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Open Access 01-12-2013 | Research

Detection of interfraction displacement and volume variance during radiotherapy of primary thoracic esophageal cancer based on repeated four-dimensional CT scans

Authors: Jin Zhi Wang, Jian Bin Li, Wei Wang, Huan Peng Qi, Zhi Fang Ma, Ying Jie Zhang, Ting Yong Fan, Qian Shao, Min Xu

Published in: Radiation Oncology | Issue 1/2013

Abstract

Background

To investigate the interfraction displacement and volume variation of primary thoracic esophagus carcinoma with enhanced four-dimensional computed tomography (4DCT) scanning during fractionated radiotherapy.

Methods

4DCT data sets were acquired at the time of treatment simulation and every ten fraction for each of 32 patients throughout treatment. Scans were registered to baseline (simulation) 4DCT scans by using bony landmarks. The gross tumor volumes (GTVs) were delineated on each data set. Coordinates of the GTV centroids were acquired on each respiration phase. Distance between center of the GTV contour on the simulation scan and the centers on subsequent scans were used to assess interfraction displacement between fractions. Volumes were constructed using three approaches: The GTV delineated from the maximum intensity projection (MIP) was defined IGTV_MIP, all 10 GTVs were combined to form IGTV₁₀, GTV_mean was the average of all 10 phases of each GTV.

Results

Interfraction displacement in left-right (LR), anterior-posterior (AP), superior-inferior (SI) directions and 3D vector were 0.13 ± 0.09 cm, 0.16 ± 0.12 cm, 0.34 ± 0.26 cm and 0.43 ± 0.24 cm, respectively between the tenth fraction and simulation 4DCT scan. 0.14 ± 0.09 cm, 0.19 ± 0.16 cm, 0.45 ± 0.43 cm and 0.56 ± 0.40 cm in LR, AP, SI and 3D vector respectively between the twentieth fraction and simulation 4DCT scan. Displacement in SI direction was larger than LR and AP directions during treatment. For distal esophageal cancer, increased interfraction displacements were observed in SI direction and 3D vector (P = 0.002 and P = 0.001, respectively) during radiotherapy. The volume of GTV_mean, IGTV_MIP, and IGTV₁₀ decreased significantly at the twentieth fraction for middle (median: 34.01%, 33.09% and 28.71%, respectively) and distal (median: 22.76%, 25.27% and 23.96%, respectively) esophageal cancer, but for the upper third, no significant variation were observed during radiotherapy.

Conclusions

Interfractional displacements in SI direction were larger than LR and AP directions. For distal location, significant changes were observed in SI direction and 3D vector during radiotherapy. For middle and distal locations, the best time to reset position should be selected at the twentieth fraction when the primary tumor target volume changed significantly, and it was preferable to guide target correction and planning modification.

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Title: Detection of interfraction displacement and volume variance during radiotherapy of primary thoracic esophageal cancer based on repeated four-dimensional CT scans
Authors: Jin Zhi Wang
Jian Bin Li
Wei Wang
Huan Peng Qi
Zhi Fang Ma
Ying Jie Zhang
Ting Yong Fan
Qian Shao
Min Xu
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2013
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-8-224

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Detection of interfraction displacement and volume variance during radiotherapy of primary thoracic esophageal cancer based on repeated four-dimensional CT scans

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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