Table 1.
Paired t test comparison between original VMAT plans and cardiac-optimized VMAT plans (n = 26)
| Dosimetry variable | Original VMAT plans (mean; SD) | Cardiac-optimized VMAT plans (mean; SD) | P Value |
|---|---|---|---|
| Cardiac parameters (Gy) | |||
| Heart Dmax | 63.63; 7.36 | 64.89; 3.23 | .378 |
| Heart Dmean | 16.1; 8.46 | 12.35; 7.44 | <.001* |
| Heart V5 | 64.14; 27.75 | 55.39; 28.06 | .002* |
| Heart V30 | 18.72; 14.44 | 12.47; 11.53 | <.001* |
| Heart V40 | 11.48; 10.44 | 7.87; 8.21 | <.001* |
| Heart V45 | 9.01; 8.85 | 6.48; 7.02 | <.001* |
| Heart V60 | 3.36; 3.73 | 2.72; 3.27 | <.001* |
| Aortic valve Dmax | 31.66; 17.53 | 22.9; 16.42 | <.001* |
| Aortic valve Dmean | 19.83; 12.64 | 11.42; 8.46 | <.001* |
| Mitral valve Dmax | 29.37; 21.64 | 24.56; 22.75 | .001* |
| Mitral valve Dmean | 16.73; 14.01 | 11.2; 12.25 | <.001* |
| Pulmonic valve Dmax | 35.43; 16.52 | 26.83; 18.71 | <.001* |
| Pulmonic valve Dmean | 25.12; 15.43 | 14.06; 14.53 | <.001* |
| Tricuspid valve Dmax | 16.6; 14.26 | 9.74; 10.55 | <.001* |
| Tricuspid valve Dmean | 10.34; 10.76 | 5.58; 6.88 | <.001* |
| Atrioventricular node Dmax | 20.41; 13.6 | 13.39; 12.4 | <.001* |
| Atrioventricular node Dmean | 14.00; 10.01 | 8.05; 7.14 | <.001* |
| Left main coronary artery Dmax | 38.77; 17.62 | 26.34; 18.89 | <.001* |
| Left main coronary artery Dmean | 30.15; 16.3 | 16.42; 14.12 | <.001* |
| Left anterior descending coronary artery Dmax | 34.78; 20.39 | 27.39; 21.11 | <.001* |
| Left anterior descending coronary artery Dmean | 22.59; 16.3 | 14.37; 13.85 | <.001* |
| Left circumflex coronary artery Dmax | 36.85; 23.71 | 32.58; 25.37 | <.001* |
| Left circumflex coronary artery Dmean | 26.86; 19.85 | 19.33; 16.92 | <.001* |
| Right coronary artery Dmax | 26.14; 18.72 | 18.13; 17.08 | <.001* |
| Right coronary artery Dmean | 15.74; 13.44 | 9.4; 9.03 | <.001* |
| Left atrium Dmax | 54.84; 17.19 | 51.82; 19.99 | .056 |
| Left atrium Dmean | 20.97; 11.86 | 17.53; 10.73 | <.001* |
| Left ventricle Dmax | 40.1; 22.45 | 35.71; 24.87 | <.001* |
| Left ventricle Dmean | 11.29; 10.3 | 8.34; 8.79 | <.001* |
| Right atrium Dmax | 36.08; 22.31 | 31.37; 23.68 | .004* |
| Right atrium Dmean | 13.89; 14.00 | 11.11; 12.27 | <.001* |
| Right ventricle Dmax | 33.15; 17.41 | 23.65; 17.85 | <.001* |
| Right ventricle Dmean | 12.24; 11.64 | 6.93; 6.22 | <.001* |
| Ascending aorta Dmax | 55.28; 12.49 | 50.77; 17.03 | .001* |
| Ascending aorta Dmean | 27.92; 11.81 | 20.4; 10.96 | <.001* |
| Pulmonary artery Dmax | 65.13; 4.22 | 65.21; 3.27 | .935 |
| Pulmonary artery Dmean | 37.89; 9.56 | 32.24; 10.48 | <.001* |
| Superior vena cava Dmax | 51.74; 17.46 | 47.39; 20.58 | .001* |
| Superior vena cava Dmean | 33.08; 18.83 | 29.4; 18.47 | .005* |
| Other OAR parameters (Gy) | |||
| Lungs: CTV V5 | 58.18; 9.5 | 56.56; 9.24 | .165 |
| Lungs: CTV V20 | 23.25; 6.85 | 22.38; 6.09 | .043* |
| Lungs: CTV Dmean | 14.07; 3.1 | 13.58; 2.83 | .005* |
| Spinal cord Dmax | 31.07; 8.31 | 28; 7.92 | .008* |
| Esophagus Dmean | 22.09; 7.23 | 21.22; 6.97 | .020* |
| PTV coverage parameters (Gy) | |||
| PTV Dmax | 67.23; 2.24 | 65.51; 6.32 | .160 |
| PTV minimum dose | 52.72; 4.29 | 51.18; 4.61 | .009* |
| PTV V100% | 95.38; 0.8 | 95.24; 0.61 | .196 |
Abbreviations: CTV = clinical target volume; Dmax = maximum dose; Dmean = mean dose; OAR = organs at risk; PTV = planning target volume; SD = standard deviation; VMAT = volumetric modulated arc therapy.
*
Significant P value.