Document Detail


Dosimetric impact of online correction via cone-beam CT-based image guidance for stereotactic lung radiotherapy.
MedLine Citation:
PMID:  20646857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the dosimetric impact of online cone-beam computed tomography (CBCT) guided correction in lung stereotactic body radiation therapy (SBRT).
METHODS AND MATERIALS: Twenty planning and 162 CBCT images from 20 patients undergoing lung SBRT were analyzed. The precorrection CBCT (CBCT after patient setup, no couch correction) was registered to planning CT using soft tissue; couch shift was applied, with a second CBCT for verification (postcorrection CBCT). Targets and normal structures were delineated on CBCTs: gross tumor volume (GTV), clinical target volume (CTV), cord, esophagus, lung, proximal bronchial tree, and aorta. Dose distributions on all organs manifested on each CBCT were compared with those planned on the CT.
RESULTS: Without CBCT guided target position correction, target dose reduced with respect to treatment plan. Mean and standard deviation of treatment dose discrepancy from the plan were -3.2% (4.9%), -2.1% (4.4%), -6.1% (10.7%), and -3.5% (7%) for GTV D(99%), GTV D(95%), CTV D(99%), and CTV D(95%), respectively. With CBCT correction, the results were -0.4% (2.6%), 0.1% (1.7%), -0.3% (4.2%), and 0.5% (3%). Mean and standard deviation of the difference in normal organ maximum dose were 2.2% (6.5%) before correction and 2.4% (5.9%) after correction for esophagus; 6.1% (14.1%) and 3.8% (8.1%) for cord; 3.1% (17.5%) and 6.2% (9.8%) for proximal bronchial tree; and 17.7% (19.5%) and 14.1% (17%) for aorta.
CONCLUSION: Online CBCT guidance improves the accuracy of target dose delivery for lung SBRT. However, treatment dose to normal tissue can vary regardless of the correction. Normal tissues should be considered during target registration, according to target proximity.
Authors:
Ana Paula Galerani; Inga Grills; Geoffrey Hugo; Larry Kestin; Nasiruddin Mohammed; K Kenneth Chao; Andrew Suen; Alvaro Martinez; Di Yan
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Publication Detail:
Type:  Journal Article     Date:  2010-06-18
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  78     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1571-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiation Oncology, Clinirad, Angelina Caron Hospital, Curitiba, Parana, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung* / pathology,  radiography,  surgery
Cone-Beam Computed Tomography*
Female
Humans
Lung / radiography*
Lung Neoplasms* / pathology,  radiography,  surgery
Male
Middle Aged
Movement*
Organs at Risk / radiography
Radiosurgery / methods*
Radiotherapy Planning, Computer-Assisted / methods*
Respiration
Tumor Burden

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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