Correlation of gross tumor volume excursion with potential benefits of respiratory gating

George Starkschall, Kenneth M. Forster, Kei Kitamura, Alex Cardenas, Susan L. Tucker, Craig W. Stevens

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

To test the hypothesis that the magnitude of thoracic tumor motion can be used to determine the desirability of respiratory gating. Twenty patients to be treated for lung tumors had computed tomography image data sets acquired under assisted breath hold at normal inspiration (100% tidal volume), at full expiration (0% tidal volume), and under free breathing. A radiation oncologist outlined gross tumor volumes (GTVs) on the breath-hold computed tomographic images. These data sets were registered to the free-breathing image data set. Two sets of treatment plans were generated: one based on an internal target volume explicitly formed from assessment of the excursion of the clinical target volume (CTV) through the respiratory cycle, representing an ungated treatment, and the other based on the 0% tidal volume CTV, representing a gated treatment with little margin for residual motion. Dose-volume statistics were correlated to the magnitude of the motion of the center of the GTV during respiration. Patients whose GTVs were >100 cm 3 showed little decrease in lung dose under gating. The other patients showed a correlation between the excursion of the center of the GTV and a reduction in potential lung toxicity. As residual motion increased, the benefits of respiratory gating increased. Gating seems to be advantageous for patients whose GTVs are >100 cm 3 and for whom the center of the GTV exhibits significant motion, provided residual motion under gating is kept small.

Original languageEnglish (US)
Pages (from-to)1291-1297
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume60
Issue number4
DOIs
StatePublished - Nov 15 2004

Fingerprint

Tumor Burden
tumors
Tidal Volume
Respiration
Lung
lungs
breathing
Neoplasms
Thorax
Therapeutics
Tomography
expiration
inspiration
dosage
respiration
toxicity
Datasets
margins
tomography
statistics

Keywords

  • Lung tumors
  • Respiratory gating
  • Tumor motion

ASJC Scopus subject areas

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

Cite this

Correlation of gross tumor volume excursion with potential benefits of respiratory gating. / Starkschall, George; Forster, Kenneth M.; Kitamura, Kei; Cardenas, Alex; Tucker, Susan L.; Stevens, Craig W.

In: International Journal of Radiation Oncology Biology Physics, Vol. 60, No. 4, 15.11.2004, p. 1291-1297.

Research output: Contribution to journalArticle

Starkschall, George ; Forster, Kenneth M. ; Kitamura, Kei ; Cardenas, Alex ; Tucker, Susan L. ; Stevens, Craig W. / Correlation of gross tumor volume excursion with potential benefits of respiratory gating. In: International Journal of Radiation Oncology Biology Physics. 2004 ; Vol. 60, No. 4. pp. 1291-1297.
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