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Title: Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography

Abstract

Purpose: To evaluate a novel four-dimensional (4D) image-guided radiotherapy (IGRT) technique in stereotactic body RT for liver tumors. Methods and Materials: For 11 patients with 13 intrahepatic tumors, a respiratory-correlated 4D computed tomography (CT) scan was acquired at treatment planning. The target was defined using CT series reconstructed at end-inhalation and end-exhalation. The liver was delineated on these two CT series and served as a reference for image guidance. A cone-beam CT scan was acquired after patient positioning; the blurred diaphragm dome was interpreted as a probability density function showing the motion range of the liver. Manual contour matching of the liver structures from the planning 4D CT scan with the cone-beam CT scan was performed. Inter- and intrafractional uncertainties of target position and motion range were evaluated, and interobserver variability of the 4D-IGRT technique was tested. Results: The workflow of 4D-IGRT was successfully practiced in all patients. The absolute error in the liver position and error in relation to the bony anatomy was 8 {+-} 4 mm and 5 {+-} 2 mm (three-dimensional vector), respectively. Margins of 4-6 mm were calculated for compensation of the intrafractional drifts of the liver. The motion range of the diaphragm dome was reproduciblemore » within 5 mm for 11 of 13 lesions, and the interobserver variability of the 4D-IGRT technique was small (standard deviation, 1.5 mm). In 4 patients, the position of the intrahepatic lesion was directly verified using a mobile in-room CT scanner after application of intravenous contrast. Conclusion: The results of our study have shown that 4D image guidance using liver contour matching between respiratory-correlated CT and cone-beam CT scans increased the accuracy compared with stereotactic positioning and compared with IGRT without consideration of breathing motion.« less

Authors:
 [1]; ; ; ; ; ; ; ;  [1]
  1. Department of Radiation Oncology, Julius-Maximilians University, Wuerzburg (Germany)
Publication Date:
OSTI Identifier:
21124213
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 71; Journal Issue: 1; Conference: 2007 interorganizational symposium on quality assurance of radiation therapy: Challenges of advanced technology, Dallas, TX (United States), 20-22 Feb 2007; Other Information: DOI: 10.1016/j.ijrobp.2008.01.005; PII: S0360-3016(08)00030-8; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; ANATOMY; COMPUTERIZED TOMOGRAPHY; DIAPHRAGM; ERRORS; EXHALATION; IMAGE PROCESSING; IMAGES; LIVER; NEOPLASMS; RADIOTHERAPY

Citation Formats

Guckenberger, Matthias, Sweeney, Reinhart A, Wilbert, Juergen, Krieger, Thomas, Richter, Anne, Baier, Kurt, Mueller, Gerd, Sauer, Otto, and Flentje, Michael. Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.01.005.
Guckenberger, Matthias, Sweeney, Reinhart A, Wilbert, Juergen, Krieger, Thomas, Richter, Anne, Baier, Kurt, Mueller, Gerd, Sauer, Otto, & Flentje, Michael. Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography. United States. https://doi.org/10.1016/j.ijrobp.2008.01.005
Guckenberger, Matthias, Sweeney, Reinhart A, Wilbert, Juergen, Krieger, Thomas, Richter, Anne, Baier, Kurt, Mueller, Gerd, Sauer, Otto, and Flentje, Michael. 2008. "Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography". United States. https://doi.org/10.1016/j.ijrobp.2008.01.005.
@article{osti_21124213,
title = {Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography},
author = {Guckenberger, Matthias and Sweeney, Reinhart A and Wilbert, Juergen and Krieger, Thomas and Richter, Anne and Baier, Kurt and Mueller, Gerd and Sauer, Otto and Flentje, Michael},
abstractNote = {Purpose: To evaluate a novel four-dimensional (4D) image-guided radiotherapy (IGRT) technique in stereotactic body RT for liver tumors. Methods and Materials: For 11 patients with 13 intrahepatic tumors, a respiratory-correlated 4D computed tomography (CT) scan was acquired at treatment planning. The target was defined using CT series reconstructed at end-inhalation and end-exhalation. The liver was delineated on these two CT series and served as a reference for image guidance. A cone-beam CT scan was acquired after patient positioning; the blurred diaphragm dome was interpreted as a probability density function showing the motion range of the liver. Manual contour matching of the liver structures from the planning 4D CT scan with the cone-beam CT scan was performed. Inter- and intrafractional uncertainties of target position and motion range were evaluated, and interobserver variability of the 4D-IGRT technique was tested. Results: The workflow of 4D-IGRT was successfully practiced in all patients. The absolute error in the liver position and error in relation to the bony anatomy was 8 {+-} 4 mm and 5 {+-} 2 mm (three-dimensional vector), respectively. Margins of 4-6 mm were calculated for compensation of the intrafractional drifts of the liver. The motion range of the diaphragm dome was reproducible within 5 mm for 11 of 13 lesions, and the interobserver variability of the 4D-IGRT technique was small (standard deviation, 1.5 mm). In 4 patients, the position of the intrahepatic lesion was directly verified using a mobile in-room CT scanner after application of intravenous contrast. Conclusion: The results of our study have shown that 4D image guidance using liver contour matching between respiratory-correlated CT and cone-beam CT scans increased the accuracy compared with stereotactic positioning and compared with IGRT without consideration of breathing motion.},
doi = {10.1016/j.ijrobp.2008.01.005},
url = {https://www.osti.gov/biblio/21124213}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 71,
place = {United States},
year = {Thu May 01 00:00:00 EDT 2008},
month = {Thu May 01 00:00:00 EDT 2008}
}