A 4D IMRT Planning Method Using Deformable Image Registration to Improve Normal Tissue Sparing with Contemporary Delivery Techniques

Overview

Journal Radiat Oncol

Publisher Biomed Central

Specialties Oncology
Radiology

Date 2011 Jul 21

PMID 21771333

Citations 11

Authors

Xiaoqiang Li

Xiaochun Wang

YuPeng Li

Xiaodong Zhang

Affiliations

Soon will be listed here.

Abstract

We propose a planning method to design true 4-dimensional (4D) intensity-modulated radiotherapy (IMRT) plans, called the t4Dplan method, in which the planning target volume (PTV) of the individual phases of the 4D computed tomography (CT) and the conventional PTV receive non-uniform doses but the cumulative dose to the PTV of each phase, computed using deformable image registration (DIR), are uniform. The non-uniform dose prescription for the conventional PTV was obtained by solving linear equations that required motion-convolved 4D dose to be uniform to the PTV for the end-exhalation phase (PTV50) and by constraining maximum inhomogeneity to 20%. A plug-in code to the treatment planning system was developed to perform the IMRT optimization based on this non-uniform PTV dose prescription. The 4D dose was obtained by summing the mapped doses from individual phases of the 4D CT using DIR. This 4D dose distribution was compared with that of the internal target volume (ITV) method. The robustness of the 4D plans over the course of radiotherapy was evaluated by computing the 4D dose distributions on repeat 4D CT datasets. Three patients with lung tumors were selected to demonstrate the advantages of the t4Dplan method compared with the commonly used ITV method. The 4D dose distribution using the t4Dplan method resulted in greater normal tissue sparing (such as lung, stomach, liver and heart) than did plans designed using the ITV method. The dose volume histograms of cumulative 4D doses to the PTV50, clinical target volume, lung, spinal cord, liver, and heart on the 4D repeat CTs for the two patients were similar to those for the 4D dose at the time of original planning.

Citing Articles

Spatiotemporal Free-Form Registration Method Assisted by a Minimum Spanning Tree During Discontinuous Transformations.

Bae J, Yoon S, Vania M, Lee D J Digit Imaging. 2021; 34(1):190-203.

PMID: 33483863 PMC: 7887135. DOI: 10.1007/s10278-020-00409-y.

Robust Optimization of SBRT Planning for Patients With Early Stage Non-Small Cell Lung Cancer.

Shang H, Pu Y, Wang Y Technol Cancer Res Treat. 2020; 19:1533033820916505.

PMID: 32314663 PMC: 7175055. DOI: 10.1177/1533033820916505.

Dosimetric study of three-dimensional static and dynamic SBRT radiotherapy for hepatocellular carcinoma based on 4DCT image deformable registration.

Ma C, Duan J, Yu S, Ma C J Appl Clin Med Phys. 2020; 21(2):60-66.

PMID: 31889422 PMC: 7020978. DOI: 10.1002/acm2.12811.

Automatic large quantity landmark pairs detection in 4DCT lung images.

Fu Y, Wu X, Thomas A, Li H, Yang D Med Phys. 2019; 46(10):4490-4501.

PMID: 31318989 PMC: 8311742. DOI: 10.1002/mp.13726.

Inverse 4D conformal planning for lung SBRT using particle swarm optimization.

Modiri A, Gu X, Hagan A, Bland R, Iyengar P, Timmerman R Phys Med Biol. 2016; 61(16):6181-202.

PMID: 27476472 PMC: 5175212. DOI: 10.1088/0031-9155/61/16/6181.

References

Engelsman M, Sharp G, Bortfeld T, Onimaru R, Shirato H . How much margin reduction is possible through gating or breath hold?. Phys Med Biol. 2005; 50(3):477-90. DOI: 10.1088/0031-9155/50/3/006. View

Mageras G, Pevsner A, Yorke E, Rosenzweig K, Ford E, Hertanto A . Measurement of lung tumor motion using respiration-correlated CT. Int J Radiat Oncol Biol Phys. 2004; 60(3):933-41. DOI: 10.1016/j.ijrobp.2004.06.021. View

Werner R, Ehrhardt J, Frenzel T, Saring D, Lu W, Low D . Motion artifact reducing reconstruction of 4D CT image data for the analysis of respiratory dynamics. Methods Inf Med. 2007; 46(3):254-60. DOI: 10.1160/ME9040. View

Keall P, Mageras G, Balter J, Emery R, Forster K, Jiang S . The management of respiratory motion in radiation oncology report of AAPM Task Group 76. Med Phys. 2006; 33(10):3874-900. DOI: 10.1118/1.2349696. View

