Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer?
Purpose: Respiratory-induced tumor motion is a major challenge in lung cancer (LC) radiotherapy. Four-dimensional computed tomography (4D-CT) using a maximum intensity projection (MIP) dataset is a commonly used and time-efficient method to generate internal target volume (ITV). This study compared...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Medical Physics |
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| Online Access: | http://www.jmp.org.in/article.asp?issn=0971-6203;year=2021;volume=46;issue=2;spage=59;epage=65;aulast=Tibdewal |
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| author | Anil Tibdewal Sabheen Bushra Naveen Mummudi Rajesh Kinhikar Yogesh Ghadi Jai Prakash Agrawal |
| author_facet | Anil Tibdewal Sabheen Bushra Naveen Mummudi Rajesh Kinhikar Yogesh Ghadi Jai Prakash Agrawal |
| author_sort | Anil Tibdewal |
| collection | DOAJ |
| description | Purpose: Respiratory-induced tumor motion is a major challenge in lung cancer (LC) radiotherapy. Four-dimensional computed tomography (4D-CT) using a maximum intensity projection (MIP) dataset is a commonly used and time-efficient method to generate internal target volume (ITV). This study compared ITV delineation using MIP or tumor delineation on all phases of the respiratory cycle. Materials and Methods: Thirty consecutive patients of LC who underwent 4D-CT from January 2014 to March 2017 were included. ITV delineation was done using MIP (ITVMIP) and all ten phases of the respiratory cycle (ITV10Phases). Both volumes were analyzed using matching index (MI). It is the ratio of the intersection of two volumes to the union of two volumes. A paired sample t-test was used for statistical analysis, and P < 0.05 was considered statistically significant. Results: The mean ± standard deviation volume of ITV10Phases was significantly larger compared to ITVMIP (134 cc ± 39.1 vs. 113 cc ± 124.2, P = 0.000). The mean MI was 0.75 (range 0.57–0.88). The mean volume of ITV10Phases not covered by ITVMIP was 26.33 cc (23.5%) and vice versa was 5.51 cc (6.1%). The mean MI was 0.73 for tumors close to the mediastinum, chest wall, and diaphragm. MI was not different between tumors ≤5 cm and >5 cm. The average time required for delineation was 9 and 96 min, respectively. The center of mass of two ITVs differed by 0.01 cm. Conclusion: ITV using MIP is significantly smaller and may miss a tumor compared to ITV delineation in 10 phases of 4D-CT. However, the time required is significantly less with MIP. Caution should be exercised in tumors proximity to the mediastinum, chest wall, and diaphragm. |
| first_indexed | 2024-12-17T13:15:55Z |
| format | Article |
| id | doaj.art-a92a9afd2b364afe89729a93467fefdc |
| institution | Directory Open Access Journal |
| issn | 0971-6203 1998-3913 |
| language | English |
| last_indexed | 2024-12-17T13:15:55Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Medical Physics |
| spelling | doaj.art-a92a9afd2b364afe89729a93467fefdc2022-12-21T21:47:00ZengWolters Kluwer Medknow PublicationsJournal of Medical Physics0971-62031998-39132021-01-01462596510.4103/jmp.JMP_65_20Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer?Anil TibdewalSabheen BushraNaveen MummudiRajesh KinhikarYogesh GhadiJai Prakash AgrawalPurpose: Respiratory-induced tumor motion is a major challenge in lung cancer (LC) radiotherapy. Four-dimensional computed tomography (4D-CT) using a maximum intensity projection (MIP) dataset is a commonly used and time-efficient method to generate internal target volume (ITV). This study compared ITV delineation using MIP or tumor delineation on all phases of the respiratory cycle. Materials and Methods: Thirty consecutive patients of LC who underwent 4D-CT from January 2014 to March 2017 were included. ITV delineation was done using MIP (ITVMIP) and all ten phases of the respiratory cycle (ITV10Phases). Both volumes were analyzed using matching index (MI). It is the ratio of the intersection of two volumes to the union of two volumes. A paired sample t-test was used for statistical analysis, and P < 0.05 was considered statistically significant. Results: The mean ± standard deviation volume of ITV10Phases was significantly larger compared to ITVMIP (134 cc ± 39.1 vs. 113 cc ± 124.2, P = 0.000). The mean MI was 0.75 (range 0.57–0.88). The mean volume of ITV10Phases not covered by ITVMIP was 26.33 cc (23.5%) and vice versa was 5.51 cc (6.1%). The mean MI was 0.73 for tumors close to the mediastinum, chest wall, and diaphragm. MI was not different between tumors ≤5 cm and >5 cm. The average time required for delineation was 9 and 96 min, respectively. The center of mass of two ITVs differed by 0.01 cm. Conclusion: ITV using MIP is significantly smaller and may miss a tumor compared to ITV delineation in 10 phases of 4D-CT. However, the time required is significantly less with MIP. Caution should be exercised in tumors proximity to the mediastinum, chest wall, and diaphragm.http://www.jmp.org.in/article.asp?issn=0971-6203;year=2021;volume=46;issue=2;spage=59;epage=65;aulast=Tibdewalfour-dimensional computed tomography scaninternal target volumelung cancermaximum intensity projection |
| spellingShingle | Anil Tibdewal Sabheen Bushra Naveen Mummudi Rajesh Kinhikar Yogesh Ghadi Jai Prakash Agrawal Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer? Journal of Medical Physics four-dimensional computed tomography scan internal target volume lung cancer maximum intensity projection |
| title | Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer? |
| title_full | Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer? |
| title_fullStr | Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer? |
| title_full_unstemmed | Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer? |
| title_short | Is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer? |
| title_sort | is maximum intensity projection an optimal approach for internal target volume delineation in lung cancer |
| topic | four-dimensional computed tomography scan internal target volume lung cancer maximum intensity projection |
| url | http://www.jmp.org.in/article.asp?issn=0971-6203;year=2021;volume=46;issue=2;spage=59;epage=65;aulast=Tibdewal |
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