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Related Experiment Video

Updated: Jun 26, 2026

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Published on: June 7, 2015

Do maximum intensity projection images truly capture tumor motion?

Kwangyoul Park¹, Long Huang, Havaleh Gagne

¹Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.

International Journal of Radiation Oncology, Biology, Physics

|January 17, 2009

Summary

Maximum intensity projection (MIP) accurately measures regular lung tumor motion but underestimates irregular motion. This finding is crucial for lung cancer treatment planning, especially with breathing variations.

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Area of Science:

Medical Imaging
Radiation Oncology
Radiotherapy Physics

Background:

Internal target volume (ITV) in lung cancer treatment is often determined using maximum intensity projection (MIP) images from four-dimensional computed tomography (4D-CT).
Accurate ITV determination is critical for effective radiotherapy, especially for targets exhibiting motion.

Purpose of the Study:

To evaluate the accuracy of MIP-based ITV determination for various target motions, particularly irregular movements.
To assess the reliability of MIP images in representing the true range of lung tumor motion during 4D-CT scans.

Main Methods:

Utilized a programmable dynamic lung phantom to simulate regular and irregular superior-inferior target motions.
Acquired 4D-CT helical scan data and analyzed reconstructed phase and MIP images using the Pinnacle 8.0 treatment planning system.

Main Results:

MIP accurately represented target motion within 2-3 mm for regular, periodic movements.
MIP systematically underestimated the true motion range by over 1 cm for irregular motions with varying amplitudes and periods.
The discrepancy between MIP-measured and real target motion decreased with faster target movement, attributed to phase-binning reconstruction algorithms.

Conclusions:

MIP is accurate for regular target motion but generally underestimates motion range during irregular breathing patterns.
Clinical application of MIP for ITV determination in lung cancer patients requires caution, particularly when breathing is irregular.
Further research may be needed to refine 4D-CT reconstruction algorithms for improved accuracy in irregular motion scenarios.