Li Jinkai,Ge Xiaolin,Wang Peipei,Li Caihong,Wang Tingting,Li Shunmei,Shi Xinlei,Chen Xin,Sun Xinchen.Feasibility of delineation internal target volumes of lung cancer using four-dimensional cone-beam CT[J].Chinese Journal of Radiological Medicine and Protection,2015,35(8):594-597
Feasibility of delineation internal target volumes of lung cancer using four-dimensional cone-beam CT
Received:November 15, 2014  
DOI:10.3760/cma.j.issn.0254-5098.2015.08.008
KeyWords:Lung Cancer  Four-dimensional  Internal target volume  Cone beam CT  Delineation target area
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Author NameAffiliationE-mail
Li Jinkai Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Ge Xiaolin Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Wang Peipei Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Li Caihong Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Wang Tingting Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Li Shunmei Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Shi Xinlei Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Chen Xin Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China  
Sun Xinchen Department of Radiation Oncology, Nanjing Medical University, First Affiliated Hospital, Nanjing, China 13770662828@163.com 
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Abstract::
      Objective To study the feasibility of contouring internal target volumes of lung cancer using four-dimensional cone-beam CT(4D-CBCT). Methods Twenty-four cases of lung cancer coming from Nanjing Medical University First Affiliated Hospital were selected with simple random sampling. Locating CT images were obtained with simulating CT under quiet breathing,and the mid-position image of 4D-CBCT were obtained in the first fraction, three-dimensional cone-beam CT(3D-CBCT) were obtained by changing image reconstruction algorithm from four-dimensional to three-dimensional. Register the planning images using the bone registration. GTVs were contoured respectively based on CT, mid-position image of 4D-CBCT and 3D-CBCT. CTVCT, ITV4D and ITV3D were defined with a margin of 7 mm accounting for microscopic disease. ITVCT were defined based on CTVCT with an isotropic internal margin of 5 mm. The differences in the position, volume, Dice's similarity coefficient (DSC) and inclusion relationship of different volumes were compared. Results In the direction of CC,the differences between ITVCT and ITV3D for the middle-lower lobe had statistical significance in the center of target location (Z=-2.027, P<0.05). ITVCT was the biggest and ITV4D was the smallest in terms of volume, and the former had statistical significance compared with ITV3D (Z=-2.941, P<0.05), while the latter had no statistical significance compared with ITV3D (P>0.05). The mean of DSC between ITVCT and ITV3D was less than 75%, while the one between ITV4D and ITV3D was more than 90% (Z=-2.940, -2.975, P<0.05). The mean percentages of ITVCT and ITV4D excluding ITV3D were approximately 40% and 5% respectively (Z=-2.952, -3.185, P<0.05). Conclusions The volume of internal target volumes of lung cancer can be reduced using the mid-position image of 4D-CBCT, which might provide an alternative of individualized adaptive radiotherapy for lung cancer.
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