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Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System
Published on: April 11, 2018
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CT ventilation functional image-based IMRT treatment plans are comparable to SPECT ventilation functional image-based
Satoshi Kida1, Matthieu Bal2, Sven Kabus3
1Department of Radiation Oncology, University of California Davis, Sacramento, USA; Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan.
Summary
Computed tomography (CT) ventilation imaging shows promise as a substitute for single-photon emission CT (SPECT) ventilation in radiotherapy planning. This approach helps avoid irradiating healthy lung regions, improving treatment accuracy for thoracic cancers.
Area of Science:
- Radiation oncology
- Medical imaging
- Pulmonary function assessment
Background:
- Intensity-modulated radiation therapy (IMRT) planning for thoracic cancers often uses anatomic information.
- Functional imaging can identify highly-aerated lung regions to spare during treatment.
- Single-photon emission CT (SPECT) ventilation imaging is a current standard for functional guidance.
Purpose of the Study:
- To compare CT ventilation functional image-based IMRT plans with SPECT ventilation functional image-based IMRT plans.
- To determine if CT ventilation imaging can effectively guide IMRT by avoiding irradiation of functional lung regions.
- To assess the comparability of IMRT plans generated using CT ventilation versus SPECT ventilation.
Main Methods:
- Three IMRT plans were created for eight thoracic cancer patients: one using CT ventilation, one using SPECT ventilation, and one using only anatomic data.
- CT ventilation images were generated using deformable image registration of 4D-CT datasets.
- Plan metrics were analyzed to compare CT-functional and SPECT-functional plans against anatomic plans and against each other.
Main Results:
- A strong correlation was observed between plan metric deviations from anatomic plans for both CT-functional (ΔCT-anatomic) and SPECT-functional (ΔSPECT-anatomic) plans (R=0.94).
- Average differences between CT-functional and SPECT-functional plan metrics were minimal (mostly <1%), with 95% limits of agreement mostly <2%.
- These findings indicate good agreement between the two functional imaging modalities for IMRT planning.
Conclusions:
- CT ventilation functional image-based IMRT plans demonstrate reasonable agreement with SPECT ventilation functional image-based plans.
- CT ventilation imaging shows potential as a surrogate for SPECT ventilation in functional image-guided radiotherapy.
- This suggests CT ventilation imaging can be utilized for precise IMRT planning in thoracic cancer treatment.
