Do Maximum Intensity Projection Images Truly Capture Tumor Motion?

Park, Kwangyoul; Huang, Long; Gagne, Havaleh; Papież, Lech

doi:10.1016/j.ijrobp.2008.10.008

Cited by 62 publications

(48 citation statements)

References 16 publications

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“…Respiratory variations (28) and the delineation error (29) may reduce the accuracy of

{PTV}_{4 D}

. Moreover, 4D CT may not accurately reflect the range of tumor motion due to the irregular tumor motion in amplitude and periodicity, and the intraphase residual motion exist in 4D CT. 30 , 31 Another margin should be used to compensate the uncertainty. The inaccurate

{PTV}_{4 D}

would have adverse impact on the study.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the advantage of individual PTVs defined on axial 3D CT and 4D CT images for liver cancer

Xing

et al. 2012

J Applied Clin Med Phys

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The purpose of this study was to compare positional and volumetric differences of planning target volumes (PTVs) defined on axial three dimensional CT (3D CT) and four dimensional CT (4D CT) for liver cancer. Fourteen patients with liver cancer underwent 3D CT and 4D CT simulation scans during free breathing. The tumor motion was measured by 4D CT. Three internal target volumes (ITVs) were produced based on the clinical target volume from 3DCT (CTV3D): i) A conventional ITV (ITVconv) was produced by adding 10 mm in CC direction and 5 mm in LR and and AP directions to CTV3D; ii) A specific ITV (ITVspec) was created using a specific margin in transaxial direction; iii) ITVvector was produced by adding an isotropic margin derived from the individual tumor motion vector. ITV4D was defined on the fusion of CTVs on all phases of 4D CT. PTVs were generated by adding a 5 mm setup margin to ITVs. The average centroid shifts between PTVs derived from 3DCT and PTV4D in left–right (LR), anterior–posterior (AP), and cranial–caudal (CC) directions were close to zero. Comparing PTV4D to PTVconv, PTVspec, and PTVvector resulted in a decrease in volume size by 33.18% ±12.39%, 24.95% ±13.01%, 48.08% ±15.32%, respectively. The mean degree of inclusions (DI) of PTV4D in PTVconv, and PTV4D in PTVspec, and PTV4D in PTVvector was 0.98, 0.97, and 0.99, which showed no significant correlation to tumor motion vector (r=‐0.470, 0.259, and 0.244; p=0.090, 0.371, and 0.401). The mean DIs of PTVconv in PTV4D, PTVspec in PTV4D, and PTVvector in PTV4D was 0.66, 0.73, and 0.52. The size of individual PTV from 4D CT is significantly less than that of PTVs from 3DCT. The position of targets derived from axial 3DCT images scatters around the center of 4D targets randomly. Compared to conventional PTV, the use of 3D CT‐based PTVs with individual margins cannot significantly reduce normal tissues being unnecessarily irradiated, but may contribute to reducing the risk of missing targets for tumors with large motion.PACS number: 87

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“…Respiratory variations (28) and the delineation error (29) may reduce the accuracy of

{PTV}_{4 D}

{PTV}_{4 D}

would have adverse impact on the study.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the advantage of individual PTVs defined on axial 3D CT and 4D CT images for liver cancer

Xing

et al. 2012

J Applied Clin Med Phys

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“…In this regard, the maximum intensity projections (MIP) reconstructed from a 4D data set, which reflects the brightest object along each ray on the projection image, may be used for the generation of the internal target volume (ITV) (34) that includes tumor motion into the radiation planning process. However, the outer excursion of respiratory motion may be underestimated by MIP in more advanced tumors and in the setting of irregular breathing patterns by approximately 20% as reported in previous studies (35–37). Thus, the ITV should be generated based on all available 4D CT data.…”

Section: Strategies To Improve Target Volume Definition Through Adaptmentioning

confidence: 60%

Strategies of Dose Escalation in the Treatment of Locally Advanced Non-Small Cell Lung Cancer: Image Guidance and Beyond

Chi

Nguyen²,

Welsh

et al. 2014

Front. Oncol.

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Radiation dose in the setting of chemo-radiation for locally advanced non-small cell lung cancer (NSCLC) has been historically limited by the risk of normal tissue toxicity and this has been hypothesized to correlate with the poor results in regard to local tumor recurrences. Dose escalation, as a means to improve local control, with concurrent chemotherapy has been shown to be feasible with three-dimensional conformal radiotherapy in early phase studies with good clinical outcome. However, the potential superiority of moderate dose escalation to 74 Gy has not been shown in phase III randomized studies. In this review, the limitations in target volume definition in previous studies; and the factors that may be critical to safe dose escalation in the treatment of locally advanced NSCLC, such as respiratory motion management, image guidance, intensity modulation, FDG–positron emission tomography incorporation in the treatment planning process, and adaptive radiotherapy, are discussed. These factors, along with novel treatment approaches that have emerged in recent years, are proposed to warrant further investigation in future trials in a more comprehensive and integrated fashion.

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“…It can be increase the efficiency of treatment planning as well as giving appropriate irradiation dose to the periodically moving target. But it must pay more attention to the following conditions: when the patient breathes irregularly, the delineation with MIP CT may induce some errors, the deviation in the maximum diameter direction may be as large as 1cm [13,14]. In the mean while, when the target is around the iso-density or hyper-density tissues, it is not accurate.…”

Section: Discussionmentioning

confidence: 99%

Application of AIP and MIP CT on Individual GTV Delineation for Tumor Moving with Respiration

Zhang¹,

Lin²,

Yu³

et al. 2012

2012 International Conference on Biomedical Engineering and Biotechnology

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Objective: To investigate the feasibility of delineating individual gross target volume (GTV) for tumors moving with respiration by using AIP/MIP CT instead of 4D-CT. Methods: CT data of three patients were acquired in Cine mode. The Cine duration time for each couch position is 4~6s, which equals to one breathing cycle plus 1s. The acquired CT data were input to a 4D-CT reconstruction system made in house to reconstruct AIP/MIP and 4D-CT. Then, the characteristics of motion tumor in AIP/MIP and 4D-CT were analyzed.

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Do Maximum Intensity Projection Images Truly Capture Tumor Motion?

Cited by 62 publications

References 16 publications

Analysis of the advantage of individual PTVs defined on axial 3D CT and 4D CT images for liver cancer

Analysis of the advantage of individual PTVs defined on axial 3D CT and 4D CT images for liver cancer

Strategies of Dose Escalation in the Treatment of Locally Advanced Non-Small Cell Lung Cancer: Image Guidance and Beyond

Application of AIP and MIP CT on Individual GTV Delineation for Tumor Moving with Respiration

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