The application of complexity metrics in the IMRT treatment planning process has been demonstrated. Complexity of treatment plans can vary for different inverse planning software versions and can depend on planning parameters and the treatment site. MCS is most suitable for inclusion within the cost function to limit complexity in IMRT optimization due to its sensitivity to complexity changes and correlation to treatment deliverability.
ABSTRACT. Respiratory motion complicates target volume definition for patients with lung cancer. The use of slow CT to aid in the definition of moving target volumes was investigated. Standard and slow scans of an oscillating phantom were acquired using gantry rotation periods of 0.8 and 1.5 s and pitches of 0.95 and 0.50, respectively. The resultant images of three spheres within the phantom, labelled as A, B and C with diameters of 3.7, 2.8 and 2.2 cm, were analysed. The central co-ordinates of each volume were determined, and the ratio of the target volume outlined on CT (TV CT ) to the true target volume (TV) was calculated. For 1.5 cm peak-to-trough (PTT) motion, standard CT mean ratios of 0.8, 0.8 and 0.7 were obtained for spheres A, B and C, respectively, whereas slow CT resulted in a mean ratio of 0.9 for all three spheres. For 2.5 cm motion, standard CT mean ratios of 0.8, 0.7 and 0.7 were obtained, whereas the slow CT mean ratios were 0.9, 0.9 and 0.8. The deviation of the central co-ordinate for the slow CT volumes was within 0.1 cm whereas deviations of up to 0.7 cm were seen using standard CT. This study indicates the potential benefit of using slow CT, even on modern scanners capable of rotation periods only down to 1.5 s, to define moving target volumes more accurately and reproducibly moving target volumes, and aid in the management of respiratory motion for patients with lung cancer.
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