Abstract
Background For treatment of patients with lung cancer, internal target volume (ITV) is often determined by using maximum intensity projections (MIP) images, generated from four dimensional computed tomography (4DCT). The study aims to determine whether MIP is capable of capturing tumour volume accurately and generating treatment plans with accurate target coverage. Methods Databases including Science direct, Pubmed, Scopus and Embase and the Cochrane library were searched for relevant articles. Articles utilising MIP based images for tumour volume generation and target coverage were assessed. Results Sixteen articles were included and analysed. MIP was shown to be inaccurate when generating tumour volumes in the presence of irregular tumour motion. However it was accurate when capturing tumour volumes for regular tumour motion. Target coverage was compromised on MIP in large tumours with irregular motion. Conversely, MIP was accurate for small tumours with regular motions. Conclusion To prevent under dosing of the target volume and overdosing of normal tissue, the MIP image set should only be used for small tumours with a small range of regular motion.
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