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Title: 4D Proton treatment planning strategy for mobile lung tumors

Abstract

Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images. Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE{sub R}IGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method. Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE{sub R}IGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans usingmore » 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased. Conclusion: The AVE{sub R}IGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors.« less

Authors:
 [1];  [1];  [2];  [1];  [2];  [2];  [2];  [2];  [1];  [1];  [1];  [1];  [3]
  1. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  2. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  3. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States). E-mail: ldong@mdanderson.org
Publication Date:
OSTI Identifier:
20944745
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2006.10.045; PII: S0360-3016(06)03385-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; IMAGES; LUNGS; PATIENTS; PLANNING; PROTON BEAMS; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RESPIRATION

Citation Formats

Kang Yixiu, Zhang Xiaodong, Chang, Joe Y., Wang He, Wei Xiong, Liao Zhongxing, Komaki, Ritsuko, Cox, James D., Balter, Peter A., Liu, Helen, Zhu, X. Ronald, Mohan, Radhe, and Dong Lei. 4D Proton treatment planning strategy for mobile lung tumors. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.10.045.
Kang Yixiu, Zhang Xiaodong, Chang, Joe Y., Wang He, Wei Xiong, Liao Zhongxing, Komaki, Ritsuko, Cox, James D., Balter, Peter A., Liu, Helen, Zhu, X. Ronald, Mohan, Radhe, & Dong Lei. 4D Proton treatment planning strategy for mobile lung tumors. United States. doi:10.1016/j.ijrobp.2006.10.045.
Kang Yixiu, Zhang Xiaodong, Chang, Joe Y., Wang He, Wei Xiong, Liao Zhongxing, Komaki, Ritsuko, Cox, James D., Balter, Peter A., Liu, Helen, Zhu, X. Ronald, Mohan, Radhe, and Dong Lei. Thu . "4D Proton treatment planning strategy for mobile lung tumors". United States. doi:10.1016/j.ijrobp.2006.10.045.
@article{osti_20944745,
title = {4D Proton treatment planning strategy for mobile lung tumors},
author = {Kang Yixiu and Zhang Xiaodong and Chang, Joe Y. and Wang He and Wei Xiong and Liao Zhongxing and Komaki, Ritsuko and Cox, James D. and Balter, Peter A. and Liu, Helen and Zhu, X. Ronald and Mohan, Radhe and Dong Lei},
abstractNote = {Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images. Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE{sub R}IGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method. Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE{sub R}IGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans using 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased. Conclusion: The AVE{sub R}IGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors.},
doi = {10.1016/j.ijrobp.2006.10.045},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 67,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 2007},
month = {Thu Mar 01 00:00:00 EST 2007}
}