Optimizing localization accuracy in head and neck, and brain radiotherapy

The British Journal of Radiology
M McJuryM H Robinson

Abstract

The purpose of this study was to investigate the impact on localization of utilizing contrast-enhanced CT scans and the formal input of a radiologist in the planning process. 25 head and neck/brain patients had pre- and post-contrast CT scans in the treatment position. Radiotherapy treatment was planned on the unenhanced CT images as per standard practice. Retrospectively, their scans (unenhanced and enhanced) were re-contoured by two oncologists and a radiologist. These new contours were compared with the original unenhanced treatment contours and differences in contour volume, geographical isocentre position and tolerance coverage of the associated planning target volumes (PTVs) were evaluated using the original plans. The use of contrast enhanced CT data during localization by the oncologist shows little change in gross tumour volumes (GTVs) or PTVs, geographical position or tolerance coverage for the targets in the brain studied here. Larger changes in mean volume are seen for the head and neck cases alone. Changes are greater and statistically significant (p < 0.05, Wilcoxon signed rank test) for localization by the radiologist. Furthermore, when comparing the original PTV marked by the oncologist with a new PTV re-contour...Continue Reading

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Sep 3, 2008·The British Journal of Radiology·S KimA Saleem
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