Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume
Abstract Background Radiotherapy of gastric mucosa-associated lymphoid tissue (MALT) lymphoma should be delivered to the entire stomach with planning target volume (PTV) that accounts for variations in stomach volume, respiratory movement, and patient set-up error. In this study, we evaluated whethe...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-020-01734-w |
| _version_ | 1828949890608136192 |
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| author | Yoshinobu Shimohigashi Ryo Toya Tetsuo Saito Yumiko Kono Yasuhiro Doi Yoshiyuki Fukugawa Takahiro Watakabe Tadashi Matsumoto Yudai Kai Masato Maruyama Natsuo Oya |
| author_facet | Yoshinobu Shimohigashi Ryo Toya Tetsuo Saito Yumiko Kono Yasuhiro Doi Yoshiyuki Fukugawa Takahiro Watakabe Tadashi Matsumoto Yudai Kai Masato Maruyama Natsuo Oya |
| author_sort | Yoshinobu Shimohigashi |
| collection | DOAJ |
| description | Abstract Background Radiotherapy of gastric mucosa-associated lymphoid tissue (MALT) lymphoma should be delivered to the entire stomach with planning target volume (PTV) that accounts for variations in stomach volume, respiratory movement, and patient set-up error. In this study, we evaluated whether the use of four-dimensional cone-beam computed tomography (4D-CBCT) reduces the PTV. Methods Eight patients underwent radiotherapy with 15 fractions of gastric MALT lymphoma using 4D-CBCT. PTV structures of 5–30 mm margins (5 mm intervals) from the clinical target volume (CTV) delineated based on the 4D-CT images (CTV-4D) were generated. For the target localization, we performed matching based on skin marking (skin matching), bone anatomy (bone matching), and stomach anatomy (4D soft-tissue matching) based on registration between planning CT and 4D-CBCT images from 10 phases. For each patient, we calculated the covering ratio (CR) of the stomach with variable PTV structures, based on the 4D-CBCT images, with a total of 150 phases [CR (%) = (number of covering phases/150 phases) × 100], for three target localization methods. We compared the CR values of the different target localization methods and defined the PTV with an average CR of ≥ 95% for all patients. Results The average CR for all patients increased from 17.9 to 100%, 19.6 to 99.8%, and 33.8 to 100%, in the skin, bone, and 4D soft-tissue matchings, respectively, as the PTV structures increased from 5 to 30 mm. The CR obtained by 4D soft-tissue matching was superior to that obtained by skin (P = 0.013) and bone matching (P = 0.008) for a PTV structure of 15 mm margin. The PTV required an additional margin of 20 mm (average CR: 95.2%), 25 mm (average CR: 99.1%), and 15 mm (average CR: 98.0%) to CTV-4D for the skin, bone, and 4D soft-tissue matchings, respectively. Conclusions This study demonstrates that the use of 4D-CBCT reduces the PTV when applying 4D soft-tissue matching, compared to skin and bone matchings. Additionally, bone matching does not reduce the PTV as compared with traditional skin matching. |
| first_indexed | 2024-12-14T06:14:23Z |
| format | Article |
| id | doaj.art-630351d9b24147149086c7abb47eb9c6 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-14T06:14:23Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-630351d9b24147149086c7abb47eb9c62022-12-21T23:14:04ZengBMCRadiation Oncology1748-717X2021-01-011611710.1186/s13014-020-01734-wImpact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volumeYoshinobu Shimohigashi0Ryo Toya1Tetsuo Saito2Yumiko Kono3Yasuhiro Doi4Yoshiyuki Fukugawa5Takahiro Watakabe6Tadashi Matsumoto7Yudai Kai8Masato Maruyama9Natsuo Oya10Department of Radiological Technology, Kumamoto University HospitalDepartment of Radiation Oncology, Kumamoto University HospitalDepartment of Radiation Oncology, Kumamoto University HospitalDepartment of Radiological Technology, Kumamoto University HospitalDepartment of Radiological Technology, Kumamoto University HospitalDepartment of Radiation Oncology, Kumamoto University HospitalDepartment of Radiation Oncology, Kumamoto University HospitalDepartment of Radiation Oncology, Kumamoto University HospitalDepartment of Radiological Technology, Kumamoto University HospitalDepartment of Radiological Technology, Kumamoto University HospitalDepartment of Radiation Oncology, Kumamoto University HospitalAbstract Background Radiotherapy of gastric mucosa-associated lymphoid tissue (MALT) lymphoma should be delivered to the entire stomach with planning target volume (PTV) that accounts for variations in stomach volume, respiratory movement, and patient set-up error. In this study, we evaluated whether the use of four-dimensional cone-beam computed tomography (4D-CBCT) reduces the PTV. Methods Eight patients underwent radiotherapy with 15 fractions of gastric MALT lymphoma using 4D-CBCT. PTV structures of 5–30 mm margins (5 mm intervals) from the clinical target volume (CTV) delineated based on the 4D-CT images (CTV-4D) were generated. For the target localization, we performed matching based on skin marking (skin matching), bone anatomy (bone matching), and stomach anatomy (4D soft-tissue matching) based on registration between planning CT and 4D-CBCT images from 10 phases. For each patient, we calculated the covering ratio (CR) of the stomach with variable PTV structures, based on the 4D-CBCT images, with a total of 150 phases [CR (%) = (number of covering phases/150 phases) × 100], for three target localization methods. We compared the CR values of the different target localization methods and defined the PTV with an average CR of ≥ 95% for all patients. Results The average CR for all patients increased from 17.9 to 100%, 19.6 to 99.8%, and 33.8 to 100%, in the skin, bone, and 4D soft-tissue matchings, respectively, as the PTV structures increased from 5 to 30 mm. The CR obtained by 4D soft-tissue matching was superior to that obtained by skin (P = 0.013) and bone matching (P = 0.008) for a PTV structure of 15 mm margin. The PTV required an additional margin of 20 mm (average CR: 95.2%), 25 mm (average CR: 99.1%), and 15 mm (average CR: 98.0%) to CTV-4D for the skin, bone, and 4D soft-tissue matchings, respectively. Conclusions This study demonstrates that the use of 4D-CBCT reduces the PTV when applying 4D soft-tissue matching, compared to skin and bone matchings. Additionally, bone matching does not reduce the PTV as compared with traditional skin matching.https://doi.org/10.1186/s13014-020-01734-wMalignant lymphomaMucosa-associated lymphoid tissue lymphomaFour-dimensional computed tomographyFour-dimensional cone-beam computed tomographyImage-guided radiotherapyPlanning target volume |
| spellingShingle | Yoshinobu Shimohigashi Ryo Toya Tetsuo Saito Yumiko Kono Yasuhiro Doi Yoshiyuki Fukugawa Takahiro Watakabe Tadashi Matsumoto Yudai Kai Masato Maruyama Natsuo Oya Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume Radiation Oncology Malignant lymphoma Mucosa-associated lymphoid tissue lymphoma Four-dimensional computed tomography Four-dimensional cone-beam computed tomography Image-guided radiotherapy Planning target volume |
| title | Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume |
| title_full | Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume |
| title_fullStr | Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume |
| title_full_unstemmed | Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume |
| title_short | Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume |
| title_sort | impact of four dimensional cone beam computed tomography on target localization for gastric mucosa associated lymphoid tissue lymphoma radiotherapy reducing planning target volume |
| topic | Malignant lymphoma Mucosa-associated lymphoid tissue lymphoma Four-dimensional computed tomography Four-dimensional cone-beam computed tomography Image-guided radiotherapy Planning target volume |
| url | https://doi.org/10.1186/s13014-020-01734-w |
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