Determination of patient-specific internal gross tumor volumes for lung cancer using four-dimensional computed tomography
Determination of patient-specific internal gross tumor volumes for lung cancer using four-dimensional computed tomography
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DOI：
10.1186/1748-717x-4-4
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发表时间：
2009-01-27
影响因子：
3.6
通讯作者：
Chang, Joe Y.
中科院分区：
文献类型：
--
作者：
Ezhil, Muthuveni;Vedam, Sastry;Chang, Joe Y.
背景资料：为了确定最佳的方法来划定患者特定的内部总靶体积（IGTV）从四维（4-D）计算机断层扫描（CT）图像数据集用于规划的放射治疗肺癌。方法：我们分析了4D-CT图像数据集的27个连续的非小细胞肺癌患者（I期：17，III期：10）。IGTV定义为每个4D-CT数据集中的大体肿瘤体积的呼吸运动包络，使用四种技术手动描绘：（1）结合来自10个呼吸相位的大体肿瘤体积（GTV）轮廓（IGTV（AllPhases））;（2）结合两个极端呼吸相位的GTV轮廓（0%和50%）（IGTV（2阶段））;（3）使用最大强度投影（MIP）定义GTV轮廓（IGTV（MIP））;以及（4）使用具有基于个体呼吸阶段中轮廓的视觉验证的修改的MIP定义GTV轮廓（IGTV（MIP-修改的））。结果：IGTV（MIP）和IGTV（2 Phases）均显著小于IGTV（AllPhases）（I期p <0.006，III期p <0.002），IGTV（MIP）和IGTV（2 Phases）均显著小于IGTV（AllPhases）（P < 0.006，III期p < 0.002）。然而，IGTV（MIP改良）的值接近IGTV（全相）测定的值（p = 0.08）。IGTV（MIP-Modified）与IGTV（AllPhases）匹配最好。结论：IGTV（MIP）和IGTV（2 Phases）低估了IGTV。IGTV（MIP-改良）被推荐用于改善肺癌中IGTV的勾画。
Background: To determine the optimal approach to delineating patient-specific internal gross target volumes (IGTV) from four-dimensional (4-D) computed tomography (CT) image data sets used in the planning of radiation treatment for lung cancers.Methods: We analyzed 4D-CT image data sets of 27 consecutive patients with non-small-cell lung cancer (stage I: 17, stage III: 10). The IGTV, defined to be the envelope of respiratory motion of the gross tumor volume in each 4D-CT data set was delineated manually using four techniques: (1) combining the gross tumor volume (GTV) contours from ten respiratory phases (IGTV(AllPhases)); (2) combining the GTV contours from two extreme respiratory phases (0% and 50%) (IGTV(2Phases)); (3) defining the GTV contour using the maximum intensity projection (MIP) (IGTV(MIP)); and (4) defining the GTV contour using the MIP with modification based on visual verification of contours in individual respiratory phase (IGTV(MIP-Modified)). Using the IGTV(AllPhases) as the optimum IGTV, we compared volumes, matching indices, and extent of target missing using the IGTVs based on the other three approaches.Results: The IGTV(MIP) and IGTV(2Phases) were significantly smaller than the IGTV(AllPhases) (p < 0.006 for stage I and p < 0.002 for stage III). However, the values of the IGTV(MIP-Modified) were close to those determined from IGTV(AllPhases) (p = 0.08). IGTV(MIP-Modified) also matched the best with IGTV(AllPhases).Conclusion: IGTV(MIP) and IGTV(2Phases) underestimate IGTVs. IGTV(MIP-Modified) is recommended to improve IGTV delineation in lung cancer.