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Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer
BACKGROUND: To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. METHODS: Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994492/ https://www.ncbi.nlm.nih.gov/pubmed/24646067 http://dx.doi.org/10.1186/1748-717X-9-77 |
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author | Zhong, Renming Wang, Jin Zhou, Lin Xu, Feng Liu, Li Zhou, Jidan Jiang, Xiaoqin Chen, Nianyong Bai, Sen Lu, You |
author_facet | Zhong, Renming Wang, Jin Zhou, Lin Xu, Feng Liu, Li Zhou, Jidan Jiang, Xiaoqin Chen, Nianyong Bai, Sen Lu, You |
author_sort | Zhong, Renming |
collection | PubMed |
description | BACKGROUND: To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. METHODS: Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients (95 tumors) treated with hypofraction radiotherapy. For all alignments between the reference CT and CBCT images (including the pre-correction, post-correction and post-treatment CBCT images), the tumor reproducibility was evaluated via online manual alignment of the tumors, and the vertebral bone uncertainties were evaluated via offline manual alignment of the vertebral bones. The difference between the tumor reproducibility and the vertebral bone uncertainty represents the change in the tumor position relative to the vertebral bone. The relative tumor positions along the coronal, sagittal and transverse axes were measured based on the reference CT image. The correlations between the vertebral bone uncertainty, the relative tumor position, the total treatment time and the tumor reproducibility were evaluated using the Pearson correlations. RESULTS: Pre-correction, the systematic/random errors of tumor reproducibility were 4.5/2.6 (medial-lateral, ML), 5.1/4.8 (cranial-caudal, CC) and 4.0/3.6 mm (anterior-posterior, AP). These errors were significantly decreased to within 3 mm, both post-correction and post-treatment. The corresponding PTV margins were 4.7 (ML), 7.4 (CC) and 5.4 (AP) mm. The changes in the tumor position relative to the vertebral bone displayed systematic/random errors of 2.2/2.0 (ML), 4.1/4.4 (CC) and 3.1/3.3 (AP) mm. The uncertainty of the vertebral bone significantly correlated to the reproducibility of the tumor position (P < 0.05), except in the CC direction post-treatment. However, no significant correlation was detected between the relative tumor position, the total treatment time and the tumor reproducibility (P > 0.05). CONCLUSIONS: Using ABC for single-breath-hold CBCT guidance is an effective method to reduce the PTV margin of hypofraction radiotherapy for lung cancer. Using ABC, the tumor position was significantly altered relative to the vertebral position. The reproducibility of the tumor position was affected by the vertebral bone but not by the relative tumor position or the total treatment time. |
format | Online Article Text |
id | pubmed-3994492 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-39944922014-05-07 Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer Zhong, Renming Wang, Jin Zhou, Lin Xu, Feng Liu, Li Zhou, Jidan Jiang, Xiaoqin Chen, Nianyong Bai, Sen Lu, You Radiat Oncol Research BACKGROUND: To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. METHODS: Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients (95 tumors) treated with hypofraction radiotherapy. For all alignments between the reference CT and CBCT images (including the pre-correction, post-correction and post-treatment CBCT images), the tumor reproducibility was evaluated via online manual alignment of the tumors, and the vertebral bone uncertainties were evaluated via offline manual alignment of the vertebral bones. The difference between the tumor reproducibility and the vertebral bone uncertainty represents the change in the tumor position relative to the vertebral bone. The relative tumor positions along the coronal, sagittal and transverse axes were measured based on the reference CT image. The correlations between the vertebral bone uncertainty, the relative tumor position, the total treatment time and the tumor reproducibility were evaluated using the Pearson correlations. RESULTS: Pre-correction, the systematic/random errors of tumor reproducibility were 4.5/2.6 (medial-lateral, ML), 5.1/4.8 (cranial-caudal, CC) and 4.0/3.6 mm (anterior-posterior, AP). These errors were significantly decreased to within 3 mm, both post-correction and post-treatment. The corresponding PTV margins were 4.7 (ML), 7.4 (CC) and 5.4 (AP) mm. The changes in the tumor position relative to the vertebral bone displayed systematic/random errors of 2.2/2.0 (ML), 4.1/4.4 (CC) and 3.1/3.3 (AP) mm. The uncertainty of the vertebral bone significantly correlated to the reproducibility of the tumor position (P < 0.05), except in the CC direction post-treatment. However, no significant correlation was detected between the relative tumor position, the total treatment time and the tumor reproducibility (P > 0.05). CONCLUSIONS: Using ABC for single-breath-hold CBCT guidance is an effective method to reduce the PTV margin of hypofraction radiotherapy for lung cancer. Using ABC, the tumor position was significantly altered relative to the vertebral position. The reproducibility of the tumor position was affected by the vertebral bone but not by the relative tumor position or the total treatment time. BioMed Central 2014-03-20 /pmc/articles/PMC3994492/ /pubmed/24646067 http://dx.doi.org/10.1186/1748-717X-9-77 Text en Copyright © 2014 Zhong et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Zhong, Renming Wang, Jin Zhou, Lin Xu, Feng Liu, Li Zhou, Jidan Jiang, Xiaoqin Chen, Nianyong Bai, Sen Lu, You Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer |
title | Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer |
title_full | Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer |
title_fullStr | Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer |
title_full_unstemmed | Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer |
title_short | Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer |
title_sort | implementation of single-breath-hold cone beam ct guided hypofraction radiotherapy for lung cancer |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994492/ https://www.ncbi.nlm.nih.gov/pubmed/24646067 http://dx.doi.org/10.1186/1748-717X-9-77 |
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