Volumetric modulated arc therapy treatment planning based on virtual monochromatic images for head and neck cancer: effect of the contrast‐enhanced agent on dose distribution
Volumetric modulated arc therapy treatment planning based on virtual monochromatic images for head and neck cancer: effect of the contrast‐enhanced agent on dose distribution
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基于头颈癌虚拟单色图像的体积调制弧形疗法治疗计划：对比增强剂对剂量分布的影响
DOI：
10.1002/acm2.12752
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发表时间：
2019
影响因子：
2.1
通讯作者：
Teshima Teruki
中科院分区：
文献类型：
--
作者：
Komiyama Riho;Ohira Shingo;Kanayama Naoyuki;Karino Tsukasa;Washio Hayate;Ueda Yoshihiro;Miyazaki Masayoshi;Teshima Teruki
较低能量水平的虚拟单色图像(VMI)可以改善图像质量，但对比剂中所含碘的计算机断层扫描(CT)数量显着增加。我们评估了对比剂的使用对体积调节性弧疗(VMAT)计划治疗头颈癌(HNC)的剂量分布的影响。基于组织特征体模在40keV(VMI40keV)、60keV(VMI60keV)和77keV(VMI77keV)下的VMI，创建查找表(LUT)。使用相应的LUT，基于40、60和77keV的对比增强(CE-)VMI为15名HNC患者生成VMAT计划，并基于非对比增强(NCE-)VMI重新计算剂量。在所有结构中，随着VMI能量水平的降低，由于造影剂引起的CT数差异显著，并且在临床靶区体积方面，CE-VMI和NCE-VMI的CT值差异最大(VMI40keV、VMI60keV和VMI77keV分别为125.3、55.9HU和33.1HU)。在基于所有VMI的治疗计划中，CTV和OARS的剂量学参数(D99%、D50%、D1%、D平均数和D0.1cc)的平均差异为1%。VMI40keV(2.4%)、VMI60keV(1.9%)和VMI77keV(1.5%)计划的CTV差异最大。对于HNC患者，在基于VMI的低能量水平的VMAT计划中，造影剂的效果更大。在治疗计划过程中，这种效果是不理想的。
Virtual monochromatic images (VMIs) at a lower energy level can improve image quality but the computed tomography (CT) number of iodine contained in the contrast‐enhanced agent is dramatically increased. We assessed the effect of the use of contrast‐enhanced agent on the dose distributions in volumetric modulated arc therapy (VMAT) planning for head and neck cancer (HNC). Based on the VMIs at 40 keV (VMI40keV), 60 keV(VMI60keV), and 77 keV (VMI77keV) of a tissue characterization phantom, lookup tables (LUTs) were created. VMAT plans were generated for 15 HNC patients based on contrast‐enhanced‐ (CE‐) VMIs at 40‐, 60‐, and 77 keV using the corresponding LUTs, and the doses were recalculated based on the noncontrast‐enhanced‐ (nCE‐) VMIs. For all structures, the difference in CT numbers owing to the contrast‐enhanced agent was prominent as the energy level of the VMI decreased, and the mean differences in CT number between CE‐ and nCE‐VMI was the largest for the clinical target volume (CTV) (125.3, 55.9, and 33.1 HU for VMI40keV, VMI60keV, and VMI77keV,respectively). The mean difference of the dosimetric parameters (D99%, D50%, D1%, Dmean, and D0.1cc) for CTV and OARs was <1% in the treatment plans based on all VMIs. The maximum difference was observed for CTV in VMI40keV(2.4%), VMI60keV(1.9%), and VMI77keV(1.5%) plans. The effect of the contrast‐enhanced agent was larger in the VMAT plans based on the VMI at a lower energy level for HNC patients. This effect is not desirable in a treatment planning procedure.
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DOI：
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DOI：
10.7314/apjcp.2013.14.3.1609
发表时间：
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期刊：
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影响因子：
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