Mirjana Josipovic1,2, Gitte F Persson1, Jens P Bangsgaard1, Lena Specht1,3, Marianne C Aznar1,2,3. 1. 1 Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen, Denmark. 2. 2 Niels Bohr Institute, Faculty of Science, University of Copenhagen, Copenhagen, Denmark. 3. 3 Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free-breathing (FB) RT had an additional CBCT in DIBH at three fractions. These CBCT scans were offline rigidly registered (on tumour) to FB and DIBH CT scans acquired at planning. All registrations were repeated to evaluate the intraobserver uncertainty. CBCT scans were scored on degree of streak artefacts and visualization of tumour and anatomical structures. We examined the impact of tumour baseline shift between consecutive DIBHs on CBCT image quality. RESULTS: CBCT scans from 15 patients were analysed. Intraobserver image registration uncertainty was approximately 2 mm in both FB and DIBH, except for the craniocaudal direction in FB, where it was >3 mm. On the 31st fraction, the intraobserver uncertainty increased compared with the second fraction. This increase was more pronounced in FB. Image quality scores improved in DIBH compared with FB for all parameters in all patients. Simulated tumour baseline shifts ≤2 mm did not affect the CBCT image quality considerably. CONCLUSION: DIBH CBCT improved image quality and reduced registration uncertainty in the craniocaudal direction in image-guided RT of locally advanced lung cancer. Baseline shifts ≤2 mm in DIBH during CBCT acquisition did not affect image quality. Advances in knowledge: DIBH RT has dosimetric advantages over FB; this work demonstrates an additional benefit of DIBH in terms of registration accuracy because of improved image quality.
OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS:Patients treated with daily cone beam CT (CBCT)-guided free-breathing (FB) RT had an additional CBCT in DIBH at three fractions. These CBCT scans were offline rigidly registered (on tumour) to FB and DIBH CT scans acquired at planning. All registrations were repeated to evaluate the intraobserver uncertainty. CBCT scans were scored on degree of streak artefacts and visualization of tumour and anatomical structures. We examined the impact of tumour baseline shift between consecutive DIBHs on CBCT image quality. RESULTS: CBCT scans from 15 patients were analysed. Intraobserver image registration uncertainty was approximately 2 mm in both FB and DIBH, except for the craniocaudal direction in FB, where it was >3 mm. On the 31st fraction, the intraobserver uncertainty increased compared with the second fraction. This increase was more pronounced in FB. Image quality scores improved in DIBH compared with FB for all parameters in all patients. Simulated tumour baseline shifts ≤2 mm did not affect the CBCT image quality considerably. CONCLUSION:DIBH CBCT improved image quality and reduced registration uncertainty in the craniocaudal direction in image-guided RT of locally advanced lung cancer. Baseline shifts ≤2 mm in DIBH during CBCT acquisition did not affect image quality. Advances in knowledge: DIBH RT has dosimetric advantages over FB; this work demonstrates an additional benefit of DIBH in terms of registration accuracy because of improved image quality.
Authors: Jean-Pierre Bissonnette; Peter A Balter; Lei Dong; Katja M Langen; D Michael Lovelock; Moyed Miften; Douglas J Moseley; Jean Pouliot; Jan-Jakob Sonke; Sua Yoo Journal: Med Phys Date: 2012-04 Impact factor: 4.071
Authors: Judit Boda-Heggemann; Jens Fleckenstein; Frank Lohr; Hansjörg Wertz; Mohammed Nachit; Manuel Blessing; Dzimitry Stsepankou; Iris Löb; Beate Küpper; Anthony Kavanagh; Vibeke N Hansen; Michael Brada; Frederik Wenz; Helen McNair Journal: Radiother Oncol Date: 2011-02-21 Impact factor: 6.280
Authors: O Sager; M Beyzadeoglu; F Dincoglan; K Oysul; Y Elcim Kahya; H Gamsiz; B Uysal; S Demiral; B Dirican; S Surenkok Journal: Neoplasma Date: 2012 Impact factor: 2.575
Authors: Elisabeth Weiss; Scott P Robertson; Nitai Mukhopadhyay; Geoffrey D Hugo Journal: Int J Radiat Oncol Biol Phys Date: 2011-12-22 Impact factor: 7.038
Authors: Dennis M Duggan; George X Ding; Charles W Coffey; Wyndee Kirby; Dennis E Hallahan; Arnold Malcolm; Bo Lu Journal: Lung Cancer Date: 2006-12-13 Impact factor: 5.705
Authors: Patrick Naumann; Vania Batista; Benjamin Farnia; Jann Fischer; Jakob Liermann; Eric Tonndorf-Martini; Bernhard Rhein; Jürgen Debus Journal: Front Oncol Date: 2020-09-25 Impact factor: 6.244
Authors: Alejandro Prado; Daniel Zucca; Miguel Ángel De la Casa; Jaime Martí; Leyre Alonso; Paz García de Acilu; Juan García; Ovidio Hernando; Pedro Fernández-Letón; Carmen Rubio Journal: Phys Imaging Radiat Oncol Date: 2022-04-29
Authors: Mirjana Josipovic; Marianne C Aznar; Jakob B Thomsen; Jonas Scherman; Sidsel Ms Damkjaer; Lotte Nygård; Lena Specht; Mette Pøhl; Gitte F Persson Journal: Br J Radiol Date: 2019-09-26 Impact factor: 3.039
Authors: Petr Burkon; Iveta Selingerova; Marek Slavik; Petr Pospisil; Lukas Bobek; Libor Kominek; Pavel Osmera; Tomas Prochazka; Miroslav Vrzal; Tomas Kazda; Pavel Slampa Journal: Front Oncol Date: 2021-02-05 Impact factor: 6.244