Design of 4D treatment planning target volumes
Design of 4D treatment planning target volumes
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DOI：
10.1016/j.ijrobp.2006.05.024
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发表时间：
2006-09-01
影响因子：
7
通讯作者：
Choi, Noah C.
中科院分区：
文献类型：
--
作者：
Rietzel, Eike;Liu, Arthur K.;Choi, Noah C.
目的：当使用非患者特异性治疗计划裕度时，呼吸运动可能导致目标的几何错过，同时不必要地照射正常组织。对患者的不同呼吸状态进行成像允许患者特定的目标设计。我们使用四维计算机断层扫描（4DCT）来描述10例肺癌患者的肿瘤运动并创建治疗体积。方法和材料：收集10例患者的四维CT和自由呼吸螺旋CT数据。在螺旋扫描上以及在4D数据的每个相位上描绘大体靶体积（GTV）。在4DCT上定义复合GTV。生成计划靶体积（PTV），包括临床靶体积、内部边界（IM）和设置边界。通过计算质心位置、体积、体积重叠和边界框，将具有不同IM的4DPTVs与标准PTVs进行比较。仅从两个极端肿瘤位置生成的4DPTV与10个呼吸相位相比的重叠率为93.7%。比较PTVs与复合4D靶体积上的边缘为15 mm（IM 5 mm）PTVs与20 mm（IM 10 mm）的螺旋CT data.Conclusion导致靶体积大小平均减少23%，具有患者特异性的肿瘤运动特征，应该可以减少内部边缘。可以使用4DCT上的极端肿瘤位置生成患者特定的治疗体积。迄今为止，已有150多名患者使用4D靶设计进行了治疗。(c)2006爱思唯尔公司
Purpose: When using non-patient-specific treatment planning margins, respiratory motion may lead to geometric miss of the target while unnecessarily irradiating normal tissue. Imaging different respiratory states of a patient allows patient-specific target design. We used four-dimensional computed tomography (4DCT) to characterize tumor motion and create treatment volumes in 10 patients with lung cancer. These were compared with standard treatment volumes.Methods and Materials: Four-dimensional CT and free breathing helical CT data of 10 patients were acquired. Gross target volumes (GTV) were delineated on the helical scan as well as on each phase of the 4D data. Composite GTVs were defined on 4DCT. Planning target volumes (PTV) including clinical target volume, internal margin (IM), and setup margin were generated. 4DPTVs with different IMs and standard PTVs were compared by computing centroid positions, volumes, volumetric overlap, and bounding boxes.Results: Four-dimensional PTVs and conventional PTVs differed in volume and centroid positions. Overlap between 4DPTVs generated from two extreme tumor positions only compared with 10 respiratory phases was 93.7%. Comparing PTVs with margins of 15 mm (IM 5 mm) on composite 4D target volumes to PTVs with 20 mm (IM 10 mm) on helical CT data resulted in a decrease in target volume sizes by 23% on average.Conclusion: With patient-specific characterization of tumor motion, it should be possible to decrease internal margins. Patient-specific treatment volumes can be generated using extreme tumor positions on 4DCT. To date, more than 150 patients have been treated using 4D target design. (c) 2006 Elsevier Inc.