Adaptive radiotherapy based on contrast enhanced cone beam CT imaging
Aste Søvik1, Jan Rødal, Hege K Skogmo
1Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, Oslo, Norway. aste.sovik@nvh.no
Acta Oncologica (Stockholm, Sweden)
|September 14, 2010
Summary
Contrast-enhanced cone beam CT (CECBCT) improves tumor visualization for adaptive radiotherapy. CECBCT-guided adaptation strategies significantly enhance treatment outcomes compared to non-adaptive approaches.
Area of Science:
- Medical Imaging
- Radiation Oncology
- Oncology
Background:
- Cone beam CT (CBCT) is crucial for radiation therapy patient setup, typically using bony anatomy for co-registration.
- Limited soft tissue contrast in CBCT hinders accurate tumor localization for treatment adaptation.
- Contrast-enhanced CBCT (CECBCT) offers potential for improved tumor visualization.
Observation:
- A canine maxillary tumor model underwent fractionated radiotherapy with repeated CBCT and CECBCT imaging.
- Iodinated contrast agent enabled clear tumor visualization in subtraction images.
- Gross tumor volumes were delineated using CECBCT data for adaptive IMRT planning.
Findings:
- Fully adaptive planning based on CECBCT (Strategy 1) yielded the highest tumor control probability (TCP) and doses closest to prescription.
- Adaptive strategies using CECBCT for repositioning (Strategy 3) showed improved outcomes over bony anatomy-based repositioning (Strategy 2).
- Non-adaptive treatment (Strategy 4) was significantly inferior to all adaptive strategies.
Implications:
- CECBCT is a valuable tool for enhancing tumor visualization in adaptive radiotherapy.
- Adaptive strategies, particularly those utilizing CECBCT for target delineation and repositioning, can optimize radiation therapy efficacy.
- Further benefits are anticipated with increased tumor mobility or deformation during treatment.
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