Analysis of the evaluation errors of dose-volume parameters for left ventricular myocardium in esophageal cancer radiotherapy
Tong Ying, Yin Yong, Lu Jie, Chen Jinhu, Liu Tonghai, Cheng Pinjing, Gong Guanzhong
School of Nuclear Science and Technology,University of South China,Hengyang 421001,China (Tong Y,Cheng PJ);Department of Radiation Physics,Shandong Cancer Hospital Affiliated to Shandong University,Ji′nan 250117,China (Yin Y,Lu J,Chen JH,Liu TH,Gong GZ)
Objective To evaluate the dynamic variation of the dose-volume parameters of the left ventricular myocardium following heart beat in radiotherapy for esophageal cancer. Methods The left ventricular myocardium of 22 patients was contoured on 20 phases (0%-95%) of electrocardiography (ECG) gated heart 4DCT images. The radiotherapy plan was designed on the simulation CT images,and then the dose distribution of radiotherapy plan was imported into MIM Maestro system and 4D dose-volume histogram (DVH) was reconstructed. The variations of position,volume and dice similarity coefficient (DSC) of the left ventricular myocardium were analyzed. The changing ranges of Dmean,V10,V20,V30 and V40 of the left ventricular myocardium during different phases were statistically compared. Results (1) The biggest displacement of the left ventricular myocardium was in Y axes. The maximum variation rate of volume and DSC of the left ventricular myocardium were (24.23±11.35)% and (184.33±128.61)% in different phases with statistical significance (both P<0.05).(2) The maximum variation rate of Dmean of the left ventricular myocardium was (87.05±38.34)% in different phases with the highest rate of 163.52% with statistical significance (P<0.05).(3) The maximum variation values of V10,V20,V30 and V40 of the left ventricular myocardium were (13.64±4.33)%,(12.84±4.55)%,(11.62±4.85)% and (3.63±2.56)% with statistical significance (all P<0.05). Conclusions The impact of heart beat on the dose-volume parameters of the left ventricular myocardium should be considered during esophageal cancer radiotherapy. Traditional static 3DCT-based assessment of the dose-volume parameters of the left ventricular myocardium can yield relatively large errors,which is probably reduces the prediction efficiency of the dose-volume parameters for radiation-induced heart injury.
Tong Ying,Yin Yong,Lu Jie et al. Analysis of the evaluation errors of dose-volume parameters for left ventricular myocardium in esophageal cancer radiotherapy[J]. Chinese Journal of Radiation Oncology, 2018, 27(9): 830-834.
[1] Gagliardi G,Constine LS,Moiseenko V,et al. Radiation dose-volume effects in the heart[J].Int J Radiat Oncol Biol Phys,2010,76(3):S77-85.DOI:10.1016/j.ijrobp.2009.04.093.
[2] Kole TP,Aghayere O,Kwah J,et al. Comparison of heart and coronary artery doses associated with intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for distal esophageal cancer[J].Int J Radiat Oncol Biol Phys,2012,83(5):1580-1586.DOI:10.1016/j.ijrobp.2011.10.053.
[3] Mast ME,Kempen-Harteveld LV,Heijenbrok MW,et al. Left-sided breast cancer radiotherapy with and without breath-hold:Does IMRT reduce the cardiac dose even further?[J].Radiother Oncol,2013,108(2):248-253.DOI:10.1016/j.radonc.2013.07.017.
[4] Duane F,Aznar MC,Bartlett F,et al. A cardiac contouring atlas for radiotherapy[J].Radiother Oncol,2017,122(3):416-422.DOI:10.1016/j.radonc.2017.01.008.
[5] Wollschläger D,Karle H,Stockinger M,et al. Radiation dose distribution in functional heart regions from tangential breast cancer radiotherapy[J].Radiother Oncol,2016,119(1):65-70.DOI:10.1016/j.radonc.2016.01.020.
[6] 张琴,杨苏萍,张雅莉.放射性心脏损伤的发病机理及其无创性检查的研究进展[J].中国临床新医学,2011,4(3):281-285.DOI:10.3969/j.issn.1674-3806.2011.03.35.
Zhang Q,Yang SP,Zhang YL.Research progress on pathogenesis of radiation-induced heart disease and its noninvasive examination[J].Chin J New Clin Med,2011,4(3):281-285.DOI:10.3969/j.issn.1674-3806.2011.03.35.
[7] 范风云,石梅,张丙芳.放射性心脏损伤及防护的研究进展[J].心脏杂,2006,18(6):721-723.DOI:10.3969/j.issn.1009-7236.2006.06.037
Fan FY,Shi M,Zhang BF.Research progress of radiation induced heart disease and protection[J].Chin Heart J,2006,18(6):721-723.DOI:10.3969/j.issn.1009-7236.2006.06.037
[8] Tan W,Wang X,Qiu D,et al. Dosimetric comparison of intensity-modulated radiotherapy plans,with or without anterior myocardial territory and left ventricle as organs at risk,in early-stage left-sided breast cancer patients[J].Int J Radiat Oncol Biol Phys,2011,81(5):1544-1551.DOI:10.1016/j.ijrobp.2010.09.028.
[9] Nolan MT,Russell DJ,Marwick TH.Long-term risk of heart failure and myocardial dysfunction after thoracic radiotherapy:a systematic review[J].Can J Cardiol,2015,32(7):908-920.DOI:10.1016/j.cjca.2015.12.020.
[10] Çiçek G,ÖuçarE,Kanat S,et al. Early effect of radiotherapy on left ventricular functions[J].Am J Cardiol,2014,113(7):S70-S71.DOI:10.1016/j.amjcard.2014.01.193.
[11] Folgar-Torres A,Alvarado-Astudillo A,Feltes N,et al. Anterior left ventricular territory:true OAR in left breast radiotherapy[J].Rep Pract Oncol Radiother,2013,18(Suppl 1):S166-S167.DOI:10.1016/j.rpor.2013.03.076.
[12] Evans ES,Prosnitz RG,Yu X,et al. Impact of patient-specific factors,irradiated left ventricular volume,and treatment set-up errors on the development of myocardial perfusion defects after radiation therapy for left-sided breast cancer[J].Int J Radiat Oncol Biol Phys,2006,66(4):1125-1134.DOI:10.1016/j.ijrobp.2006.06.025.
[13] Nalbantov G,Ruysscher DD,Vandecasteele K,et al. OC-0501 Irradiation of the left ventricle of the heart is correlated with post-treatment dyspnea in nsclc patients[J].Radiother Oncol,2012,103(Suppl 1):S201-S202.DOI:10.1016/S0167-8140(12)70840-X.
[14] Kataria T,Bisht SS,Gupta D,et al. Quantification of coronary artery motion and internal risk volume from ECG gated radiotherapy planning scans[J].Radiother Oncol,2016,121(1):59-63.DOI:10.1016/j.radonc.2016.08.006.
[15] Piper J.Evaluation of an intensity-based free-form deformable registration algorithm[J].Med Phys,2007,34(6):2353-2354.DOI:10.1118/1.2760445.
2018, Vol. 27 
