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Evaluation of Normal Lung Tissue Complication Probability in Gated and Conventional Radiotherapy Using the 4D Xcat Digital Phantom Publisher Pubmed



Shahzadeh S1 ; Gholami S2, 3 ; Aghamiri SMR1 ; Mahani H4, 5 ; Nabavi M2 ; Kalantari F6
Authors
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Authors Affiliations
  1. 1. Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran
  2. 2. Radiotherapy Oncology Research Centre, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Research Center for Molecular and Cellular Imaging, Tehran University of Medical Science, Tehran, Iran
  5. 5. Radiation Application Research School, Nuclear Science and Technology Research Institute, Tehran, Iran
  6. 6. Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, United States

Source: Computers in Biology and Medicine Published:2018


Abstract

Purpose: The present study was conducted to investigate normal lung tissue complication probability in gated and conventional radiotherapy (RT) as a function of diaphragm motion, lesion size, and its location using 4D-XCAT digital phantom in a simulation study. Materials and methods: Different time series of 3D-CT images were generated using the 4D-XCAT digital phantom. The binary data obtained from this phantom were then converted to the digital imaging and communication in medicine (DICOM) format using an in-house MATLAB-based program to be compatible with our treatment planning system (TPS). The 3D-TPS with superposition computational algorithm was used to generate conventional and gated plans. Treatment plans were generated for 36 different XCAT phantom configurations. These included four diaphragm motions of 20, 25, 30 and 35 mm, three lesion sizes of 3, 4, and 5 cm in diameter and each tumor was placed in four different lung locations (right lower lobe, right upper lobe, left lower lobe and left upper lobe). The complication of normal lung tissue was assessed in terms of mean lung dose (MLD), the lung volume receiving ≥20 Gy (V20), and normal tissue complication probability (NTCP). Results: The results showed that the gated RT yields superior outcomes in terms of normal tissue complication compared to the conventional RT. For all cases, the gated radiation therapy technique reduced the mean dose, V20, and NTCP of lung tissue by up to 5.53 Gy, 13.38%, and 23.89%, respectively. Conclusions: The results of this study showed that the gated RT provides significant advantages in terms of the normal lung tissue complication, compared to the conventional RT, especially for the lesions near the diaphragm. © 2018 Elsevier Ltd
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