Volume changes with stereotactic body radiation therapy in early lung cancer: Time trends and outcomes

Pathak, Rima; Tibdewal, Anil; Laskar, Sarbani Ghosh; Chaudhari, Suresh; Agarwal, Jai Prakash

doi:10.1111/1754-9485.12476

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…It concluded a correlation between a marked reduction in the size during the SBRT in early lung cancer and worse clinical outcomes, progression‐free survival and overall survival. 26 Repeated CBCT before and after each fraction has been proposed to address such a problem as a tool for the target volume monitoring in lung SBRT. 27 The addition of an automated method to delineate the target volume would help to figure out the magnitude of intrafraction and interfraction tumour deformations and the necessity to repeat the planning in case of undesired dosimetric violations, known as adaptive radiation therapy (ART).…”

Section: Discussionmentioning

confidence: 99%

“…Another study retrospectively observed the interfraction tumour volume change in twenty‐two patients. It concluded a correlation between a marked reduction in the size during the SBRT in early lung cancer and worse clinical outcomes, progression‐free survival and overall survival 26 . Repeated CBCT before and after each fraction has been proposed to address such a problem as a tool for the target volume monitoring in lung SBRT 27 .…”

Section: Discussionmentioning

confidence: 99%

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Clinical validation of a semi‐automated segmentation algorithm for target volume definition on planning CT and CBCT in stereotactic body radiotherapy (SBRT) for peripheral lung lesions

Mohamed

Risse

Schmitz

et al. 2022

J of Medical Radiation Sci

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Introduction Stereotactic body radiotherapy (SBRT) is an ablative method for lung malignancies. Here, the definition of the gross target volume (GTV) is subject to interobserver variation. In this study, we aimed to evaluate the interobserver variability during SBRT and its dosimetric impact, as well as to introduce a semi‐automated delineation tool for both planning computer tomography (P‐CT) and cone beam CT (CBCT) to help to standardise GTV delineation and adaptive volume‐change registration. Methods The interobserver variation of GTV manual contours from five physicians was analysed in 15 patients after lung SBRT on free breathing (FB) P‐CT ( n = 15) and CBCT ( n = 90) before and after each fraction. The dosimetric impact from interobserver variations of GTV based on the original treatment plan was analysed. Next, the accuracy of an in‐house easy‐to‐use semi‐automated‐segmentation algorithm for pulmonary lesions was compared with gold standard contours in FB P‐CT and CBCT, as well as 4D P‐CT of additional 10 patients. Results The interobserver variability in manual contours resulted in violations of dose coverage of the planning target volume (PTV), which, in turn, resulted in compromised tumour control probability in contours from four physicians. The validation of the semi‐automated delineation algorithm using thorax phantom led to a highly reliable accuracy in defining GTVs. Comparing the unsupervised auto‐contours with the gold standard delineation revealed high equal high concordance for FB P‐CT, 4D P‐CT and CBCT, with a DSC of 0.83, 0.76 and 0.8, respectively. The supervised use of the semi‐automated delineation tool improved its accuracy, with DSCs of 0.86, 0.86 and 0.8 for FB P‐CT, 4D P‐CT and CBCT, respectively. The use of the algorithm was associated with a significantly shorter working time. The semi‐automated delineation tool can accurately register volume changes in CBCTs. Conclusion The segmentation algorithm provides a reliable, standardised and time‐saving alternative for manual delineation in lung SBRT in P‐CT and CBCT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical validation of a semi‐automated segmentation algorithm for target volume definition on planning CT and CBCT in stereotactic body radiotherapy (SBRT) for peripheral lung lesions

Mohamed

Risse

Schmitz

et al. 2022

J of Medical Radiation Sci

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“…Pathak et al [24], using KVCT obtained before each fractional treatment, analyzed the changes that might occur during SBRT in 22 lung cancer patients. Their results showed that total tumor volume changed significantly during SBRT.…”

Section: Disease Markersmentioning

confidence: 99%

Optimized CyberKnife Lung Treatment: Effect of Fractionated Tracking Volume Change on Tracking Results

Wang

Qiu

et al. 2020

Disease Markers

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Objectives. To explore the impact of volume change in the fractionated tracking of stereotactic radiotherapy on the results of synchronous, respiratory tracking algorithm using CyberKnife. Methods. A total of 38 lung tumor patients receiving stereotactic radiotherapy at our center from March 2018 to October 2019 were counted. Photoshop CS4 image processing software was used to obtain the pixels and the average value of brightness of the tracking volume in the image and calculate the grayscale within the contour of the tracking volume on the real-time X-ray image. At the same time, parameters of the synchronous respiratory tracking algorithm of the fractional CyberKnife were extracted for comparison between the volume of image-guided image tracking and the number of fractions during stereotactic radiotherapy. We also analyzed the relationship between fraction tumor location and characteristics and the calculated results of synchronous respiratory tracking by CyberKnife. Results. There were no significant differences between the first four fractions (p>0.05) for left lung lesions and no significant differences between the first five fractions for right lung lesions (p≥0.05). For peripheral lung cancer, longer fractional treatment led to greater variation in grayscale (G-A: >4 fractions p<0.05), while for central lung cancer, longer fractional treatment led to greater variation in parameters of the synchronous respiratory tracking algorithm (Uncertainty A and Uncertainty B: >4 fractions p<0.05). There was a significant correlation between radiotherapy-graded tumor density and relevant parameters, and the correlation was strong (>0.7, p<0.05). Conclusion. With the increase of treatment fractions, the gray value in the patient tracking volume decreased. Patients of >4 fractions were advised to reevaluate with simulated CT and replan. For tumors with small diameter and low density, the imaging changes of volume should be closely followed during treatment. For left lung and central lung cancer, carefully select the synchronous tracking treatment with 2-view.

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Uniqueness of lung cancer in Southeast Asia

Noronha,

Budukh,

Chaturvedi

et al. 2024

The Lancet Regional Health - Southeast Asia

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Volume changes with stereotactic body radiation therapy in early lung cancer: Time trends and outcomes

Abstract: Gross tumour volume undergoes significant changes during SBRT. Early regression in tumour volume may be used as a predictor of poor LRFS and OS.

Cited by 3 publications

References 27 publications

Clinical validation of a semi‐automated segmentation algorithm for target volume definition on planning CT and CBCT in stereotactic body radiotherapy (SBRT) for peripheral lung lesions

Clinical validation of a semi‐automated segmentation algorithm for target volume definition on planning CT and CBCT in stereotactic body radiotherapy (SBRT) for peripheral lung lesions

Optimized CyberKnife Lung Treatment: Effect of Fractionated Tracking Volume Change on Tracking Results

Uniqueness of lung cancer in Southeast Asia

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