4D CT image artifacts affect local control in SBRT of lung and liver metastases

被引：35

作者：

Sentker, Thilo ^{[1
,3
]}

Schmidt, Vladimir ^{[1
]}

Ozga, Ann-Kathrin ^{[2
]}

Petersen, Cordula ^{[1
]}

Madesta, Frederic ^{[3
]}

Hofmann, Christian ^{[4
]}

Werner, Rene ^{[3
]}

Gauer, Tobias ^{[1
]}

机构：

[1] Univ Med Ctr Hamburg Eppendorf, Dept Radiotherapy & Oncol, Hamburg, Germany

[2] Univ Med Ctr Hamburg Eppendorf, Inst Med Biometry & Epidemiol, Hamburg, Germany

[3] Univ Med Ctr Hamburg Eppendorf, Dept Computat Neurosci, Martinistr 52, D-20246 Hamburg, Germany

[4] Siemens Healthcare GmbH, Forchheim, Germany

来源：

RADIOTHERAPY AND ONCOLOGY | 2020年 / 148卷

关键词：

4D radiotherapy; SBRT; Liver; Lung; 4D CT artifacts; Local control; BODY RADIATION-THERAPY; RADIOTHERAPY; DELIVERY;

D O I：

10.1016/j.radonc.2020.04.006

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background and purpose: 4D CT images often contain artifacts that are suspected to affect treatment planning quality and clinical outcome of lung and liver SBRT. The present study investigates the correlation between the presence of artifacts in SBRT planning 4D CT data and local metastasis control. Materials and methods: The study includes 62 patients with 102 metastases (49 in the lung and 53 in the liver), treated between 2012 and 2016 with SBRT for mainly curative intent. For each patient, 10-phase 4D CT images were acquired and used for ITV definition and treatment planning. Follow-up intervals were 3 weeks after treatment and every 3-6 months thereafter. Based on the number and type of image artifacts, a strict rule-based two-class artifact score was introduced and assigned to the individual 4D CT data sets. Correlation between local control and artifact score (consensus rating based on two independent observers) were analyzed using uni- and multivariable Cox proportional hazards models with random effects. Metastatic site, target volume, metastasis motion, breathing irregularity-related measures, and clinical data (chemotherapy prior to SBRT, target dose, treatment fractionation) were considered as covariates. Results: Local recurrence was observed in 17/102 (17%) metastases. Significant univariable factors for local control were artifact score (severe CT artifacts vs. few CT artifacts; hazard ratio 8.22; 95%-CI 2.04-33.18) and mean patient breathing period (> 4.8 s vs. < 4.8 s; hazard ratio 3.58; 95%-CI 1.18-10.84). Following multivariable analysis, artifact score remained as dominating prognostic factor, although statistically not significant (hazard ratio 10.28; 95%-CI 0.57-184.24). Conclusion: The results support the hypothesis that image artifacts in 4D CT treatment planning data negatively influence clinical outcome in SBRT of lung and liver metastases, underlining the need to account for 4D CT artifacts and improve image quality. (C) 2020 Elsevier B.V. All rights reserved.

引用

页码：229 / 234

页数：6

共 23 条

[1] Stereotactic radiation therapy for liver metastases: factors affecting local control and survival [J].

Andratschke, Nicolaus H. J. ;

Nieder, Carsten ;

Heppt, Franz ;

Molls, Michael ;

Zimmermann, Frank .

RADIATION ONCOLOGY, 2015, 10

[2] Clinical Outcome of Stereotactic Ablative Body Radiotherapy for Lung Metastatic Lesions in Non-small Cell Lung Cancer Oligometastatic Patients [J].

De Rose, F. ;

Cozzi, L. ;

Navarria, P. ;

Ascolese, A. M. ;

Clerici, E. ;

Infante, M. ;

Alloisio, M. ;

Testori, A. ;

Toschi, L. ;

Finocchiaro, G. ;

Santoro, A. ;

Scorsetti, M. .

CLINICAL ONCOLOGY, 2016, 28 (01) :13-20

[3]

Gauer T, 2018, STRAHLENTHER ONKOL, V194, P570, DOI 10.1007/s00066-018-1264-8

[4]

Guckenberger M, 2020, STRAHLENTHER ONKOL, P1

[5] LACK OF CORRELATION BETWEEN EXTERNAL FIDUCIAL POSITIONS AND INTERNAL TUMOR POSITIONS DURING BREATH-HOLD CT [J].

Hunjan, Sandeep ;

Starkschall, George ;

Prado, Karl ;

Dong, Lei ;

Balter, Peter .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2010, 76 (05) :1586-1591

[6] The management of respiratory motion in radiation oncology report of AAPM Task Group 76 [J].

Keall, Paul J. ;

Mageras, Gig S. ;

Balter, James M. ;

Emery, Richard S. ;

Forster, Kenneth M. ;

Jiang, Steve B. ;

Kapatoes, Jeffrey M. ;

Low, Daniel A. ;

Murphy, Martin J. ;

Murray, Brad R. ;

Ramsey, Chester R. ;

Van Herk, Marcel B. ;

Vedam, S. Sastry ;

Wong, John W. ;

Yorke, Ellen .

MEDICAL PHYSICS, 2006, 33 (10) :3874-3900

[7] Stereotactic body radiotherapy for oligo-metastatic liver disease - Influence of pre-treatment chemotherapy and histology on local tumor control [J].

Klement, R. J. ;

Guckenberger, M. ;

Alheid, H. ;

Allgaeuer, M. ;

Becker, G. ;

Blanck, O. ;

Boda-Heggemann, J. ;

Brunner, T. ;

Duma, M. ;

Gerum, S. ;

Habermehl, D. ;

Hildebrandt, G. ;

Lewitzki, V. ;

Ostheimer, C. ;

Papachristofilou, A. ;

Petersen, C. ;

Schneider, T. ;

Semrau, R. ;

Wachter, S. ;

Andratschke, N. .

RADIOTHERAPY AND ONCOLOGY, 2017, 123 (02) :227-233

[8] An in silico performance characterization of respiratory motion guided 4DCT for high-quality low-dose lung cancer imaging [J].

Martin, Spencer ;

Brien, Ricky O' ;

Hofmann, Christian ;

Keall, Paul ;

Kipriditis, John .

PHYSICS IN MEDICINE AND BIOLOGY, 2018, 63 (15)

[9] Cancer treatment and survivorship statistics, 2016 [J].

Miller, Kimberly D. ;

Siegel, Rebecca L. ;

Lin, Chun Chieh ;

Mariotto, Angela B. ;

Kramer, Joan L. ;

Rowland, Julia H. ;

Stein, Kevin D. ;

Alteri, Rick ;

Jemal, Ahmedin .

CA-A CANCER JOURNAL FOR CLINICIANS, 2016, 66 (04) :271-289

[10] Dosimetric Impact of the Interplay Effect During Stereotactic Lung Radiation Therapy Delivery Using Flattening Filter-Free Beams and Volumetric Modulated Arc Therapy [J].

Ong, Chin Loon ;

Dahele, Max ;

Slotman, Ben J. ;

Verbakel, Wilko F. A. R. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2013, 86 (04) :743-748

← 1 2 3 →