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Internal Tumor Volume Motion and Volume Size Assessment Using 4D CT Lung Data

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I Jurkovic

I Jurkovic1*, S Stathakis2 , Y Li2 , A Patel2 , J Vincent2 , N Papanikolaou2 , P Mavroidis2 , (1) University of Texas Health Science Center at San Antonio, San Antonio, TX, (2) Cancer Therapy and Research Center University of Texas Health Sciences Center at San Antonio, San Antonio, TX


SU-E-J-79 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To assess internal tumor volume change through breathing cycle and associated tumor motion using the 4DCT data.

Methods: Respiration induced volume change through breathing cycle and associated motion was analyzed for nine patients that were scanned during the different respiratory phases. The examined datasets were the maximum and average intensity projections (MIP and AIP) and the 10 phases of the respiratory cycle. The internal target volume (ITV) was delineated on each of the phases and the planning target volume (PTV) was then created by adding setup margins to the ITV. Tumor motion through the phases was assessed using the acquired 4DCT dataset, which was then used to determine if the margins used for the ITV creation successfully encompassed the tumor in three dimensions.

Results: Results showed that GTV motion along the superior inferior axes was the largest in all the cases independent of the tumor location and/or size or the use of abdomen compression. The extent of the tumor motion was found to be connected with the size of the GTV. The smallest GTVs exhibited largest motion vector independent of the tumor location. The motion vector size varied through the phases depending on the tumor size and location and it was smallest for phases 20 and 30. The smaller the volume of the delineated GTV, the greater its volume difference through the different respiratory phases was. The average GTV volume change was largest for the phases 60 and 70.

Conclusion: Even if GTV is delineated using both AIP and MIP datasets, its motion extent will exceed the used margins especially for the very small GTV volumes. When the GTV size is less than 10 cc it is recommended to use fusion of the GTVs through all the phases to create the planning ITV.

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