| Xu Hua,Gong Guanzhong,Liu Tonghai,et al.Application of 4D-CT and deformable registration in assessment of dose accumulation in radiotherapy for hepatocellular carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2015,35(5):349-352 |
| Application of 4D-CT and deformable registration in assessment of dose accumulation in radiotherapy for hepatocellular carcinoma |
| Received:August 16, 2014 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.05.007 |
| KeyWords:4D-CT Deformable registration Hepatocellular carcinoma Radiotherapy |
| FundProject:国家自然科学基金(81272699,81301936);山东省科技发展计划项目(2014GSF118011) |
| Author Name | Affiliation | E-mail | | Xu Hua | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | Gong Guanzhong | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | Liu Tonghai | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | Wei Hong | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | Ma Changsheng | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | Yin Yong | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | yongyinsd@163.com |
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| Abstract:: |
| Objective To explore the effect of respiration on dose accumulation for target volume and normal liver in radiotherapy for hepatocellular carcinoma (HCC) while applying 4D-CT and deformable registration. Methods Nineteen HCC patients who had received transcatheter arterial chemoembolization were enrolled in this study. All patients underwent 3D- and 4D-CT simulation in free breathing. The 3D dose (Dose-3D) was calculated from the treatment planning designed on the 3D-CT image. The Dose-3D then was recalculated on ten phases of 4D-CT images respectively, and the end-inspiration and end-expiration doses were defined as Dose-EI and Dose-EE. The 4D dose (Dose-4D) was obtained by deforming and accumulating ten-phase doses of 4D-CT images on the end-expiration phase image. The dosimetric differences of planning target volume and normal liver were compared among Dose-3D, Dose-4D, Dose-EI and Dose-EE. Results The D99 and D95 of planning target volume (PTV) in Dose-3D were higher than those of Dose-4D, Dose-EI and Dose-EE(χ2=32.75,26.31,P<0.05). The conformal index (CI) and homogeneity index (HI) in Dose-3D were better than those of Dose-4D, Dose-EI and Dose-EE, in which CI decreased from 0.78 to 0.63, 0.60 and 0.57, while HI increased from 0.08 to 0.15, 0.16 and 0.19 (χ2=37.80,31.86,P<0.05). No statistically significant differences were found in dosimetric indices of PTV between Dose-4D and Dose-EI, Dose-EE, and between Dose-EI and Dose-EE (P>0.05). The mean dose (Dmean), V5, V10, V20, V30 and V40 of normal liver were similar among four dose distributions (P>0.05). Conclusions More objective and precise dose distribution for target volume and normal liver could be obtained by applying both 4D-CT and deformable registration, which is beneficial to accurately predicting the dose-volume indices of radiation-induced liver injury and offering more reliable evidence of escalation for target dose. |
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