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Open Access 01-12-2014 | Research

Reconstitution of internal target volumes by combining four-dimensional computed tomography and a modified slow computed tomography scan in stereotactic body radiotherapy planning for lung cancer

Authors: Seong Soon Jang, Gil Ja Huh, Suk Young Park, Po Song Yang, Hae Nam Chung, Jae Hyuk Seo, Ji Chan Park, Young Jun Yang, Eun Youn Cho

Published in: Radiation Oncology | Issue 1/2014

Abstract

Background

To evaluate the volumetric and geometric differences in the ITVs generated by four-dimensional (4D) computed tomography (CT), a modified slow CT scan, and a combination of these CT methods in lung cancer patients treated with stereotactic body radiotherapy (SBRT).

Methods

Both 4D CT and modified slow CT using a multi-slice CT scanner were performed for SBRT planning in 14 patients with 15 pulmonary targets. Volumetric and geometric analyses were performed for (1) ITVall, generated by combining the gross tumor volumes (GTVs) from all 8 phases of the 4D CT; (2) ITV2, generated by combining the GTVs from 2 extreme phases of the 4D CT; (3) ITVslow, derived from the GTV on the modified slow CT scan; (4) ITVall+slow, generated by combining ITVall and ITVslow; and (5) ITV2+slow, generated by combining ITV2 and ITVslow. Three SBRT plans were performed using 3 ITVs to assess the dosimetric effects on normal lung caused by the various target volumes.

Results

ITVall (11.8 ± 8.3 cm³) was significantly smaller than ITVall+slow (12.5 ± 8.9 cm³), with mean values of 5.8% for the percentage volume difference, and a mean of 7.5% of ITVslow was not encompassed in ITVall. The geometric coverages of ITV2 and ITVslow for ITVall were 84.7 ± 6.6% and 76.2 ± 9.3%, respectively, but the coverage for ITVall increased to 90.9 ± 5.9% by using the composite of these two ITVs. There were statistically significant increases in the lung-dose parameters of the plans based on ITVall+slow compared to the plans based on ITVall or ITV2+slow. However, the magnitudes of these differences were relatively small, with a value of less than 3% in all dosimetric parameters.

Conclusions

Due to its ability to provides additional motion information, the combination of 4D CT and a modified slow CT scan in SBRT planning for lung cancer can be used to reduce possible errors in true target delineation caused by breathing pattern variations.

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Title: Reconstitution of internal target volumes by combining four-dimensional computed tomography and a modified slow computed tomography scan in stereotactic body radiotherapy planning for lung cancer
Authors: Seong Soon Jang
Gil Ja Huh
Suk Young Park
Po Song Yang
Hae Nam Chung
Jae Hyuk Seo
Ji Chan Park
Young Jun Yang
Eun Youn Cho
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-9-106

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reconstitution of internal target volumes by combining four-dimensional computed tomography and a modified slow computed tomography scan in stereotactic body radiotherapy planning for lung cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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