Impact of four-dimensional computed tomography pulmonary ventilation imaging-based functional avoidance for lung cancer radiotherapy

International Journal of Radiation Oncology, Biology, Physics
Tokihiro YamamotoPaul J Keall

Abstract

To quantify the dosimetric impact of four-dimensional computed tomography (4D-CT) pulmonary ventilation imaging-based functional treatment planning that avoids high-functional lung regions. 4D-CT ventilation images were created from 15 non-small-cell lung cancer patients using deformable image registration and quantitative analysis of the resultant displacement vector field. For each patient, anatomic and functional plans were created for intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). Consistent beam angles and dose-volume constraints were used for all cases. The plans with Radiation Therapy Oncology Group (RTOG) 0617-defined major deviations were modified until clinically acceptable. Functional planning spared the high-functional lung, and anatomic planning treated the lungs as uniformly functional. We quantified the impact of functional planning compared with anatomic planning using the two- or one-tailed t test. Functional planning led to significant reductions in the high-functional lung dose, without significantly increasing other critical organ doses, but at the expense of significantly degraded the planning target volume (PTV) conformity and homogeneity. The average reduction in the ...Continue Reading

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Citations

Oct 5, 2013·Medical Physics·Tokihiro YamamotoPaul J Keall
Nov 8, 2013·European Journal of Nuclear Medicine and Molecular Imaging·Jason CallahanRodney J Hicks
Mar 3, 2012·Medical Physics·Kaifang DuJoseph M Reinhardt
Dec 22, 2015·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Tokihiro YamamotoMegan Daly
Mar 12, 2013·International Journal of Radiation Oncology, Biology, Physics·Yevgeniy VinogradskiyMary K Martel
Sep 15, 2012·Academic Radiology·Tokihiro YamamotoPaul J Keall
Dec 27, 2011·International Journal of Radiation Oncology, Biology, Physics·Shuanghu Tiger YuanFeng-Ming Spring Kong
Jan 10, 2016·Medical Physics·John KipritidisPaul J Keall
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