Feasibility and potential benefits of defining the internal gross tumor volume of hepatocellular carcinoma using contrast-enhanced 4D CT images obtained by deformable registration

Radiation Oncology

Yong Yin¹  Jian Zhu¹  Tonghai Liu¹  Jie Lu¹  Jinhu Chen¹  Lusheng Chen¹  Hong Wei¹  Guanzhong Gong¹  Hua Xu¹ 

[1] Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117, China

关键词: Deformable registration;    Radiotherapy;    Hepatocellular carcinoma;    Four-dimensional computed tomography;   

Others  :  1151269
DOI  :  10.1186/s13014-014-0221-7

 received in 2014-04-21, accepted in 2014-09-24,  发布年份 2014

【 摘 要 】

Objective

To study the feasibility and the potential benefits of defining the internal gross tumor volume (IGTV) of hepatocellular carcinoma (HCC) using contrast-enhanced 4D CT images obtained by combining arterial-phase (AP) contrast-enhanced (CE) 3D CT and non-contrast-enhanced (NCE) 4D CT images using deformable registration (DR).

Methods

Ten HCC patients who had received radiotherapy beforehand were selected for this study. The following CT simulation images were acquired sequentially: NCE 4D CT in free breathing, NCE 3D CT and APCE 3D CT in end-expiration breath holding. All 4D CT images were sorted into ten phases according to breath cycle (CT₀₀?~?CT₉₀). Gross tumor volumes (GTVs) were contoured on all CT images and the IGTV_-1 was obtained by merging the GTVs in each phase of 4D CT images. The GTV on the APCE 3D CT image was deformably registered to each 4D CT phase image according to liver shape using RayStation^TM 3.99.0.7 version treatment planning system. The IGTV_-DR was obtained by merging the GTVs after DR on the 4D CT images. Volume differences among the GTVs and between the IGTV_-1 and the IGTV_-DR were compared.

Results

The edge of most lesions could be definitively identified using APCE 3D CT images compared to NCE 4D and 3D CT images. The GTV volume on APCE 3D CT images increased by an average of 34.79% (P?P?>?0.05). The GTV volumes after DR on 4D CT different phase images increased by an average of 36.29% (P?P?>?0.05). Lastly, the volume of IGTV_-DR increased by an average of 19.91% compared to that of IGTV_-1 (P?

Conclusion

NCE 4D CT imaging alone has the potential risk of missing a partial volume of the HCC. The combination of APCE 3D CT and NCE 4D CT images using the DR technique improved the accuracy of the definition of the IGTV in HCC.

【 授权许可】

   
2014 Xu et al.; licensee BioMed Central Ltd.

【 图 表 】

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