Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration

Barnes, Elizabeth; Murray, B.; Robinson, Don; Underwood, Lori J.; Hanson, John; Roa, Wilson

doi:10.1016/s0360-3016(01)01592-9

Cited by 203 publications

(130 citation statements)

References 22 publications

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“…Acquiring a CT scan during a breath-hold reduces imaging motion artefact due to respiration resulting in a smaller more defined GTV 15,16 . It has also been shown that increasing the lung volume with a deep inspiration breath-hold alone results in a median reduction in the V 20 of almost 2% compared to tidal breathing lung volumes 25 . In this study, the standard and free-breathing GTV-PTV margin was applied to patients scanned in breath-hold.…”

Section: Ptv and Prv Calculationsmentioning

confidence: 99%

Defining the margins in the radical radiotherapy of non-small cell lung cancer (NSCLC) with active breathing control (ABC) and the effect on physical lung parameters

Panakis

McNair

Christian

et al. 2008

Radiotherapy and Oncology

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Section: Ptv and Prv Calculationsmentioning

confidence: 99%

Defining the margins in the radical radiotherapy of non-small cell lung cancer (NSCLC) with active breathing control (ABC) and the effect on physical lung parameters

Panakis

McNair

Christian

et al. 2008

Radiotherapy and Oncology

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“…If no significant improvements in survival have yet been reported using these techniques, several studies have highlighted better dose conformity and a reduction in dose to organs at risk (OARs). ( 6 – 10 ) …”

Section: Introductionmentioning

confidence: 99%

Initial evaluation of a four‐dimensional computed tomography system, using a programmable motor

Simon

Giraud

Servois

et al. 2006

J Applied Clin Med Phys

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A dynamic lung tumor phantom was used to investigate the geometric reconstruction accuracy of a commercial four‐dimensional computed tomography (4D‐CT) system. A ball filled with resin, embedded in a cork cube, was placed on a moving platform. Various realistic antero‐posterior (AP) motions were programmed to reproduce the respiratory motion of a lung tumor. Several three‐dimensional (3D) CT and 4D‐CT images of this moving object were acquired and compared using different acquisition parameters. Apparent volume and diameter of the ball were measured and compared to the real values. The position of two points (the AP limits of the ball) during the motion in the coordinate system of the CT scanner were also compared with the expected values. Volume error was shown to increase with object speed. However, although the volume error was associated with intraslice artifacts, it did not reflect large interslice inconstancies in object position and should not be used as an indicator of image accuracy. The 3D‐CT gave a random position of the tumor along the phantom excursion; accuracy in the assessment of position by 4D‐CT ranged from 0.4 mm to 2.6 mm during extreme phases of breathing. We used average projection (AVE) and maximum intensity projection (MIP) algorithms available on the commercial software to create internal target volumes (ITVs) by merging gross tumor volume (GTV) images at various respiratory phases. The ITVs were compared to a theoretical value computed from the programmed ball excursion. The ITVs created from the MIP algorithm were closer to the theoretical value (within 12%) than were those created from the AVE algorithm (within 40%).PACS numbers: 87.53.Xd, 87.56.Mp, 87.57.Ce, 87.59.Fm

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“…Note the clear improvement in the tumor delineation with the gated image, and the lack of a clear boundary between the tumor, lung and liver in the nongated image, as well as, in this case, a larger tumor volume. One method to reduce image artifacts due to motion, and also reduce the radiotherapy beam margins without compromising the treatment is to use respiration-gated such as breath-hold techniques [19][20][21][22][23][24] and active breathing control (ABC) 25 . Respiration gating is investigated here, as it is a non-interventional technique, and thus the most comfortable for the patient.…”

Section: Introductionmentioning

confidence: 99%

Potential radiotherapy improvements with respiratory gating

Keall

Kini

Vedam

et al. 2002

Australas. Phys. Eng. Sci. Med.

147

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Gating is a relatively new and potentially useful therapeutic addition to external beam radiotherapy applied to regions affected by intra-fraction motion. The impact was of gating on treatment margins, image artifacts, and volume and positional accuracy was investigated by CT imaging of sinusoidally moving spheres. The motion of the spheres simulates target motion. During the CT imaging of dynamically moving spheres, gating reproduced the static volume to within 1%, whereas errors of over 20% were observed where gating was not used. Using a theoretical analysis of margins, gating alone or in combination with an electronic portal imaging device may allow a 2-11 mm reduction in the CTV to PTV margin, and thus less healthy tissue need be irradiated. Gating may allow a reduction of treatment margins, an improvement in image quality, and an improvement in positional and volumetric accuracy of the gross tumor volume.

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Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration

Cited by 203 publications

References 22 publications

Defining the margins in the radical radiotherapy of non-small cell lung cancer (NSCLC) with active breathing control (ABC) and the effect on physical lung parameters

Defining the margins in the radical radiotherapy of non-small cell lung cancer (NSCLC) with active breathing control (ABC) and the effect on physical lung parameters

Initial evaluation of a four‐dimensional computed tomography system, using a programmable motor

Potential radiotherapy improvements with respiratory gating

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