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- W2022073885 abstract "Patients undergoing radiation therapy for head and neck cancers frequently have dental fillings or implants that can introduce significant artifact in diagnostic and treatment planning CT imaging. This may impact the accuracy of clinical target volume (CTV) delineation for highly conformal radiation therapy. However, the scope of the problem has not been quantified. We evaluated the incidence and impact of dental artifact on CTV delineation for patients undergoing curative radiation therapy for oropharyngeal or oral cavity cancer. This work serves as the basis for exploring novel solutions to address this problem. We retrospectively reviewed the treatment plans of patients with oropharyngeal or oral cavity cancer who received either post-operative or definitive radiation therapy at our institution from 2010-2012. Treatment planning CT images were evaluated for the presence or absence of dental amalgam streak artifacts. If present, the treatment plan was reviewed for CTV definition interference, defined as extension of the artifact into the high-risk CTV. We identified 110 treatment plans that were available for review, including 71 oropharynx and 39 oral cavity. Dental amalgam artifact was identified in 81 plans (73.6%), including 53 oropharynx (74.6%) and 28 oral cavity (71.8%). Artifacts were easily identified as an abrupt change in the Hounsfield units on the treatment planning CT scan, obscuring visualization of the treatment targets and surrounding normal tissue. Artifact was found to extend into or obscure visualization of the CTV in 77 cases (95%), including 49 of the 53 oropharynx cases (92.5%) and all 28 oral cavity cases (100%). We have identified a high incidence of dental artifact on treatment planning CT scans in patients undergoing head and neck radiation therapy. We confirmed that this artifact obscures and may affect accuracy of target volume delineation in a large percentage of patients. In addition, this may interfere with post-treatment surveillance imaging and dose calculation for both highly conformal radiation therapy and charged particle therapy. There is need for practical approaches to reduce the impact of these artifacts. Image processing strategies have been explored but have not been widely adopted. Our group in collaboration with dental colleagues is currently investigating the effectiveness of a novel composite dental amalgam." @default.
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- W2022073885 date "2013-10-01" @default.
- W2022073885 modified "2023-09-27" @default.
- W2022073885 title "Incidence and Impact of Dental Amalgam Artifact on Radiation Therapy Target Volumes in Oropharyngeal and Oral Cavity Cancer" @default.
- W2022073885 doi "https://doi.org/10.1016/j.ijrobp.2013.06.1163" @default.
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