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Establishment and verification of a displacement model for the solitary pulmonary lesion based on 4D-CT technology
Shang Dongping, Wang Min, Duan Jinghao, Yu Jinming, Yin Yong
Department of Radiation Oncology,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences,Ji'nan 250117, China
AbstractObjective To measure the displacement of the solitary pulmonary lesion (SPL) located in different pulmonary segments based on 4D-CT technology (4DCT) and to establish and verify a relevant mathematical model of tumor displacement. Methods The modeling samples of 290 SPLs were subject to both 4DCT and active breath control (ABC) spiral CT scans. The tumor displacement in different pulmonary segments was measured based on 4DCT images. The tumor volume was obtained by contouring the gross tumor volume (GTV) on ABC spiral CT images. The diaphragm movement was measured by X-ray simulator. The vital capacity and tidal volume were gained by pneumatometer. The baseline data, such as gender, age, height, weight, respiratory rate, and tumor lobe and segment where tumors were located, were collected. Multivariate linear regression was used to analyze the correlation between the 3D-tumor displacement and gender, age, height, weight, respiratory rate, tumor location, volume and diaphragm movement. The displacement model was established based on the modeling sample of 290 cases. Then,it was verified by comparing the tumor displacement derived from the model with that of 4DCT technology based on the randomly selected 17 SPLs. Results The displacement model for tumors located in the upper lobe was established as Xup=-0.267+0.002TV+0.446DM, Yup=-1.704+0.004TV+0.725DM+2.250SII+1.349SIII and Zup=0.043+0.626DM+0.599SII+0.519SIII. The displacement model of the middle lobe tumors was Xmid=0.539+0.758DM, Ymid=-2.316+2.707DM+0.009TV and Zmid=0.717+1.112DM. The displacement model for tumors located in the lower lobe was Xlow=-0.425+0.004TV+0.857DM,Ylow=4.691+4.817DM+0.005TV-0.307RR+3.148SIX+2.655SX and Zlow=0.177+0.003TV+0.908DM.(DM:diaphragm movement, TV:tidal volume, RR:respiratory rate, SII:posterior segment, SIII:anterior segment, SIX:lateral basal segment, SX:posterior basal segment). There was no significant difference between two results derived from the displacement model and 4DCT technology.(P>0.05). Conclusions The diaphragm movement and tidal volume are the main influencing factors of 3D lung tumor displacement. The tumor displacement in the superior-inferior direction is correlated with different pulmonary segments of the upper and lower lobes. The displacement of tumors located in different segments of middle lobes is similar. The displacement model can predict the displacement of SPLs located in different lobes, providing reference for individualized delineation of PTV.
Shang Dongping,Wang Min,Duan Jinghao et al. Establishment and verification of a displacement model for the solitary pulmonary lesion based on 4D-CT technology[J]. Chinese Journal of Radiation Oncology, 2020, 29(6): 472-476.
Shang Dongping,Wang Min,Duan Jinghao et al. Establishment and verification of a displacement model for the solitary pulmonary lesion based on 4D-CT technology[J]. Chinese Journal of Radiation Oncology, 2020, 29(6): 472-476.
[1] Wang L, Hayes S, Paskalev K, et al. Dosimetric comparison of stereotactic body radiotherapy using 4DCT and multiphase CT images for treatment planning of lung cancer:evaluation of the impact on daily dose coverage[J]. Radiother Oncol, 2009, 91(3):314-324. DOI:10.1016/j.radonc.2008.11.018. [2] Dou TH, Thomas DH, O′connell DP, et al. A method for assessing ground-truth accuracy of the 5DCT technique[J]. Int J Radiat Oncol Biol Phys, 2015, 93(4):925-933. DOI:10.1016/j.ijrobp.2015.07.2272. [3] Shang D, Yue J, Li J, et al. Comparison of the different width detector on the GTV delineation of the solitary pulmonary lesion[J]. J Can Res Ther, 2017, 13(4):693-698. DOI:10.4103/jcrt. JCRT.1448.16. [4] Susan S. Gray′s anatomy:the anatomical basis of clinical practice[M].41st ed. Edinburgh:Elsevier churchill, 2017:953-969. [5] 戚焕鹏, 李建彬, 张英杰, 等. 基于自主呼吸控制三维CT分析周围型肺癌四维CT各时相大体肿瘤体积伪影[J]. 中华放射肿瘤学杂志, 2012, 21(6):508-512. DOI:10.3760/cma.j.issn.1004-4 221.2012.06.007. [6] Rodriguez-Romero R, Castro-Tejero P. The influence of respiratory motion on CT image volume definition[J]. Med Phys, 2014, 41(4):041701. DOI:10.1118/1.4866889. [7] Kumar AS, Singh IR, Sharma SD, et al. Radiation dose measurements during kilovoltage-cone beam computed tomography imaging in radiotherapy[J]. J Cancer Res Ther, 2016, 12(2):858-863. DOI:10.4103/0973-1482.164699. [8] Dieleman EM, Senan S, Vincent A, et al. Four-dimensional computed tomographic analysis of esophageal mobility during normal respiration[J]. Int J Radiat Oncol Biol Phys, 2007, 67(3):775-780. DOI:10.1016/j.ijrobp.2006.09.054. [9] 陈少卿, 于金明, 尹勇, 等. PET用于勾画生物靶区的呼吸运动体模研究[J]. 中华肿瘤防治杂志, 2007, 14(7):548-550. DOI:1673-5269.2007-0548-03. [10] 曹永珍, 黑月林, 吕仲红, 等. 立体定向放疗中肿瘤和膈肌运动的研究[J]. 中华放射肿瘤学杂志, 2000, 9(4):262-265. DOI:10.3760/j.issn.1004-4221.2000.04.012. [11] Weiss E, Wijesooriya K, Dill SV, et al. Tumor and normal tissue motion in the thorax during respiration:analysis of volumetric and positional variations using 4DCT[J]. Int J Radiat Oncol Biol Phys, 2007, 67(1):296-307. DOI:10.1016/j.ijrobp.2006.09.009. [12] 张英杰, 李建彬, 田世雨, 等. 基于四维CT对肺癌原发灶位移和体积变化相关性研究[J]. 中华放射肿瘤学杂志, 2011, 20(6):513-516. DOI:10.3760/cma.j.issn.1004-4221.2011.06.019. [13] Britton KR, Starkschall G, Tucker SL, et al. Assessment of gross tumor volume regression and motion changes during radiotherapy for non-small-cell lung cancer as measured by four-dimensional computed tomography[J]. Int J Radiat Oncol Biol Phys, 2007, 68(4):1036-46. DOI:10.1016/j.ijrobp.2007.01.021.: [14] 李奉祥,李建彬,张英杰, 等. 基于3DCT与4DCT定义的非小细胞肺癌计划靶区的比较[J]. 中华放射医学与防护杂志, 2011, 31(2):200-204. DOI:10.3760/cma.j.issn.0254-5098.2011.02.022. [15] 鞠潇, 周宗玫, 李明辉, 等. 应用四维CT评价大体肿瘤体积随呼吸运动的位移及影响因素[J]. 中华放射肿瘤学杂志, 2011, 20(3):198-201. DOI:10.3760/cma.j.issn.1004-4221.2011.03.008