Evaluating Correlation between Geometrical Relationship and Dose Difference Caused by Respiratory Motion Using Statistical Analysis

Abstract

Dose differences between three-dimensional (3D) and four-dimensional (4D) doses could be varied according to the geometrical relationship between a planning target volume (PTV) and an organ at risk (OAR). The purpose of this study is to evaluate the correlation between the overlap volume histogram (OVH), which quantitatively shows the geometrical relationship between the PTV and OAR, and the dose differences. 4D computed tomography (4DCT) images were acquired for 10 liver cancer patients. Internal target volume-based treatment planning was performed. A 3D dose was calculated on a reference phase (end-exhalation). A 4D dose was accumulated using deformation vector fields between the reference and other phase images of 4DCT from deformable image registration, and dose differences between the 3D and 4D doses were calculated. An OVH between the PTV and selected OAR (duodenum) was calculated and quantified on the basis of specific overlap volumes that corresponded to 10%, 20%, 30%, 40%, and 50% of the OAR volume overlapped with the expanded PTV. Statistical analysis was performed to verify the correlation with the OVH and dose difference for the OAR. The minimum mean dose difference was 0.50 Gy from case 3, and the maximum mean dose difference was 4.96 Gy from case 2. The calculated range of the correlation coefficients between the OVH and dose difference was from −0.720 to −0.712, and the R-square range for regression analysis was from 0.506 to 0.518 (p-value ＜0.05). However, when the 10% overlap volume was applied in the six cases that had OVH value ≤2, the average percent mean dose differences were 34.80±12.42%. Cases with quantified OVH values of 2 or more had mean dose differences of 29.16±11.36%. In conclusion, no significant statistical correlation was found between the OVH and dose differences. However, it was confirmed that a higher difference between the 3D and 4D doses could occur in cases that have smaller OVH value.