Localization accuracy of the clinical target volume during image-guided radiotherapy of lung cancer.
Localization accuracy of the clinical target volume during image-guided radiotherapy of lung cancer.
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DOI：
10.1016/j.ijrobp.2010.11.032
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发表时间：
2011-10-01
影响因子：
7
通讯作者：
Orton, Matthew
中科院分区：
文献类型：
--
作者：
Hugo, Geoffrey D.;Weiss, Elisabeth;Badawi, Ahmed;Orton, Matthew
评价治疗过程中原定义的临床靶区体积(CTV)的位置和形状，以及基于大体肿瘤体积(GTV)的在线CT引导对CTV定位精度的影响。对17例接受放射治疗的患者进行每周屏气CT扫描。使用可变形配准将GTV和CTV从第一周CT图像传播到所有其他每周CT图像。将正在治疗的CT扫描严格配准到基于GTV位置的计划CT扫描以模拟在线引导，并计算CTV质心和边界的残差。治疗5周后，GTV平均体积为77%+/−20%，而处方CTV92%+/−10%。GTV定位后CTV质心位置的平均绝对残差为2.9 mm+/−3.0 mm，范围为0.3~2 0.0 mm。治疗期间CTV形心残差与GTV体积回归和回归各向异性相关(p=0.02和0.03，Spearman等级相关)。77%的患者和50%的患者CTV边界位置的残余误差大于2 mm。在这些部分中，CTV边界的残余误差分别为3.5+/−1.6 mm(LR)、3.1+/−0.9 mm(AP)和6.4+/−7.5 mm(SI)。基于可见GTV的在线引导在CTV定位中产生重大错误，特别是对于高度退化的肿瘤。这项研究的结果将有助于设计CTV本地化的边际或开发新的在线CTV本地化策略。
To evaluate the position and shape of the originally-defined clinical target volume (CTV) over the treatment course, and assess the impact of gross tumor volume (GTV)-based online CT guidance on CTV localization accuracy. Weekly breath hold CT scans were acquired in 17 patients undergoing radiotherapy. Deformable registration was used to propagate the GTV and CTV from the first weekly CT to all other weekly CT images. The on-treatment CT scans were registered rigidly to the planning CT scan based on the GTV location to simulate online guidance, and residual error in the CTV centroids and borders was calculated. The mean GTV volume after five weeks relative to volume at the beginning of treatment was 77% +/− 20%, while for the prescribed CTV it was 92% +/− 10%. The mean absolute residual error magnitude in the CTV centroid position after a GTV-based localization was 2.9 mm +/− 3.0 mm, and varied from 0.3 mm to 20.0 mm over all patients. Residual error of the CTV centroid was associated with GTV volume regression and anisotropy of regression during treatment (p=0.02 and 0.03, Spearman rank correlation). 77% of patients and 50% of fractions had a residual error in CTV border position greater than 2 mm. Of these fractions, residual error of the CTV borders was 3.5 +/− 1.6 mm (LR), 3.1 +/− 0.9 mm (AP), and 6.4 +/− 7.5 mm (SI). Online guidance based on the visible GTV produces substantial error in CTV localization, particularly for highly-regressing tumors. The results of this study will be useful in designing margins for CTV localization or for developing new online CTV localization strategies.
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设置不确定性、轮廓变化和组织不均匀性对靶剂量-体积直方图的影响
影响因子：
3.8
作者：
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作者：
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DOI：
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发表时间：
2007-04-01
影响因子：
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作者：
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