Lipiodol versus diaphragm in 4D-CBCT-guided stereotactic radiotherapy of hepatocellular carcinomas
| Autor: | Stewart Y. Tung, Venus Lee, G Law, Mark K. H. Chan, Hollis Luk, Oliver Blanck, Kwong Lok Siu, Francis A. S. Lee, Frank C.S. Wong, Chi-Leung Chiang, N. Y. Sin |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Cone beam computed tomography Carcinoma Hepatocellular medicine.medical_treatment Diaphragm Radiosurgery 030218 nuclear medicine & medical imaging 03 medical and health sciences Ethiodized Oil 0302 clinical medicine Fiducial Markers medicine Humans Radiology Nuclear Medicine and imaging Chemoembolization Therapeutic Four-Dimensional Computed Tomography Retrospective Studies business.industry Radiotherapy Planning Computer-Assisted Liver Neoplasms Cone-Beam Computed Tomography Combined Modality Therapy Diaphragm (structural system) Radiation therapy Oncology 030220 oncology & carcinogenesis Lipiodol Radiology Tomography business Fiducial marker Nuclear medicine medicine.drug |
| Zdroj: | Strahlentherapie und Onkologie. 192:92-101 |
| ISSN: | 1439-099X 0179-7158 |
| Popis: | The purpose of this work was to investigate the potential of lipiodol as a direct tumor surrogate alternative to the diaphragm surrogate on four-dimensional cone-beam computed tomography (4D-CBCT) image guidance for stereotactic radiotherapy of hepatocellular carcinomas. A total of 29 hepatocellular carcinomas (HCC) patients treated by stereotactic radiotherapy following transarterial chemoembolization (TACE) with homogeneous or partial defective lipiodol retention were included. In all, 4–7 pretreatment 4D-CBCT scans were selected for each patient. For each scan, either lipiodol or the diaphragm was used for 4D registration. Resulting lipiodol/diaphragm motion ranges and position errors relative to the reconstructed midventilation images were analyzed to obtain the motion variations, and group mean (ΔM), systematic (Σ), and random (σ) errors of the treatment setup. Of the lipiodolized tumors, 55 % qualified for direct localization on the 4D-CBCT. Significant correlations of lipiodol and diaphragm positions were found in the left–right (LR), craniocaudal (CC), and anteroposterior (AP) directions. ΔM and σ obtained with lipiodol and diaphragm were similar, agreed to within 0.5 mm in the LR and AP, and 0.3 mm in the CC directions, and Σ differed by 1.4 (LR), 1.1 (CC), and 0.6 (AP) mm. Variations of diaphragm motion range > 5 mm were not observed with lipiodol and in one patient with diaphragm. The margin required for the tumor prediction error using the diaphragm surrogate was 6.7 (LR), 11.7 (CC), and 4.1 (AP) mm. Image-guidance combining lipiodol with 4D-CBCT enabled accurate localization of HCC and thus margin reduction. A major limitation was the degraded lipiodol contrast on 4D-CBCT. |
| Databáze: | OpenAIRE |
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