Feasibility Study on Deformable Image Registration for Lung SBRT Patients for Dose-Driven Adaptive Therapy

• 作者: Eun Young Han Jose Penagaricano Ming Chao Xin Zhang
• 来源期刊: 医学物理学、临床工程、放射肿瘤学(英文)
• 学科: 医学
• 关键词: LUNG SBRT ADAPTIVE RADIOTHERAPY CBCT Deformable Image REGISTRATION
• 年，卷（期）: 2015,（3）
• 页码范围: 224-232
• 页数: 9页
• 分类号: R73

摘要

The purpose of the study was to evaluate a treatment dose using planning computed tomography (pCT) that was deformed to pre-treatment cone beam computed tomography (CBCT) for lung stereotactic body radiation therapy (SBRT) treatment. Five lung SBRT patients were retrospectively selected, and their daily CBCTs were employed in this study. Dosimetric comparison was performed between the original and recalculated plans from the deformed pCT (dose per fraction) by comparing a target coverage and organs at risk. Dose summation of five fractions was computed and compared to the original plan. A phantom study was conducted to evaluate the dosimetric accuracy for the dose per fraction. In the phantom study, the difference between the mean Hounsfield Unit (HU) values of the original and deformed pCTs is less than 0.5%. In patient study, the mean HU deviation of the five deformed pCTs compared to that of the original pCT was within ±5%, which is dosimetrically insignificant. While the internal target volume (ITV) shrank by 17% on average among the five patients, mean lung dose (MLD) increased by up to 7%, and D95% of PTV decreased slightly but stayed within 5%. Results showed that MLD might be a better indicative metric of normal lung dose than V20Gy as the ITV volume decreases. This study showed a feasibility to use a deformed pCT for evaluation of the dose per fraction and for a possible plan adaptation in lung SBRT cases. Readers should be cautious in selecting patients before clinical application due to the image quality of CBCT.