4D proton treatment planning strategy for mobile lung tumors
4D proton treatment planning strategy for mobile lung tumors
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DOI：
10.1016/j.ijrobp.2006.10.045
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发表时间：
2007-03-01
影响因子：
7
通讯作者：
Dong, Lei
中科院分区：
文献类型：
--
作者：
Kang, Yixiu;Zhang, Xiaodong;Dong, Lei
目的：探讨策略设计补偿器为基础的三维质子治疗计划移动的肺肿瘤使用四维计算机断层扫描（4DCT）images.Methods和材料：四维CT集10例肺癌患者在这项研究中使用。通过合并呼吸周期不同阶段的肿瘤体积获得内部大体肿瘤体积（IGTV）。对于每例患者，我们根据以下剂量计算评价了四种计划策略：（1）平均（AVE）CT;（2）自由呼吸（FB）CT;（3）最大强度投影（MIP）CT;以及（4）AVE CT，其中IGTV内的CT体素值被恒定密度（AVE_RIGTV）取代。对于每一个策略，在呼吸周期中产生的累积剂量分布，使用可变形图像配准method.Results：有明显的剂量分布之间的剂量差异，计算在一个单一的CT数据集，和运动校正的4D剂量分布，计算通过结合剂量分布提供给每个阶段的4DCT。使用1 cm涂抹参数的AVE_RIGTV计划具有最佳的总体目标覆盖率和关键结构保留。MIP计划方法导致不必要的大治疗体积。使用1 cm涂抹的AVE和FB计划未在所有患者中提供充分的4D靶区覆盖。通过使用一个更大的涂抹值，可以实现足够的4D目标覆盖，但是，关键器官剂量increased.Conclusion：AVE_RIGTV方法是一种有效的策略，用于设计质子治疗计划移动的肺肿瘤。(c)2007年爱思唯尔公司
Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images.Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE_RIGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method.Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE_RIGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans using 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased.Conclusion: The AVE_RIGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors. (c) 2007 Elsevier Inc.