Abstract：Objective To investigate the impact of anatomical landmarks on registration in image-guided radiotherapy (IGRT) for central and peripheral lung cancer. Methods Twenty-five patients with central or peripheral lung cancer for IGRT were enrolled in this study. Kilo-voltage cone-beam CT (kV-CBCT) scanning was acquired before irradiotion. Tumor coverage on CBCT was assessed using gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV) contours according to tumor alignment, carina registration, and spine registration, respectively. The grading analysiswas based on visual tumor assessment as follows:grade 0, tumor within GTV;grade 1, tumor outside GTV but inside CTV;grade 2, tumor outside CTV but inside PTV;and grade 3, tumor outside PTV. Results Totally 177 sets of kV-CBCT of 25 patients was collected. According to the registration landmarks of the tumor, carina and spine for central lung cancer, the percentages were 57.55%, 53.77% and 16.04% in grade 0, 39.62%, 45.28% and 58.49% in grade 1, and 1.89%, 0.94% and 25.47% in grade 2, respectively. For peripheral lung cancer, the percentages were 47.89%, 14.08% and 2.82% in grade 0, 43.66%, 29.58% and 45.07% in grade 1, and 8.45%, 40.85% and 35.21% in grade 2, respectively. Conclusions For central lung cancer,the tumor was recommended as the best registration landmark, and the carina was recommended as well, while the spine was not recommended. For peripheral lung cancer, the tumor was recommended as the best registration landmark, while the spine and the carina were not recommended.
Zhang Yanxin,Hui Zhouguang,Li Minghui et al. Comparison of difference registration landmarks for image-guided radiotherapy for lung cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(5): 552-555.
[1] Jaffray DA, Siewerdsen JH, Wong JW, et al. Flat-panel cone-beam computed tomography for image-guide radiation therapy[J]. Int J Radiat Oncol Biol Phys,2002,53(5):1337-1349.DOI:10.1016/S0360-3016(02)02884-5. [2] Marks LB,Ma J.Challenges in the clinical application of advanced technologies to reduce radiation-associated normal tissue injury[J].Int J Radiat OncolBiol Phys,2007,69(1):4-12.DOI:10.1016/j.ijrobp.2007.05.010. [3] Guckenberger M.Image-guided radiotherapy based on kilo voltage cone-beam computed tomography-a review of technology and clinical outcome[J].Eur Oncol Haematolt,2011,7(2):121-124.DOI:10.17925/EOH.2011.07.02.121. [4] 龚洪翰,马大庆,李健丁,等.呼吸系统[A]//吴恩惠.医学影像诊断学[M].北京:人民卫生出版社,2001:510. [5] Lavoie C, Higgins J, Bissonnette JP, et al. Volumetric image guidance using carina vs. spine as registration landmarks for conventionally fractionated lung radiotherapy[J]. Int J Radiat Oncol Biol Phys,2012,84(3):1086-1092.DOI:10.1016/j.ijrobp.2012.02.012. [6] 孙文泽,宋丽萍,马军,等.图像引导下放射治疗中心型非小细胞肺癌配准范围、配准方式及靶区外放的研究[J].中南大学学报(医学版),2013,38(2):132-137.DOI:10.3969/j.issn.1672-7347.2013.02.004. [7] 梁军,张涛,张寅,等.肺癌锥形束CT图像不同配准方式的误差分析[J].中华放射肿瘤学杂志,2011,20(2):106-108.DOI:10.3760/cma.j.issn.1004-4221.2011.02.007. [8] Guckenberger M,Meyer J, Wilbert J, et al. Precision of image guided radiotherapy (IGRT) in six degrees of freedom and limitations in clinical practice[J].Strahlenther Onkol,2007,183(f6):307-313. [9] Higgins J, Bezjak A, Franks K, et al. Comparison of spine, carina,and tumor as registration landmarks for volumetric image-guided lung radiotherapy[J].Int J Radiat Onco Biol Phys,2009,73(5):1404-1413.DOI:10.1016/j.ijrobp.2008.06.1926. [10] 郝春成,葛晓峰,徐向英,等.肺癌影像引导下放疗图像配准标记点的研究[J].现代肿瘤学,2013,21(3):622-624.DOI:10.3969/j.issn.1672-4992.2013.03.56. [11] 王艳阳,傅小龙,夏冰,等.不同标记点对肺癌图像引导放疗图像配准结果的影响[J].中华放射肿瘤学杂志,2010,19(6):517-519.DOI:10.3760/cma.j.issn.1004-4221.2010.06.011. [12] Samson MJ,van Sornsen de Koste JR,de Boer Hc,et al An analysis of anatomic landmark mobility and setup deviations in radiotherapy for lung cancer[J].Int J Radiat Oncol Biol Phys,1999,43(4):827-832.DOI:10.1016/S0360-3016(98)00467-2.
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