Rishabh Kumar, Anil Gupta, Bhaskar Vishwanathan, Rose Kamal, Deepak Thaper
{"title":"全阶段 ITV（内部靶体积）是肝细胞癌目标定义的金标准吗？","authors":"Rishabh Kumar, Anil Gupta, Bhaskar Vishwanathan, Rose Kamal, Deepak Thaper","doi":"10.1002/acm2.14532","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Stereotactic ablative body radiation (SABR) is a well-recognized treatment option for hepatocellular carcinoma (HCC). Due to the inherent motion of liver tumors, effective motion management is crucial for successful SABR. In the motion-encompassing motion management technique, all 10 respiratory phase image datasets are delineated and designated as the internal target volume (ITV). Some treatment centers use single or combination image sets to delineate the target volume. This study determines which specialty image set most closely matches an all-phase ITV contour on a synchronized contrast-enhanced 4DCT.</p>\n </section>\n \n <section>\n \n <h3> Materials and methods</h3>\n \n <p>Synchronized 4DCT contrast and delayed scans were acquired for 10 patients in the study. The maximum intensity projection (MiP), average intensity projection (AvgIP), and minimum intensity projection (MinIP) images were generated. The ITV delineation was done in all 10 phases (ITV_all_phase). The ITV_2phase combines the peak inhale and exhale phase, ITV_2 M combines MiP and MinIP, and ITV_3 M combines MiP, MinIP, and AvgIP. All ITVs were compared to ITV_all_phase with Dice similarity index (DSI) and volumes.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Using ITV_all_phase as the reference, the DSI and the mean ITV volumes for the different ITVs were as follows: ITV_all_phase (1 and 116.69 cc), ITV_2phase (0.87 and 105.27 cc), MiP (0.76 and 98.24 cc), AvgIP (0.72 and 94.54 cc), ITV_MinIP (0.67 and 81.08 cc), ITV_2 M (0.84 and 106.26 cc), and ITV_3 M (0.86 and 112.51 cc).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The study demonstrates that in the motion-encompassing technique of motion management, the target volume generated by delineating all phases of 4DCT provides the most accurate representation for patients with HCC. Specialty image sets and their combinations, while sometimes close, tend to result in less accurate targeting. Hence, the all-phase 4DCT method should be preferred to avoid geographical misses and ensure optimal treatment outcomes. However, our conclusion may be limited by the technique we employed.</p>\n </section>\n </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"25 12","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.14532","citationCount":"0","resultStr":"{\"title\":\"Is an all-phase ITV (internal target volume) a gold standard in the target definition of hepatocellular carcinoma?\",\"authors\":\"Rishabh Kumar, Anil Gupta, Bhaskar Vishwanathan, Rose Kamal, Deepak Thaper\",\"doi\":\"10.1002/acm2.14532\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Stereotactic ablative body radiation (SABR) is a well-recognized treatment option for hepatocellular carcinoma (HCC). Due to the inherent motion of liver tumors, effective motion management is crucial for successful SABR. In the motion-encompassing motion management technique, all 10 respiratory phase image datasets are delineated and designated as the internal target volume (ITV). Some treatment centers use single or combination image sets to delineate the target volume. This study determines which specialty image set most closely matches an all-phase ITV contour on a synchronized contrast-enhanced 4DCT.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials and methods</h3>\\n \\n <p>Synchronized 4DCT contrast and delayed scans were acquired for 10 patients in the study. The maximum intensity projection (MiP), average intensity projection (AvgIP), and minimum intensity projection (MinIP) images were generated. The ITV delineation was done in all 10 phases (ITV_all_phase). The ITV_2phase combines the peak inhale and exhale phase, ITV_2 M combines MiP and MinIP, and ITV_3 M combines MiP, MinIP, and AvgIP. All ITVs were compared to ITV_all_phase with Dice similarity index (DSI) and volumes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Using ITV_all_phase as the reference, the DSI and the mean ITV volumes for the different ITVs were as follows: ITV_all_phase (1 and 116.69 cc), ITV_2phase (0.87 and 105.27 cc), MiP (0.76 and 98.24 cc), AvgIP (0.72 and 94.54 cc), ITV_MinIP (0.67 and 81.08 cc), ITV_2 M (0.84 and 106.26 cc), and ITV_3 M (0.86 and 112.51 cc).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The study demonstrates that in the motion-encompassing technique of motion management, the target volume generated by delineating all phases of 4DCT provides the most accurate representation for patients with HCC. 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Is an all-phase ITV (internal target volume) a gold standard in the target definition of hepatocellular carcinoma?
Background
Stereotactic ablative body radiation (SABR) is a well-recognized treatment option for hepatocellular carcinoma (HCC). Due to the inherent motion of liver tumors, effective motion management is crucial for successful SABR. In the motion-encompassing motion management technique, all 10 respiratory phase image datasets are delineated and designated as the internal target volume (ITV). Some treatment centers use single or combination image sets to delineate the target volume. This study determines which specialty image set most closely matches an all-phase ITV contour on a synchronized contrast-enhanced 4DCT.
Materials and methods
Synchronized 4DCT contrast and delayed scans were acquired for 10 patients in the study. The maximum intensity projection (MiP), average intensity projection (AvgIP), and minimum intensity projection (MinIP) images were generated. The ITV delineation was done in all 10 phases (ITV_all_phase). The ITV_2phase combines the peak inhale and exhale phase, ITV_2 M combines MiP and MinIP, and ITV_3 M combines MiP, MinIP, and AvgIP. All ITVs were compared to ITV_all_phase with Dice similarity index (DSI) and volumes.
Results
Using ITV_all_phase as the reference, the DSI and the mean ITV volumes for the different ITVs were as follows: ITV_all_phase (1 and 116.69 cc), ITV_2phase (0.87 and 105.27 cc), MiP (0.76 and 98.24 cc), AvgIP (0.72 and 94.54 cc), ITV_MinIP (0.67 and 81.08 cc), ITV_2 M (0.84 and 106.26 cc), and ITV_3 M (0.86 and 112.51 cc).
Conclusion
The study demonstrates that in the motion-encompassing technique of motion management, the target volume generated by delineating all phases of 4DCT provides the most accurate representation for patients with HCC. Specialty image sets and their combinations, while sometimes close, tend to result in less accurate targeting. Hence, the all-phase 4DCT method should be preferred to avoid geographical misses and ensure optimal treatment outcomes. However, our conclusion may be limited by the technique we employed.
期刊介绍：
Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission.
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