Wolthaus J, Schneider C, Sonke J, Van Herk M, Belderbos J, Rossi M . Mid-ventilation CT scan construction from four-dimensional respiration-correlated CT scans for radiotherapy planning of lung cancer patients. Int J Radiat Oncol Biol Phys. 2006; 65(5):1560-71. DOI: 10.1016/j.ijrobp.2006.04.031. View

Low D, Nystrom M, Kalinin E, Parikh P, Dempsey J, Bradley J . A method for the reconstruction of four-dimensional synchronized CT scans acquired during free breathing. Med Phys. 2003; 30(6):1254-63. DOI: 10.1118/1.1576230. View

Rosu M, Balter J, Chetty I, Kessler M, McShan D, Balter P . How extensive of a 4D dataset is needed to estimate cumulative dose distribution plan evaluation metrics in conformal lung therapy?. Med Phys. 2007; 34(1):233-45. DOI: 10.1118/1.2400624. View

Kang Y, Zhang X, Chang J, Wang H, Wei X, Liao Z . 4D Proton treatment planning strategy for mobile lung tumors. Int J Radiat Oncol Biol Phys. 2007; 67(3):906-14. DOI: 10.1016/j.ijrobp.2006.10.045. View

Yamamoto T, Langner U, Loo Jr B, Shen J, Keall P . Retrospective analysis of artifacts in four-dimensional CT images of 50 abdominal and thoracic radiotherapy patients. Int J Radiat Oncol Biol Phys. 2008; 72(4):1250-8. PMC: 2583232. DOI: 10.1016/j.ijrobp.2008.06.1937. View

10.

Wolthaus J, Sonke J, Van Herk M, Belderbos J, Rossi M, Lebesque J . Comparison of different strategies to use four-dimensional computed tomography in treatment planning for lung cancer patients. Int J Radiat Oncol Biol Phys. 2008; 70(4):1229-38. DOI: 10.1016/j.ijrobp.2007.11.042. View

11.

Suh Y, Weiss E, Zhong H, Fatyga M, Siebers J, Keall P . A deliverable four-dimensional intensity-modulated radiation therapy-planning method for dynamic multileaf collimator tumor tracking delivery. Int J Radiat Oncol Biol Phys. 2008; 71(5):1526-36. PMC: 2600678. DOI: 10.1016/j.ijrobp.2008.04.018. View

12.

Flynn R, Bowen S, Bentzen S, Mackie T, Jeraj R . Intensity-modulated x-ray (IMXT) versus proton (IMPT) therapy for theragnostic hypoxia-based dose painting. Phys Med Biol. 2008; 53(15):4153-67. PMC: 2695924. DOI: 10.1088/0031-9155/53/15/010. View

13.

Alber M, Paulsen F, Eschmann S, Machulla H . On biologically conformal boost dose optimization. Phys Med Biol. 2003; 48(2):N31-5. DOI: 10.1088/0031-9155/48/2/404. View

14.

Yorke E, Wang L, Rosenzweig K, Mah D, Paoli J, Chui C . Evaluation of deep inspiration breath-hold lung treatment plans with Monte Carlo dose calculation. Int J Radiat Oncol Biol Phys. 2002; 53(4):1058-70. DOI: 10.1016/s0360-3016(02)02778-5. View

15.

Chang J, Zhang X, Wang X, Kang Y, Riley B, Bilton S . Significant reduction of normal tissue dose by proton radiotherapy compared with three-dimensional conformal or intensity-modulated radiation therapy in Stage I or Stage III non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2006; 65(4):1087-96. DOI: 10.1016/j.ijrobp.2006.01.052. View

16.

Gui M, Feng Y, Yi B, Dhople A, Yu C . Four-dimensional intensity-modulated radiation therapy planning for dynamic tracking using a direct aperture deformation (DAD) method. Med Phys. 2010; 37(5):1966-75. PMC: 2862055. DOI: 10.1118/1.3319498. View

17.

Barnes E, Murray B, Robinson D, UNDERWOOD L, Hanson J, Roa W . Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration. Int J Radiat Oncol Biol Phys. 2001; 50(4):1091-8. DOI: 10.1016/s0360-3016(01)01592-9. View

18.

Rietzel E, Chen G, Choi N, Willet C . Four-dimensional image-based treatment planning: Target volume segmentation and dose calculation in the presence of respiratory motion. Int J Radiat Oncol Biol Phys. 2005; 61(5):1535-50. DOI: 10.1016/j.ijrobp.2004.11.037. View

19.

Pan T, Lee T, Rietzel E, Chen G . 4D-CT imaging of a volume influenced by respiratory motion on multi-slice CT. Med Phys. 2004; 31(2):333-40. DOI: 10.1118/1.1639993. View

20.

Bentzen S . Theragnostic imaging for radiation oncology: dose-painting by numbers. Lancet Oncol. 2005; 6(2):112-7. DOI: 10.1016/S1470-2045(05)01737-7. View