Incorporating heterogeneity correction and 4DCT in lung stereotactic body radiation therapy (SBRT): The effect on target coverage, organ-at-risk doses, and dose conformity

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists
Kevin N FranksJean-Pierre Bissonnette

Abstract

This study evaluates the dosimetric impact of 4-dimensional computed tomography (4DCT) target volumes and heterogeneity correction (HC) on target coverage, organ-at-risk (OAR) doses, and dose conformity in lung stereotactic body radiation therapy (SBRT). Twelve patients with lung cancer, scanned using both helical CT and 4DCT, were treated with SBRT (60 Gy in 3 fractions). The clinical plans were calculated without HC and based on targets from the free-breathing helical CT scan (PTV(HEL)). Retrospectively, the clinical plans were recalculated with HC and were evaluated based on targets from 4DCT datasets (PTV(4D)) accounting for patient-specific target motion. The PTV(4D) was greater than PTV(HEL) when tumor motion exceeded 7.5 mm (vector). There were significant decreases in target coverage (V100) for the recalculated vs. clinical plans (0.84 vs. 0.94, p < 0.02) for the same monitor units. When the recalculated plans were optimized for equivalent V100 of the clinical plans, there were significant increases in the 60-Gy dose spillage (1.27 vs. 1.13, p < 0.001) and 30-Gy dose spillage (5.20 vs. 3.73, p < 0.001) vs. the clinical plans. There was a significant increase (p < 0.04) in the mean OAR doses between the optimized re-calc...Continue Reading

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Citations

Aug 5, 2014·Medical Physics·David WiantBenjamin J Sintay
Feb 7, 2012·Acta Oncologica·Einar WaldelandEirik Malinen
Mar 15, 2011·Clinical Oncology : a Journal of the Royal College of Radiologists·J BrockM Brada
Mar 17, 2017·Journal of Applied Clinical Medical Physics·Chirasak KhamfongkhrueaSasikarn Chamchod

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