Stereotactic body radiation therapy planning for liver tumors using functional images from dual-energy computed tomography
Stereotactic body radiation therapy planning for liver tumors using functional images from dual-energy computed tomography
复制标题
DOI：
10.1016/j.radonc.2019.12.002
复制
发表时间：
2020-04-01
影响因子：
5.7
通讯作者：
Teshima, Teruki
中科院分区：
文献类型：
--
作者：
Ohira, Shingo;Kanayama, Naoyuki;Teshima, Teruki
目的：本研究旨在使用双能计算机断层扫描（DECT）和基于功能图像的立体定向身体放射治疗计划生成肝脏的功能图像，以尽量减少对功能肝脏（V-fl）体积的剂量。材料与方法：对15例肝肿瘤患者进行归一化碘密度（NID）图绘制。将NID < 0.46的肝脏体积定义为V-fl，计算Vfl与肝脏总容积（FLR）之比。评估FLR与纤维化-4 （FIB-4）之间的关系。对于15% < FLR < 85%的患者，回顾性制定功能体积调节弧治疗方案（F-VMAT）以保留V-fl，并与临床方案（C-VMAT）进行比较。结果：FLR与FIB-4呈显著强相关（r = -0.71, p < 0.01）。生成的10个F-VMAT方案中，D-99%、D-50%、D-1%的剂量学参数和符合性指数与C-VMAT方案相当（p > 0.05）。对于V-fl， F-VMAT方案的V-5Gy （122.4 +/- 31.7 vs 181.1 +/- 57.3 cc）、V-10Gy （44.4 +/- 22.2 vs 98.2 +/- 33.3 cc）、V-15Gy （22.6 +/- 20.3 vs 49.8 +/- 33.7 cc）、V-20Gy （11.6 +/- 14.1 vs 24.9 +/- 25.1 cc）和D-mean （3.9 +/- 2.3 vs 5.8 +/- 3.0 Gy）值均低于C-VMAT方案（p < 0.01）。结论：成功地使用了DECT衍生的功能图像，允许在不影响目标覆盖的情况下减少对V-fl的剂量。(C) 2019 Elsevier B.V.版权所有
Purpose: This study aimed to generate a functional image of the liver using dual-energy computed tomography (DECT) and a functional-image-based stereotactic body radiation therapy plan to minimize the dose to the volume of the functional liver (V-fl).Material and methods: A normalized iodine density (NID) map was generated for fifteen patients with liver tumors. The volume of liver with an NID < 0.46 was defined as V-fl, and the ratio between Vfl and the total volume of the liver (FLR) was calculated. The relationship between the FLR and Fibrosis-4 (FIB-4) was assessed. For patients with 15% < FLR < 85%, functional volumetric modulated-arc therapy plans (F-VMAT) were retrospectively generated to preserve V-fl, and compared to the clinical plans (C-VMAT).Results: FLR showed a significantly strong correlation with FIB-4 (r = -0.71, p < 0.01). For ten generated F-VMAT plans, the dosimetric parameters of D-99%, D-50%, D-1% and the conformity index were comparable to those of the C-VMAT (p > 0.05). For V-fl, F-VMAT plans achieved lower V-5Gy (122.4 +/- 31.7 vs 181.1 +/- 57.3 cc), V-10Gy (44.4 +/- 22.2 vs 98.2 +/- 33.3 cc), V-15Gy (22.6 +/- 20.3 vs 49.8 +/- 33.7 cc), V-20Gy (11.6 +/- 14.1 vs 24.9 +/- 25.1 cc), and D-mean (3.9 +/- 2.3 vs 5.8 +/- 3.0 Gy) values than the C-VMAT plans (p < 0.01).Conclusions: The functional image derived from DECT was successfully used, allowing for a reduction in the dose to the V-fl without compromising target coverage. (C) 2019 Elsevier B.V. All rights reserved.