Comparison between target margins derived from 4DCT scans and real‐time tumor motion tracking: Insights from lung tumor patients treated with robotic radiosurgery

Descovich, M.; McGuinness, C.; Kannarunimit, Danita; Chen, Josephine; Pinnaduwage, Dilini; Pouliot, Jean; Kased, Norbert; Gottschalk, Alexander; Yom, Sue S.

doi:10.1118/1.4907956

Cited by 27 publications

(77 citation statements)

References 22 publications

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“…A preliminary analysis of tumor motion was performed. The respiratory amplitude measured with planning 4D‐CT and with online tumor tracking data was in agreement with previously published studies . In addition, motion amplitudes captured with 4D‐CT were representative of median excursions measured during treatment for each anatomical direction and in each lung lobe .…”

Section: Discussionsupporting

confidence: 88%

Evaluation of target coverage and margins adequacy during CyberKnife Lung Optimized Treatment

et al. 2018

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Section: Discussionsupporting

confidence: 88%

Evaluation of target coverage and margins adequacy during CyberKnife Lung Optimized Treatment

et al. 2018

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“…Corradetti MN et al [34] Stated that margins were 0.49 cm, 0.85 cm and 0.77 cm in RL, AP, and SI direction calculated by the van Herk recipe, respectively, which is smaller than the present result. We presume that their set-up, which used the full-body vacuum cushion system, resulted in their smaller inter-fractional error.…”

Section: Discussioncontrasting

confidence: 87%

4DCT and CBCT based PTV margin in Stereotactic Body Radiotherapy(SBRT) of non-small cell lung tumor adhered to chest wall or diaphragm

Chen

et al. 2016

Radiat Oncol

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BackgroundLarge tumor motion often leads to larger treatment volumes, especially the lung tumor located in lower lobe and adhered to chest wall or diaphragm. The purpose of this work is to investigate the impacts of planning target volume (PTV) margin on Stereotactic Body Radiotherapy (SBRT) in non-small cell lung cancer (NSCLC).MethodsSubjects include 20 patients with the lung tumor located in lower lobe and adhered to chest wall or diaphragm who underwent SBRT. Four-dimensional computed tomography (4DCT) were acquired at simulation to evaluate the tumor intra-fractional centroid and boundary changes, and Cone-beam Computer Tomography (CBCT) were acquired during each treatment to evaluate the tumor inter-fractional set-up displacement. The margin to compensate for tumor variations uncertainties was calculated with various margin calculated recipes published in the exiting literatures.ResultsThe means (±standard deviation) of tumor centroid changes were 0.16 (±0.13) cm, 0.22 (±0.15) cm, and 1.37 (±0.81) cm in RL, AP, and SI directions, respectively. The means (±standard deviation) of tumor edge changes were 0.21 (±0.18) cm, 0.50 (±0.23) cm, and 0.19 (±0.44) cm in RL, AP, and SI directions, respectively. The means (±standard deviation) of tumor set-up displacement were 0.03 (±0.24) cm, 0.02 (±0.26) cm, and 0.02 (±0.43) cm in RL, AP, and SI directions, respectively. The PTV margin to compensate for lung cancer tumor variations uncertainties were 0.88, 0.98 and 2.68 cm in RL, AP and SI directions, which were maximal among all margin recipes.Conclusions4DCT and CBCT imaging are appropriate to account for the tumor intra-fractional centroid, boundary variations and inter-fractional set-up displacement. The PTV margin to compensate for lung cancer tumor variations uncertainties can be obtained. Our results show that a conventional 1.0 cm margin in the SI plane dose not suffice to compensate the geometrical variety of the tumor located in lower lobe and adhered to chest wall and diaphragm.

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“…However, since the ITV is larger than with a treatment using a fiducial, caution is necessary. Concerning tracking, as a decline may occur in tumor control by excessive narrowing of the margin leading to deviations in the irradiation point, the careful use of LOT is recommended [38]. Regarding the concomitant use of this tracking method and IMRT in the present study, only patients in whom accuracy was guaranteed were used by simulating tracking errors in advance [17].…”

Section: Discussionmentioning

confidence: 97%

A phase I/II study on stereotactic body radiotherapy with real-time tumor tracking using CyberKnife based on the Monte Carlo algorithm for lung tumors

et al. 2017

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Comparison between target margins derived from 4DCT scans and real‐time tumor motion tracking: Insights from lung tumor patients treated with robotic radiosurgery

Abstract: The use of bony alignment for CyberKnife lung stereotactic body radiation therapy requires careful considerations, in terms of the potential for increased toxicity or local miss. Our method could be used by other centers to determine the adequacy of ITV-to-PTV margins for their patients.

Cited by 27 publications

References 22 publications

Evaluation of target coverage and margins adequacy during CyberKnife Lung Optimized Treatment

Evaluation of target coverage and margins adequacy during CyberKnife Lung Optimized Treatment

4DCT and CBCT based PTV margin in Stereotactic Body Radiotherapy(SBRT) of non-small cell lung tumor adhered to chest wall or diaphragm

A phase I/II study on stereotactic body radiotherapy with real-time tumor tracking using CyberKnife based on the Monte Carlo algorithm for lung tumors

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