Image-guided radiotherapy for liver cancer using respiratory-correlated computed tomography and cone-beam computed tomography.

Purpose: To evaluate a novel four-dimensional (4D) image-guided radiotherapy (IGRT) technique in stereotactic body RT for liver tumors. Methods and Materials: For 11 patients with 13 intrahepatic tumors, a respiratory-correlated 4D computed tomography (CT) scan was acquired at treatment planning. Th...

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Publicado en:International Journal of Radiation Oncology, Biology, Physics Vol. 71; no. 1; pp. 297 - 305
Autores principales: Guckenberger M, Sweeney RA, Wilbert J, Krieger T, Richter A, Baier K, Mueller G, Sauer O, Flentje M, Guckenberger, Matthias, Sweeney, Reinhart A, Wilbert, Juergen, Krieger, Thomas, Richter, Anne, Baier, Kurt, Mueller, Gerd, Sauer, Otto, Flentje, Michael
Formato: research Journal Article
Publicado: Pergamon Press - An Imprint of Elsevier Science May2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2008
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        10.1016/j.ijrobp.2008.01.005
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        atl: Image-guided radiotherapy for liver cancer using respiratory-correlated computed tomography and cone-beam computed tomography.
      aug:
        au:
          Guckenberger M
          Sweeney RA
          Wilbert J
          Krieger T
          Richter A
          Baier K
          Mueller G
          Sauer O
          Flentje M
          Guckenberger, Matthias
          Sweeney, Reinhart A
          Wilbert, Juergen
          Krieger, Thomas
          Richter, Anne
          Baier, Kurt
          Mueller, Gerd
          Sauer, Otto
          Flentje, Michael
        affil: Department of Radiation Oncology, Julius-Maximilians University, Wuerzburg, Germany
      sug:
        subj:
          Diagnostic Imaging Methods
          Liver Neoplasms Radiography
          Liver Neoplasms Radiotherapy
          Liver Neoplasms
          Radiotherapy, Computer-Assisted Methods
          Respiration
          Stereotaxic Techniques
          Tomography, X-Ray Computed Methods
          Adult
          Aged
          Carcinoma, Hepatocellular Radiography
          Carcinoma, Hepatocellular Radiotherapy
          Female
          Male
          Middle Age
          Movement
          Observer Bias
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Purpose: To evaluate a novel four-dimensional (4D) image-guided radiotherapy (IGRT) technique in stereotactic body RT for liver tumors. Methods and Materials: For 11 patients with 13 intrahepatic tumors, a respiratory-correlated 4D computed tomography (CT) scan was acquired at treatment planning. The target was defined using CT series reconstructed at end-inhalation and end-exhalation. The liver was delineated on these two CT series and served as a reference for image guidance. A cone-beam CT scan was acquired after patient positioning; the blurred diaphragm dome was interpreted as a probability density function showing the motion range of the liver. Manual contour matching of the liver structures from the planning 4D CT scan with the cone-beam CT scan was performed. Inter- and intrafractional uncertainties of target position and motion range were evaluated, and interobserver variability of the 4D-IGRT technique was tested. Results: The workflow of 4D-IGRT was successfully practiced in all patients. The absolute error in the liver position and error in relation to the bony anatomy was 8 +/- 4 mm and 5 +/- 2 mm (three-dimensional vector), respectively. Margins of 4-6 mm were calculated for compensation of the intrafractional drifts of the liver. The motion range of the diaphragm dome was reproducible within 5 mm for 11 of 13 lesions, and the interobserver variability of the 4D-IGRT technique was small (standard deviation, 1.5 mm). In 4 patients, the position of the intrahepatic lesion was directly verified using a mobile in-room CT scanner after application of intravenous contrast. Conclusion: The results of our study have shown that 4D image guidance using liver contour matching between respiratory-correlated CT and cone-beam CT scans increased the accuracy compared with stereotactic positioning and compared with IGRT without consideration of breathing motion.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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