -8.1 to 10.0 Gy], and mean D98OON decreased up to 3.3 Gy [total Delta D98OON range -13.6 to 1.2 Gy]. VMAT plans optimized for optic disc Internal Target Volume and lens Planning organ-at-Risk Volume resulted in higher MLD over gaze directions. D98OON became >= 95% of prescribed dose over 95/100 evaluated gaze directions, while all-gaze bilateral D98OON significantly changed in 1 of 10 volunteers.Conclusion: With modern CSI techniques, eye movements result in higher lens doses and a mean detriment for orbital optic nerve dose coverage of

AB - Purpose: Optic nerves are part of the craniospinal irradiation (CSI) target volume. Modern radiotherapy techniques achieve highly conformal target doses while avoiding organs-at-risk such as the lens. The magnitude of eye movement and its influence on CSI target- and avoidance volumes are unclear. We aimed to evaluate the movement-range of lenses and optic nerves and its influence on dose distribution of several planning techniques.Methods: Ten volunteers underwent MRI scans in various gaze directions (neutral, left, right, cranial, caudal). Lenses, orbital optic nerves, optic discs and CSI target volumes were delineated. 36-Gy cranial irradiation plans were constructed on synthetic CT images in neutral gaze, with Volumetric Modulated Arc Therapy, pencil-beam scanning proton therapy, and 3D-conventional photons. Movement-amplitudes of lenses and optic discs were analyzed, and influence of gaze direction on lens and orbital optic nerve dose distribution.Results: Mean eye structures' shift from neutral position was greatest in caudal gaze; -5.8 +/- 1.2 mm (+/- SD) for lenses and 7.0 +/- 2.0 mm for optic discs. In 3D-conventional plans, caudal gaze decreased Mean Lens Dose (MLD). In VMAT and proton plans, eye movements mainly increased MLD and diminished D98 orbital optic nerve (D98OON) coverage; mean MLD increased up to 5.5 Gy [total Delta MLD range -8.1 to 10.0 Gy], and mean D98OON decreased up to 3.3 Gy [total Delta D98OON range -13.6 to 1.2 Gy]. VMAT plans optimized for optic disc Internal Target Volume and lens Planning organ-at-Risk Volume resulted in higher MLD over gaze directions. D98OON became >= 95% of prescribed dose over 95/100 evaluated gaze directions, while all-gaze bilateral D98OON significantly changed in 1 of 10 volunteers.Conclusion: With modern CSI techniques, eye movements result in higher lens doses and a mean detriment for orbital optic nerve dose coverage of

KW - Craniospinal irradiation

KW - VMAT

KW - 3D-conventional

KW - Proton

KW - Lens

KW - Optic nerve

KW - RADIOTHERAPY

KW - GERMINOMA

KW - CATARACT

KW - ANGLE

U2 - 10.1016/j.ctro.2021.08.009

DO - 10.1016/j.ctro.2021.08.009

M3 - Article

C2 - 34522796

SN - 2405-6308

VL - 31

SP - 28

EP - 33

JO - Clinical and Translational Radiation Oncology

JF - Clinical and Translational Radiation Oncology

ER -