Correlation Between CT-Simulator and Dynamic Magnetic Resonance Images in Determining The Location of Gross Tumor Volume in Radiotherapy Treatment Planning for Lung Cancer

Abstract

Objective: This study aimed to determine the accuracy of the average tumor location in CT-simulator images and PTV margins in radiotherapy treatment planning by detecting lung tumor mobility in dynamic MRI scans of patients presenting with lung cancer.Materials and Method: Dynamic MRI examination was performed in 12 lung cancer patients scheduled for 3-dimensional conformal RT 3D-CRT using CT-simulator. In this study, maximum tumor displacement CC-MRI, ML-MRI, AP-MRI was measured that occurred in CC, AP and ML axes in expiratory and inspiratory phases of dynamic MRI. The distance from the upper limit of GTV to the reference line CC-CT was measured in CT-simulator images. CC-CT and CCmean-MRI values were compared with the Wilcoxon signed-rank test. Furthermore, correlation of these values was evaluated with Spearman’s correlation test.Results: In comparison of CC-CT and CCmean-MRI values, no statistically significant difference was detected between CT-simulator and dynamic MRI modalities p=0.172 . In addition, a high level of correlation was found between these two imaging methods p

Keywords

• lung cancer,respiratory motion,radiotherapy,dynamic magnetic resonance imaging,CT-simulator

References

1. Heelan RT, Demas BE, Carevelli JF, et al. Superior sulcus tumors: CT and MR imaging. Radiology 1989;170:637–641. [CrossRef]
2. Pauls S, Breining T, Muche R, et al. The role of dynamic, contrast- enhanced MRI in differentiating lung tumor subtypes. Clin Imaging 2011;35:259–265. [CrossRef]
3. Kramer H, Groen HJM. Current concepts in the mediastinal lymph node staging of nonsmall cell lung cancer. Ann Surg 2003;238:180– 188. [CrossRef]
4. Tavlayan E. The effect of CT and MRI image registration on target volume determination and dose distribution in the radiotherapy planning of brain tumors. Master of Science Thesis. İzmir; 2006. pp.1–6.
5. Shimizu S, Shirato H, Kagei K, et al. Impact of respiratory movement on the computed tomographic images of small lung tumors in three-dimensional (3D) radiotherapy. Int J Radiat Oncol Biol Phys 2000;46:1127–1133. [CrossRef]
6. Stevens CW, Munden RF, Forster KM, et al. Respiratory-driven lung tumor motion in depend of tumor size, tumor location, and pulmonary function. Int J Radiat Oncol Biol Phys 2001;51:62–68. [CrossRef]
7. Gierada DS, Curtin JJ, Erickson SJ, Prost RW, Strandt JA, Goodman LR. Diaphragmatic motion: fast gradient-recalled-echo MR imaging in healthy subjects. Radiology 1995;194:879–884. [CrossRef]
8. Napadow VJ, Mai V, Bankier A, Gilbert RJ, Edelman R, Chen Q. Determination of regional pulmonary parenchymal strain during normal respiration using spin inversion tagged magnetization MRI. J Magn Reson Imaging 2001;13:467–474. [CrossRef]

9. Plathow C, Fink C, Ley S, et al. Measurement of tumor diameter- dependent mobility of lung tumors by dynamic MRI. Radiother Oncol 2004;73:349–354. [CrossRef]
10. Harada T, Shirato H, Ogura S, et al. Real-time tumor-tracking radiation therapy for lung carcinoma by the aid of insertion of a gold marker using bronchofiberscopy. Cancer 2002;95:1720–1727. [CrossRef]
11. Wong JW, Sharpe MB, Jaffray DA, et al. The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol Biol Phys 1999;44:911–919. [CrossRef]
12. Lohr F, Debus J, Frank C, et al. Noninvasive patient fixation for extracranial stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 1999;45:521–527. [CrossRef]
13. Ohara K, Okumura T, Akisada M, et al. Irradiation synchronized with respiration gate. Int J Radiat Oncol Biol Phys 1989;17:853–857. [CrossRef]
14. Kubo HD, Hill BC. Respiration gated radiotherapy treatment: a technical study. Phys Med Biol 1996;41:83–91. [CrossRef]
15. Shimizu S, Shirato H, Aoyama H, et al. High-speed magnetic resonance imaging for four-dimensional treatment planning of conformal radiotherapy of moving body tumors. Int J Radiat Oncol Biol Phys 2000;48:471–474. [CrossRef]
16. Lagerwaard FJ, Van Sornsen de Koste JR, Nijssen-Visser MR, et al. Multiple slow CT scans for incorporating lung tumor mobility in radiotherapy planning. Int J Radiat Oncol Biol Phys 2001;51:932–937. [CrossRef]
17. Hof H, Herfarth KK, Münter M, Essig M, Wannenmacher M, Debus J. The use of the multislice CT for the determination of respiratory lung tumor movement in stereotactic single-dose irradiation. Strahlenther Onkol 2003;8:542–547. [CrossRef]
18. Kovacs A, Hadjiev J, Lakosi F, et al. Dynamic MR Based Analysis of Tumor Movement in Upper and Mid Lobe Localized Lung Cancer. Pathol Oncol Res 2009;15:269–277. [CrossRef]