Lung Dose for Minimally Moving Thoracic Lesions Treated With Respiration Gating

Ivaylo B Mihaylov, Mirek Fatyga, Eduardo G. Moros, Jose Penagaricano, Fritz A. Lerma

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To evaluate incidental doses to benign lung tissue for patients with minimally moving lung lesions treated with respiratory gating. Methods and Materials: Seventeen lung patient plans were studied retrospectively. Tumor motion was less than 5 mm in all cases. For each patient, mid-ventilation (MidVen) and mid-inhalation (MidInh) breathing phases were reconstructed. The MidInh phase was centered on the end-of-inhale (EOI) phase within a 30% gating window. Planning target volumes, heart, and spinal cord were delineated on the MidVen phase and transferred to the MidInh phase. Lungs were contoured separately on each phase. Intensity-modulated radiotherapy plans were generated on the MidVen phases. The plans were transferred to the MidInh phase, and doses were recomputed. The evaluation metric was based on dose indices, volume indices, generalized equivalent uniform doses, and mass indices for targets and critical structures. Statistical tests were used to establish the significance of the differences between the reference (MidVen) and compared (MidInh) dose distributions. Results: Statistical tests demonstrated that the indices evaluated for targets, cord, and heart differed by within 2.3%. The index differences in the lungs, however, are in excess of 6%, indicating the potentially achievable lung sparing and/or dose escalation. Conclusions: Respiratory gating is a clinical option for patients with minimally moving lung lesions treated at EOI. Gating will be more beneficial for larger tumors, since dose escalation in those cases will result in a larger increase in the tumor control probability.

Original languageEnglish (US)
Pages (from-to)285-291
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume77
Issue number1
DOIs
StatePublished - May 1 2010
Externally publishedYes

Fingerprint

respiration
lungs
lesions
Respiration
Thorax
Inhalation
ventilation
dosage
Lung
Ventilation
statistical tests
tumors
Intensity-Modulated Radiotherapy
Neoplasms
spinal cord
Cardiac Volume
breathing
planning
radiation therapy
Spinal Cord

Keywords

  • 4D
  • Dose
  • Gating
  • IMRT
  • Lung
  • Motion management

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Lung Dose for Minimally Moving Thoracic Lesions Treated With Respiration Gating. / Mihaylov, Ivaylo B; Fatyga, Mirek; Moros, Eduardo G.; Penagaricano, Jose; Lerma, Fritz A.

In: International Journal of Radiation Oncology Biology Physics, Vol. 77, No. 1, 01.05.2010, p. 285-291.

Research output: Contribution to journalArticle

Mihaylov, Ivaylo B ; Fatyga, Mirek ; Moros, Eduardo G. ; Penagaricano, Jose ; Lerma, Fritz A. / Lung Dose for Minimally Moving Thoracic Lesions Treated With Respiration Gating. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 77, No. 1. pp. 285-291.
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abstract = "Purpose: To evaluate incidental doses to benign lung tissue for patients with minimally moving lung lesions treated with respiratory gating. Methods and Materials: Seventeen lung patient plans were studied retrospectively. Tumor motion was less than 5 mm in all cases. For each patient, mid-ventilation (MidVen) and mid-inhalation (MidInh) breathing phases were reconstructed. The MidInh phase was centered on the end-of-inhale (EOI) phase within a 30{\%} gating window. Planning target volumes, heart, and spinal cord were delineated on the MidVen phase and transferred to the MidInh phase. Lungs were contoured separately on each phase. Intensity-modulated radiotherapy plans were generated on the MidVen phases. The plans were transferred to the MidInh phase, and doses were recomputed. The evaluation metric was based on dose indices, volume indices, generalized equivalent uniform doses, and mass indices for targets and critical structures. Statistical tests were used to establish the significance of the differences between the reference (MidVen) and compared (MidInh) dose distributions. Results: Statistical tests demonstrated that the indices evaluated for targets, cord, and heart differed by within 2.3{\%}. The index differences in the lungs, however, are in excess of 6{\%}, indicating the potentially achievable lung sparing and/or dose escalation. Conclusions: Respiratory gating is a clinical option for patients with minimally moving lung lesions treated at EOI. Gating will be more beneficial for larger tumors, since dose escalation in those cases will result in a larger increase in the tumor control probability.",
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