Impact of tumour motion compensation and delineation methods on FDG PET-based dose painting plan quality for NSCLC radiation therapy

被引：13
作者：
Thomas, Hannah Mary [1 ,2 ]
Kinahan, Paul E. [3 ]
Samuel, James Jebaseelan E. [2 ]
Bowen, Stephen R. [1 ,3 ]
机构：
[1] Univ Washington, Sch Med, Dept Radiat Oncol, 1959 NE Pacific St Box 356043, Seattle, WA 98195 USA
[2] VIT Univ, Dept Phys, Sch Adv Sci, Vellore, Tamil Nadu, India
[3] Univ Washington, Sch Med, Dept Radiol, 1959 NE Pacific St Box 356043, Seattle, WA 98195 USA
来源：
JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY | 2018年 / 62卷 / 01期
关键词：
dose painting; NSCLC; PET; CT; respiratory gating; segmentation; CELL LUNG-CANCER; POSITRON-EMISSION-TOMOGRAPHY; MULTIOBSERVER VALIDATION; ESCALATION; RADIOTHERAPY; PHANTOM; SEGMENTATION; CHEMOTHERAPY; PATTERNS; VOLUMES;
D O I：
10.1111/1754-9485.12693
中图分类号：
R8 [特种医学]; R445 [影像诊断学];
学科分类号：
1002 ; 100207 ; 1009 ;
摘要：
IntroductionTo quantitatively estimate the impact of different methods for both boost volume delineation and respiratory motion compensation of [18F] FDG PET/CT images on the fidelity of planned non-uniform dose painting' plans to the prescribed boost dose distribution. MethodsSix locally advanced non-small cell lung cancer (NSCLC) patients were retrospectively reviewed. To assess the impact of respiratory motion, time-averaged (3D AVG), respiratory phase-gated (4D GATED) and motion-encompassing (4D MIP) PET images were used. The boost volumes were defined using manual contour (MANUAL), fixed threshold (FIXED) and gradient search algorithm (GRADIENT). The dose painting prescription of 60Gy base dose to the planning target volume and an integral dose of 14Gy (total 74Gy) was discretized into seven treatment planning substructures and linearly redistributed according to the relative SUV at every voxel in the boost volume. Fifty-four dose painting plan combinations were generated and conformity was evaluated using quality index VQ0.95-1.05, which represents the sum of planned dose voxels within 5% deviation from the prescribed dose. Trends in plan quality and magnitude of achievable dose escalation were recorded. ResultsDifferent segmentation techniques produced statistically significant variations in maximum planned dose (P<0.02), as well as plan quality between segmentation methods for 4D GATED and 4D MIP PET images (P<0.05). No statistically significant differences in plan quality and maximum dose were observed between motion-compensated PET-based plans (P>0.75). Low variability in plan quality was observed for FIXED threshold plans, while MANUAL and GRADIENT plans achieved higher dose with lower plan quality indices. ConclusionsThe dose painting plans were more sensitive to segmentation of boost volumes than PET motion compensation in this study sample. Careful consideration of boost target delineation and motion compensation strategies should guide the design of NSCLC dose painting trials.
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收藏
页码：81 / 90
页数：10
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