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Functional image-based radiotherapy planning for non-small cell lung cancer: a simulation study

Bates, E.L., Bragg, C.M., Wild, J.M., Hatton, M.Q.F. and Ireland, R.H. (2009) Functional image-based radiotherapy planning for non-small cell lung cancer: a simulation study. Radiotherapy and Oncology, 93 (1). pp. 32-36. ISSN 0167-8140

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Abstract

Background and purpose: To investigate the incorporation of data from single-photon emission computed tomography (SPECT) or hyperpolarized helium-3 magnetic resonance imaging (He-3-MRI) into intensity-modulated radiotherapy (IMRT) planning for non-small cell lung cancer (NSCLC). Material and methods: Seven scenarios were simulated that represent cases of NSCLC with significant functional lung defects. Two independent IMRT plans were produced for each scenario; one to minimise total lung volume receiving >= 20 Gy (V-20), and the other to minimise only the functional lung volume receiving >= 20 Gy (FV20). Dose-volume characteristics and a plan quality index related to planning target volume coverage by the 95% isodose (V-PTV95/FV20) were compared between anatomical and functional plans using the Wilcoxon signed ranks test.

Results: Compared to anatomical IMRT plans, functional planning reduced FV20 (median 2.7%, range 0.6-3.5%, p = 0.02), and total lung V-20 (median 1.5%, 0.5-2.7%, p = 0.02), with a small reduction in mean functional lung dose (median 0.4 Gy, 0-0.7 Gy, p = 0.03). There were no significant differences in target volume coverage or organ-at-risk doses. Plan quality index was improved for functional plans (median increase 1.4, range 0-11.8, p = 0.02).

Conclusions: Statistically significant reductions in FV20, V-20 and mean functional lung dose are possible when IMRT planning is supplemented by functional information derived from SPECT or He-3-MRI. (C) 2009 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 93 (2009) 32-36

Item Type: Article
Copyright, Publisher and Additional Information: © 2009 Elsevier. This is an author produced version of a paper subsequently published in Radiotherapy and Oncology. Uploaded in accordance with the publisher's self-archiving policy.
Keywords: Intensity-modulated radiotherapy; Non-small cell lung cancer; SPECT; Hyperpolarized helium-3 MRI; Radiotherapy treatment planning
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield)
The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield) > Division of Genomic Medicine (Sheffield) > Department of Oncology (Sheffield)
Depositing User: Miss Anthea Tucker
Date Deposited: 10 Nov 2009 11:51
Last Modified: 08 Feb 2013 16:59
Published Version: http://dx.doi.org/10.1016/j.radonc.2009.05.018
Status: Published
Publisher: Elsevier
Refereed: Yes
Identification Number: 10.1016/j.radonc.2009.05.018
URI: http://eprints.whiterose.ac.uk/id/eprint/10123

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