Conformal treatment planning using 4DCT can decrease ipsilateral lung dose and improve tumor coverage: A prospective 4DCT treatment planning study

Parikh, Parag J.; Wahab, Sasha H.; Lü, Wei; Nantz, Regan; Hubenschmidt, J; Nystrom, M.; El-Naqa, I.; Pierburg, B.; Bradley, Jeffrey D.; Low, Daniel A.

doi:10.1016/j.ijrobp.2004.07.080

Cited by 2 publications

(1 citation statement)

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“…While respiratory control techniques can reduce treatment planning errors 16, 17, 24 , many lung cancer patients are unable to precisely manipulate their breathing. Fluoroscopy has been used to assess organ motion 24-26 , but poor soft tissue resolution, and the lack of 3D data inherent to fluoroscopic imaging limit the precise determination of trajectories 27, 28 . 4DCT imaging is a new technique that utilizes time-resolved CT images to directly incorporate organ motion into treatment planning, allowing for a more accurate determination of organ and tumor trajectories 29,30 . Unfortunately, breathing irregularities during data acquisition can cause considerable image distortion that may not be readily apparent during visual inspection of images.…”

Section: Introductionmentioning

confidence: 99%

Effect of Novel Amplitude/Phase Binning Algorithm on Commercial Four-Dimensional Computed Tomography Quality

Olsen

Hubenschmidt

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Respiratory motion is a significant source of anatomic uncertainty in radiotherapy treatment planning, and may result in errors of portal size and subsequent radiation dose. While 4DCT allows for more accurate analysis of the respiratory cycle, breathing irregularities during data acquisition may cause considerable image distortions. The aim of this study was to examine the impact of respiratory irregularities on 4DCT imaging, and to evaluate a novel image reconstruction algorithm based upon percentile-based tagging of the respiratory cycle.Materials/Methods-Respiratory correlated helical CT was acquired on 11 consecutive patients. Inspiration and expiration datasets were reconstructed using the default phase based method as well as a novel respiration percentile based method using patient specific metrics to define ranges of the reconstruction. Image output was analyzed in a blinded fashion for both the phase and percentile based reconstructions to determine the prevalence and severity of image artifacts.Results-The percentile-based algorithm resulted in a significant reduction in artifact severity compared to the phase-based algorithm, although overall artifact prevalence did not differ between the two algorithms. The magnitude of differences in respiratory tag placement between the phase and percentile based algorithms was correlated with the presence of image artifacts.Conclusions-We conclude that our novel 4DCT reconstruction method may be useful to detect clinically relevant image distortions that may otherwise go unnoticed, and to reduce image distortion associated with some respiratory irregularities. Further work is necessary to assess the clinical impact on areas of possible irregular breathing.

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Section: Introductionmentioning

confidence: 99%