The effect of longitudinal CT resolution and pixel size (FOV) on target delineation and treatment planning in stereotactic radiosurgery.

The acquisition of high-quality, anatomic images is essential for the accurate delineation of tumor volumes and critical structures used for stereotactic radiosurgery (SRS) treatment planning. This study investigates the effect of CT slice thickness and field of view (FOV), i.e., longitudinal and axial CT resolution, on volume delineation and treatment planning in SRS and suggests optimal CT acquisition parameters for brain SRS simulation. Optimization of such parameters will maximize clinical efficacy, alter data storage requirements, reduce dosimetric uncertainties, and may ultimately facilitate more favorable clinical outcomes. Changes in the extent, shape and the absolute volume of the GTV were recorded when the longitudinal and axial CT resolution were modified. These changes ultimately impacted the PTV dose coverage. Reducing CT slice thickness from 2mm to 1mm resulted in an average decrease of 8.6%±13.9% (max=52.2%) and 3.0 %±4.3% (max=13.1%) in PTV D and PTV D95, respectively. Increasing CT slice thickness from 2mm to 3mm resulted in an average decrease of 10%±9.9% (max=26.8%) and 5.8%±5.8% (max=17.4%) in PTV D and PTV D95, respectively. Similarly, on average, PTV coverage decreased when FOV decreased. The average decrease in PTV D and PTV D95 for a 350cm FOV was 5.2%±7.2% (max=21.4%) and 1.9%±3.2% (max=7.5%), respectively. Decreasing FOV to 250cm yielded similar results with the average decrease of 5.6%±5.0% (max=13.2%) and 1.6%±2.6% (max=6.3%) in PTV D and PTV D95, respectively. These results suggest that the slice thickness and FOV of CT images affect target delineation and may potentially compromise the quality of the target coverage.