Gagné Isabelle M, Robinson Don M
Department of Physics, University of Alberta, Edmonton, Alberta, Canada.
Med Phys. 2004 Dec;31(12):3378-92. doi: 10.1118/1.1799291.
Accurate planning target volume delineation is vital to the success of conformal radiation techniques such as standard three-dimensional conformal radiotherapy and intensity modulated radiation therapy. With the exception of breath-hold schemes, all current approaches acquire images while the tumor is nonstationary and, as such, are subject to the presence of motion artifacts. In lung cancer sites where tumor mobility can be significant, the detrimental effect of these motion-induced distortions on image quality and subsequently target volume delineation cannot be ignored in the pursuit of improved treatment outcomes. To investigate the fundamental nature and functional dependence of computed tomography (CT) artifacts associated with lung tumor motion, and the implications for tumor delineation, a filtered backprojection algorithm was developed in MATLAB to generate transverse CT simulation images. In addition, a three-dimensional phantom capable of mimicking the essential motions of lung tumors was constructed for experimental verification. Results show that the spatial extent of a mobile object is distorted from its true shape and location and does not accurately reflect the volume occupied during the extent of motion captured. The presence of motion also negatively impacts image intensity (density) integrity rendering accurate volume delineation highly problematic and calling into question the use of such data in CT-based heterogeneity correction algorithms for dosimetric calculation.
精确的计划靶区勾画对于诸如标准三维适形放疗和调强放疗等适形放射技术的成功至关重要。除了屏气方案外,目前所有方法都是在肿瘤非静止时采集图像,因此会出现运动伪影。在肿瘤移动性可能很大的肺癌部位,在追求改善治疗效果的过程中,这些运动引起的畸变对图像质量以及随后的靶区勾画的不利影响不容忽视。为了研究与肺肿瘤运动相关的计算机断层扫描(CT)伪影的基本性质和功能依赖性,以及对肿瘤勾画的影响,在MATLAB中开发了一种滤波反投影算法来生成横向CT模拟图像。此外,构建了一个能够模拟肺肿瘤基本运动的三维体模用于实验验证。结果表明,移动物体的空间范围会偏离其真实形状和位置,并且不能准确反映在捕获的运动范围内所占据的体积。运动的存在也会对图像强度(密度)完整性产生负面影响,使得精确的体积勾画极具问题,并质疑在基于CT的剂量计算异质性校正算法中使用此类数据的合理性。