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ID 46736
file
creator
Nishibuchi, Ikuno
Murakami, Yuji
Kenjo, Masahiro
Kaneyasu, Yuko
subject
functional imaging
4D-CT
IMRT
COPD
NDC
Medical sciences
abstract
(Purpose) To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD).
(Materials and Methods) Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values lower than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fr) were designed and compared in each patient as follows: 1) Plan A: anatomical IMRTor VMAT plan based on the total lung 2) Plan F: functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (V20: the percentage of total lung volume irradiated with ≥ 20 Gy,MLD:mean dose of total lung) of the two plans were compared.
(Results) V20 was lower in Plan F than in Plan A (mean 1.5 %, p= 0.025 in IMRT, mean 1.6 %, p= 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p= 0.083 in IMRT, mean 0.5 Gy, p= 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses.
(Conclusions) Functional image-guided radiotherapy planning based on LAAin respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.
description
This work was supported in part by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant no. 22591385), and a Grant-in-Aid for Scientific Research from the Association for Nuclear Technology in Medicine.
This work was partly presented at the 52nd Annual Meeting of the American Society of Radiation Oncology, San Diego, CA, Oct 31 - Nov 4, 2010.
journal title
International Journal of Radiation Oncology, Biology, Physics
volume
Volume 82
issue
Issue 4
start page
e663
end page
e670
date of issued
2012-03-15
publisher
Elsevier Inc.
issn
0360-3016
1879-355X
ncid
publisher doi
pubmed id
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
rights
Copyright (c) 2012. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
relation url
department
University Medical Hospital
Graduate School of Biomedical & Health Sciences