| Qi Yuanjun,Li Jianbin,Zhang Yingjie,Shao Qian,Liu Xijun,Li Fengxiang,Wang Jinzhi,Li Zhenxiang,Wang Wei.The effectiveness of abdominal compression in the target movement and external extension boundary of peripheral pulmonary tumors treated with stereotactic radiotherapy based on 4DCT[J].Chinese Journal of Radiological Medicine and Protection,2021,41(2):134-139 |
| The effectiveness of abdominal compression in the target movement and external extension boundary of peripheral pulmonary tumors treated with stereotactic radiotherapy based on 4DCT |
| Received:May 06, 2020 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.02.010 |
| KeyWords:Lung neoplasms Four-dimensional CT Stereotactic body radiation therapy Abdominal compression Cone beam CT |
| FundProject:国家自然科学基金青年基金项目（81201735）；山东省重点研发计划项目（2015GSF118011） |
| Author Name | Affiliation | E-mail | | Qi Yuanjun | Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Li Jianbin | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | lijianbin@msn.com | | Zhang Yingjie | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Shao Qian | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Liu Xijun | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Li Fengxiang | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Wang Jinzhi | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Li Zhenxiang | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Wang Wei | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | |
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| Abstract:: |
| Objective To investigate the effectiveness of abdominal compression in tumor motion and the target volume, and analyze the suitable margins of planning target volume (PTV) for patients treated with lung-SBRT based on 4DCT. Methods Patients diagnosed with peripheral pulmonary tumor were enrolled. The patients were divided into the whole group, upper-middle-lobe group (group A) and the lower-lobe group (group B ). Each patient underwent 3DCT, 4DCT with abdominal compression (4DCTcom) and 4DCT with free breath (4DCTfree) scans. The GTVs were delineated and IGTVs on these images. PTV MIP5 mm, PTV MIP4 mm, PTV MIP3 mm were constructed with a 5,4,3 mm margin in left-right (LR), anterior-posterior (AP) directions and cranial-caudal (CC) directions. Results The median motion vector with compression reduced by 30.92% in whole group, increased by 3.42% in group A and reduced by 18.80% in group B, respectively. And there were no significant differences of TMA LR, TMAAP, TMACC and motion vector by the Wilcoxon test (P>0.05 ). The median sizes of IGTV MIPcom, IGTV MIPfree and IGTV10com, IGTV10free were 4.01,5.36 cm3and 6.59, 7.65 cm3, with statistically significant difference (Z=-3.45, -3.14, P<0.01 ). The median ratio of DI of IGTV CBCTcom in PTV MIP5 mm, PTV MIP4 mm and PTV MIP3 mm≥95% was 100%, 100% and 83.33%, respectively. Conclusions The patients' respiratory pattern changed with abdominal compression and abdominal compression is useful in reducing the size of IGTV MIP and IGTV10, which could reduce the target volume and protect the normal tissue. Adding a 4 mm margin to IGTV MIPcom based on 4DCT account for respiration in SBRT is a tendency for precise radiotherapy. |
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