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An investigation into the range dependence of target delineation strategies for stereotactic lung radiotherapy

Overview of attention for article published in Radiation Oncology, November 2017
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Title
An investigation into the range dependence of target delineation strategies for stereotactic lung radiotherapy
Published in
Radiation Oncology, November 2017
DOI 10.1186/s13014-017-0907-8
Pubmed ID
Authors

Dennis J. Mohatt, John M. Keim, Mathew C. Greene, Ami Patel-Yadav, Jorge A. Gomez, Harish K. Malhotra

Abstract

The "gold standard" approach for defining an internal target volume (ITV) is using 10 gross tumor volume (GTV) phases delineated over the course of one respiratory cycle. However, different sites have adopted several alternative techniques which compress all temporal information into one CT image set to optimize work flow efficiency. The purpose of this study is to evaluate alternative target segmentation strategies with respect to the 10 phase gold standard. A Quasar respiratory motion phantom was employed to simulate lung tumor movement. Utilizing 4DCT imaging, a gold standard ITV was created by merging 10 GTV time resolved image sets. Four alternative planed ITV's were compared using free breathing (FB), average intensity projection (AIP), maximum image projection (MIP), and an augmented FB (FB-Aug) set where the ITV included structures from FB plus max-inhale/exhale image sets. Statistical analysis was performed using the Dice similarity coefficient (DSC). Seventeen patients previously treated for lung SBRT were also included in this retroactive study. PTV's derived from the FB image set are the least comparable with the 10 phase benchmark (DSC = 0.740-0.408). For phantom target motion greater than 1 cm, FB and AIP ITV delineation exceeded the 10 phase benchmark by 2% or greater, whereas MIP target segmentation was found to be consistently within 2% agreement with the gold standard (DSC > 0.878). Clinically, however, the FB-Aug method proved to be most favorable for tumor movement up to 2 cm (DSC = 0.881 ± 0.056). Our results indicate the range of tumor motion dictates the accuracy of the defined PTV with respect to the gold standard. When considering delineation efficiency relative to the 10 phase benchmark, the FB-Aug technique presents a potentially proficient and viable clinical alternative. Among various techniques used for image segmentation, a judicious balance between accuracy and efficiency is inherently required to account for tumor trajectory, range and rate of mobility.

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Mendeley readers

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The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 24 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 3 13%
Other 2 8%
Student > Doctoral Student 2 8%
Professor 2 8%
Researcher 2 8%
Other 3 13%
Unknown 10 42%
Readers by discipline Count As %
Physics and Astronomy 5 21%
Medicine and Dentistry 5 21%
Psychology 1 4%
Nursing and Health Professions 1 4%
Engineering 1 4%
Other 0 0%
Unknown 11 46%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 November 2017.
All research outputs
#20,451,228
of 23,007,053 outputs
Outputs from Radiation Oncology
#1,694
of 2,072 outputs
Outputs of similar age
#286,718
of 329,030 outputs
Outputs of similar age from Radiation Oncology
#18
of 26 outputs
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