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• W2109082455 abstract "Four-dimensional CT (4D-CT) imaging is a “snap movie” of patient's internal motion at the time of CT imaging. Motion and imaging uncertainties can affect the accuracy of the measured target motion and the internal target volume (ITV). The goal of this study is to quantitatively assess the phase-by-phase uncertainties of the internal target motion derived from repeat 4D-CTs. Sixteen intrathoracic (15 Lung, 1 esophagus) cancer patients received repeat 4D-CT imaging within the same day, as a part of an institutional review board approved protocol. Specifically, the patient was scanned once, then allowed to get up from the table for several minutes, and a repeat 4D-CT was performed. As reference, the GTV and reference bony structure (vertebral bodies) were delineated for the end-expiration (EE) phase of the first 4D-CT. To remove setup error in the second 4D-CT set, all CT images were first aligned to the bony reference. Location of the GTV relative to bony structures was then detected for each phase using an in-house 3D rigid registration algorithm. GTV locations were compared in pairs phase-by-phase between the first and second 4D-CT sets and then across patients. In order to assess GTV volume variations as results of changes in GTV location and GTV shape, we propagated the original GTV from the reference phase CT to the rest of CT data sets using a previously developed deformable image registration method. The shape and misalignment for a GTV pair was analyzed according to each phase using a volume overlap index (VOI), which is defined as the overlap of two volumes divided by the average of the two GTVs. The detected GTV positional variations (mean shifts ± 1 standard deviation [1SD]) were 2.4 ± 1.6 mm across all phases and all patients (range, 0 to 9.4 mm). The smallest mean positional shift (2.1 mm) occurred in the EE phase and the largest positional shift (2.9 mm) occurred in the mid-inspiration (MI) phase. Similarly, the variations across patients (1SD) were the smallest for the EE phase (2.4 mm) and the largest for the MI phase (3.5 mm). The VOI for GTV ranged from 0.45 to 0.95 (mean: 0.84) for the EE phase, and 0.48 to 0.95 (mean: 0.87) for the end-inspiration phase. A smaller VOI indicates worse volume alignment of the GTV for the corresponding phase. The misalignment of smaller GTVs has the most significant impact. The ITV determined using two 4D-CT sets increased by 12% on average (range, 4% to 39%) over the ITV determined using only one 4D-CT set. We found phase-by-phase positional uncertainties of GTV in repeat 4D-CT imaging of thoracic patients. It is recommended that an additional margin be assigned if the ITV is derived from only one 4D-CT scan." @default.
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• W2109082455 date "2008-09-01" @default.
• W2109082455 modified "2023-09-27" @default.
• W2109082455 title "Phase-by-phase Reproducibility of Thoracic Anatomy Based on 4D-CT Imaging and Effects on Resultant Internal Target Volumes (ITV)" @default.
• W2109082455 doi "https://doi.org/10.1016/j.ijrobp.2008.06.253" @default.
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