Comparison of liver stereotactic body radiotherapy plans based on free breathing and averaged CTs after trans-arterial chemoembolization using lipiodol

IF 2.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2025-09-29 DOI:10.1002/acm2.70271

Sei-Kwon Kang, Jai-Woong Yoon, Me Young Kim, Soah Park, Kwang-Ho Cheong, Taeryool Koo, Tae Jin Han

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引用次数: 0

Abstract

Purpose

To identify which CT set is more suitable for predicting the four-dimensional (4D) cumulative dose distribution in liver stereotactic body radiotherapy (SBRT) with lipiodol retention.

Methods

For 15 patients, who underwent liver SBRT after trans-arterial chemoembolization (TACE), volumetric modulated arc therapy (VMAT) plans were retrospectively generated on free breathing (FB) and average intensity projection (AVG) CT sets using the x-ray Voxel Monte Carlo (XVMC) algorithm. The three-dimensional (3D) FB and AVG plans were compared with corresponding 4D plans, which were created by deformable registration using 10-phase plans. For both internal target volume (ITV) and planning target volume (PTV), the volume covered by the prescription dose of 36 Gy (V36) and the dose covering 95% of the volume (D95) were evaluated. The relative (3D/4D) normal liver volume >19.2 Gy and rib volume 28.8 Gy were also compared for FB and AVG plans.

Results

The mean values of the relative electron densities inside the PTV for FB and AVG were slightly different (1.050 for FB vs. 1.039 for AVG). For both ITV and PTV, V36 and D95 showed no statistically significant difference between FB and AVG. Also, the relative rib volumes >28.8 Gy and the normal liver volumes >19.2 Gy were not statistically different between FB and AVG plans.

Conclusion

For liver SBRT with lipiodol retention, 3D plans based on FB and AVG images were virtually equivalent in producing the 4D cumulative doses under the accuracy of the XVMC algorithm.

Abstract Image

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基于自由呼吸的肝脏立体定向放疗方案与经动脉化疗栓塞后平均ct的比较。

目的：探讨哪一套CT更适合预测肝立体定向体放疗（SBRT）中脂醇潴留的四维累积剂量分布。方法：对15例经动脉化疗栓塞（TACE）后行肝脏SBRT的患者，采用x线体素蒙特卡罗（XVMC）算法在自由呼吸（FB）和平均强度投影（AVG） CT集上回顾性生成体积调制弧线治疗（VMAT）方案。将三维（3D） FB和AVG图与相应的4D图进行比较，4D图采用10相图进行可变形配准。对于内靶体积（ITV）和计划靶体积（PTV），分别评价处方剂量36 Gy覆盖的体积（V36）和覆盖体积95%的剂量（D95）。比较FB和AVG两组正常肝脏相对体积（3D/4D）为19.2 Gy，肋骨相对体积为28.8 Gy。结果：FB与AVG的PTV内相对电子密度平均值略有差异（FB为1.050，AVG为1.039）。ITV和PTV的V36和D95在FB和AVG方案间差异无统计学意义，相对肋骨体积>28.8 Gy和正常肝脏体积>19.2 Gy在FB和AVG方案间差异无统计学意义。结论：对于脂醇滞留的肝脏SBRT，在XVMC算法精度下，基于FB和AVG图像的3D方案在产生4D累积剂量方面几乎相同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

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