Improving Soft-Tissue Contrast in Four-Dimensional Computed Tomography Images of Liver Cancer Patients Using a Deformable Image Registration Method

Wang, He; Krishnan, Sunil; Wang, Xiaochun; Beddar, Sam; Briere, Tina Marie; Crane, Christopher H.; Mohan, Radhe; Dong, Lei

doi:10.1016/j.ijrobp.2008.04.054

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…GTV COM was not used as this would have required the results of DIR of 4D CT. Unlike in the lung, liver tumors are often poorly visualized on 4D CT despite intravenous contrast(29), prohibiting the use of rigid registration to accurately measure GTV COM. Additionally, the effect of choosing COM of the GTV versus the liver, a relatively large organ, as a surrogate for all motion within the abdomen is unknown, as large differences between GTV and liver COM, or between GTV COM for multifocal cases, were sometimes observed.…”

Section: Discussionmentioning

confidence: 99%

Effect of Breathing Motion on Radiotherapy Dose Accumulation in the Abdomen Using Deformable Registration

Velec

Moseley

Eccles

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To investigate the effect of breathing motion and dose accumulation on the planned radiotherapy dose to liver tumors and normal tissues using deformable image registration.Method and Materials-Twenty one free-breathing stereotactic liver cancer radiotherapy patients, planned on static exhale CT for 27 -60 Gy in 6 fractions, were included. A biomechanical model-based deformable image registration algorithm, retrospectively deformed each exhale CT to inhale CT. This deformation map was combined with exhale and inhale dose grids from the treatment planning system to accumulate dose over the breathing cycle. Accumulation was also investigated using a simple rigid liver-to-liver registration. Changes to tumor and normal tissue dose were quantified.Results-Relative to static plans, mean dose change (range) after deformable dose accumulation (as % of prescription dose) was −1 (−14, 8) to minimum tumor, −4 (−15, 0) to max bowel, −4 (−25, 1) to max duodenum, 2 (−1, 9) to max esophagus, −2 (−13, 4) to max stomach, 0 (−3, 4) to mean liver, and −1 (−5, 1) and −2 (−7, 1) to mean left and right kidneys. Compared to deformable registration, rigid modeling had changes up to 8% to minimum tumor and 7% to maximum normal tissues.Conclusion-Deformable registration and dose accumulation revealed potentially significant dose changes to either a tumor or normal tissue in the majority of cases due to breathing motion. These changes may not be accurately accounted for with rigid motion.

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Section: Discussionmentioning

confidence: 99%

Effect of Breathing Motion on Radiotherapy Dose Accumulation in the Abdomen Using Deformable Registration

Velec

Moseley

Eccles

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…Patients underwent four-dimensional computed tomography (4D-CT) simulation with intravenous contrast. [10,11] In patients with inadequate renal function or history of allergy to contrast agent, simulation was performed without contrast. To ensure a consistent breathing pattern, patient education and training were provided before 4D-CT acquisition.…”

Section: Treatment Planningmentioning

confidence: 99%

Proton beam therapy outcomes for localized unresectable hepatocellular carcinoma

Chadha

Gunther

Hsieh

et al. 2019

Radiotherapy and Oncology

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Background and purpose: This study documents the utilization and efficacy of proton beam therapy (PBT) in western patients with localized unresectable hepatocellular carcinoma (HCC). Methods and methods: Forty-six patients with HCC, Child-Pugh class of A or B, no prior radiotherapy history, and ECOG performance status 0-2 received PBT at our institution from 2007 to 2016. Radiographic control within the PBT field (local control, LC) and overall survival (OS) were calculated from the start of PBT. Results: Most (83%) patients had Child-Pugh class A. Median tumor size was 6 cm (range, 1.5-21.0 cm); 22% of patients had multiple tumors and 28% had tumor vascular thrombosis. Twenty-five (54%) patients received prior treatment. Median biologically effective dose (BED) was 97.7 GyE (range, 33.6-144 GyE) administered in 15 fractions. Actuarial 2-year LC and OS rates were 81% and 62%; median OS was 30.7 months. Out-of-field intrahepatic failure was the most common site of disease progression. Patients receiving BED ≥90 GyE had a significantly better OS than those receiving BED <90 GyE (49.9 vs. 15.8 months, p = 0.037). A trend toward 2year LC improvement was observed in patients receiving BED ≥90 GyE compared with those receiving BED <90 GyE (92% vs. 63%, p = 0.096). On multivariate analysis, higher BED (p = 0.023; hazard ratio = 0.308) significantly predicted improved OS. Six (13%) patients experienced acute grade 3 toxicity. Conclusions: High-dose PBT is associated with high rates of LC and OS for unresectable HCC. Dose escalation may further improve outcomes.

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“…All patients underwent 4-dimensional CT simulation; intravenous contrast was administered in patients with creatinine values 1.5 mg/d. 22,23 In the eastern cohort, abdominal belt compression was used to reduce respiratory motion (n Z 94), and gating at exhalation phase (Anzai Medical, Tokyo, Japan) was implemented in patients with organ motion >10 mm (n Z 8). 14 In the western cohort, 29 patients were treated at free breathing with the use of internal target volumes.…”

Section: Proton Beam Therapymentioning

confidence: 99%

Predictors of Radiation-Induced Liver Disease in Eastern and Western Patients With Hepatocellular Carcinoma Undergoing Proton Beam Therapy

Hsieh

Venkatesulu

Lee

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

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Improving Soft-Tissue Contrast in Four-Dimensional Computed Tomography Images of Liver Cancer Patients Using a Deformable Image Registration Method

Cited by 10 publications

References 30 publications

Effect of Breathing Motion on Radiotherapy Dose Accumulation in the Abdomen Using Deformable Registration

Effect of Breathing Motion on Radiotherapy Dose Accumulation in the Abdomen Using Deformable Registration

Proton beam therapy outcomes for localized unresectable hepatocellular carcinoma

Predictors of Radiation-Induced Liver Disease in Eastern and Western Patients With Hepatocellular Carcinoma Undergoing Proton Beam Therapy

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