title: Validation of target volume and position in respiratory gated CT planning and treatment.
abstract: The capability of a commercial respiratory gating system based on video tracking of reflective markers to reduce motion-induced CT planning and treatment errors was evaluated. Spherical plastic shells (2.8-82 cm3), simulating the gross target volume (GTV), were placed in a water-filled body phantom that was moved sinusoidally along the longitudinal axis of the CT scanner and the accelerator for +/- 1 cm at 15-30 cycle/min. During gated CT imaging, the x-ray exposure was initiated by the gating system shortly before the end of expiration (so that the imaging time would be centered at the end of expiration); it was terminated by the scanner after completion of each slice. In nongated CT images, the target appeared distorted and often broken up. GTVs volume errors ranged 16%-110% in axial scans, and 7%-36% in spiral scans. In gated CT images, the spheres appeared 3 and 5 mm longer than their actual diameters (volume errors 2%-16%), at the respective respiration rates of 15 and 20 cycles/min. At 30 cycles/min the target appeared 1 cm longer, and volume error ranged 25%-53%. During treatment, gating kept the beam on for a duration equal to the CT acquisition time of 1 s/slice. The difference in positional errors between gated CT and portal films was 1 mm, regardless the size of residual motion errors. Because of the potential of suboptimal placement of the gating window between CT imaging and treatment, an extra 1.5-2.5 mm safety margin can be added regardless of the size of residual motion error. For respiratory rates > or = 30 cycles/min, the effectiveness of gating is limited by large residual motion in the 1 s CT acquisition time.
authors.affiliation: Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. sshen@uabmc.edu
authors.forename: Sui
authors.initials: S
authors.lastname: Shen
authors.forename: Jun
authors.initials: J
authors.lastname: Duan
authors.forename: John B
authors.initials: JB
authors.lastname: Fiveash
authors.forename: Ivan A
authors.initials: IA
authors.lastname: Brezovich
authors.forename: Brian A
authors.initials: BA
authors.lastname: Plant
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Spencer
authors.forename: Richard A
authors.initials: RA
authors.lastname: Popple
authors.forename: Prem N
authors.initials: PN
authors.lastname: Pareek
authors.forename: James A
authors.initials: JA
authors.lastname: Bonner
mesh_terms: D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D009068:Movement; D009367:Neoplasm Staging / Q000379:methods; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D019047:Phantoms, Imaging; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity; D014741:Video Recording / Q000379:methods