Abstract
Abstract Purpose: Targets in the thorax regions are subject to respiratory motion and the average position maybe changed daily. This study aims to assess the degree of target average position change in respect to the bony structure using cone-beam computed tomography (CBCT). The work further validates the planning target volume (PTV) margin used in the stereotactic body radiotherapy (SBRT) of lung cancers. Methods and Materials:All patients underwent 4D CT scanning in preparation for lung SBRT. The internal target volume (ITV) is outlined from the reconstructed 4D data using the maximum-intensity projection (MIP) algorithm. The clinical target volume (CTV) is defined as the ITV plus 3 mm margin and an additional 3 mm margin is added to the CTV to make the PTV. Conformal treatment planning is performed on the helical images, to which the MIP images were fused. Prior to each treatment, CBCT is used to align with the simulation CT (helical) based on bony anatomy. The necessary shifts are recorded. The treating physician then checks and modifies the alignment based on target relocalization within the PTV (soft tissue alignment). The final shifts are derived based on the soft tissue alignment. Two sets of shifts are compared here for the purpose of the study.
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