PMID- 17222359
OWN - NLM
STAT- MEDLINE
DCOM- 20090924
LR  - 20161124
VI  - 26
IP  - 1
DP  - 2007 Jan
TI  - [Internal target volume definition using four-dimensional CT and dosimetric 
      evaluation for hepatocellular carcinoma].
PG  - 1-8
AB  - BACKGROUND & OBJECTIVE: Accurate definition of target volume is difficult in 
      three-dimensional conformal radiotherapy (3D CRT) for liver tumors because of the 
      wide moving extent of tumors with respiration. This study was to define 
      individualized internal target volume (ITV) using four-dimensional computed 
      tomography (4D-CT), and compare planning target volumes (PTVs) and dose 
      distribution of 3D planning with 4D planning for hepatocellular carcinoma (HCC). 
      METHODS: Seven primary HCC patients received 4D-CT scanning. Gross tumor volumes 
      (GTVs) and clinical target volumes (CTVs) were contoured on all 10 respiratory 
      phases of CT images. The 3D and 4D treatment plans were made for each patient 
      using different PTVs, namely, PTV-3D derived from a single CTV plus conventional 
      margins; PTV-4D derived from ITV-4D which encompassing all 10 CTVs plus setup 
      margins (SM). The two plans were designed at the 20% respiratory phase CT images 
      using 3D treatment planning system and compared with respect to PTVs, dose 
      distribution to normal tissues, normal tissue complication probability. The 
      prescription dose and design of irradiating fields were identical for both plans. 
      RESULTS: The average PTV was (417.6+/-197.7) cm(3) in 3D plan and (331.9+/-183.1) 
      cm(3) in 4D plan, decreased by 20.50% (12.60%-34.40%). PTV coverage and dose 
      uniformity were similar in the 2 plans. 4D plans spared more normal liver, 
      kidney, stomach, and small intestine than 3D plans, especially for the liver. The 
      V30 and V40 of the liver were lower in 4D plans than in 3D plans (33.59% vs. 
      38.77%, 22.62% vs. 27.32%); the mean dose to normal liver was decreased from 
      24.13 Gy to 21.5 Gy; liver complication probability was decreased from 21.57% to 
      15.86%. Without increasing the normal tissue complication probability, the 
      prescription dose was higher in 4D plans than in 3D plans [(54.86+/-2.79) Gy vs. 
      (50.57+/-1.51) Gy], increased by 9.72% (4%-16%). CONCLUSIONS: The 3D plans have 
      pitfalls of geometric miss or over coverage of target volume. The 4D plans can 
      accurately definite target volume to spare more normal tissues and make dose 
      escalation as compared with 3D CRT.
FAU - Xi, Mian
AU  - Xi M
AD  - State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. 
      R. China.
FAU - Liu, Meng-Zhong
AU  - Liu MZ
FAU - Deng, Xiao-Wu
AU  - Deng XW
FAU - Liu, Hui
AU  - Liu H
FAU - Huang, Xiao-Yan
AU  - Huang XY
FAU - Zhang, Li
AU  - Zhang L
FAU - Li, Qiao-Qiao
AU  - Li QQ
FAU - Hu, Yong-Hong
AU  - Hu YH
FAU - Cai, Ling
AU  - Cai L
FAU - Cui, Nian-Ji
AU  - Cui NJ
LA  - chi
PT  - Comparative Study
PT  - Journal Article
PL  - China
TA  - Ai Zheng
JT  - Ai zheng = Aizheng = Chinese journal of cancer
JID - 9424852
SB  - IM
MH  - Adult
MH  - Aged
MH  - Carcinoma, Hepatocellular/diagnostic imaging/*radiotherapy
MH  - Female
MH  - Humans
MH  - Kidney/radiation effects
MH  - Liver/radiation effects
MH  - Liver Neoplasms/diagnostic imaging/*radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Radiographic Image Interpretation, Computer-Assisted/*methods
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Conformal/methods
MH  - Respiration
MH  - Tomography, X-Ray Computed/*methods
EDAT- 2007/01/16 09:00
MHDA- 2009/09/25 06:00
CRDT- 2007/01/16 09:00
PHST- 2007/01/16 09:00 [pubmed]
PHST- 2009/09/25 06:00 [medline]
PHST- 2007/01/16 09:00 [entrez]
AID - 1000-467X2007011 [pii]
PST - ppublish
SO  - Ai Zheng. 2007 Jan;26(1):1-8.