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Added by André Pèlegrin
Group name EquipeAP
Item Type Journal Article
Title Tracking, gating, free-breathing, which technique to use for lung stereotactic treatments? A dosimetric comparison
Creator Prunaretty et al.
Author Jessica Prunaretty
Author Pierre Boisselier
Author Olivier Riou
Author Sebastien Simeon
Author Ludovic Bedos
Author David Azria
Author Pascal Fenoglietto
Abstract Background: The management of breath-induced tumor motion is a major challenge for lung stereotactic body radiation therapy (SBRT). Three techniques are currently available for these treatments: tracking (T), gating (G) and free-breathing (FB). Aim: To evaluate the dosimetric differences between these three treatment techniques for lung SBRT. Materials and methods: Pretreatment 4DCT data were acquired for 10 patients and sorted into 10 phases of a breathing cycle, such as 0% and 50% phases defined respectively as the inhalation and exhalation maximum. GTVph, PTVph (=GTVph + 3 mm) and the ipsilateral lung were contoured on each phase.For the tracking technique, 9 fixed fields were adjusted to each PTVph for the 10 phases. The gating technique was studied with 3 exhalation phases (40%, 50% and 60%). For the free-breathing technique, ITVFB was created from a sum of all GTVph and a 3 mm margin was added to define a PTVFB. Fields were adjusted to PTVFB and dose distributions were calculated on the average intensity projection (AIP) CT. Then, the beam arrangement with the same monitor units was planned on each CT phase.The 3 modalities were evaluated using DVHs of each GTVph, the homogeneity index and the volume of the ipsilateral lung receiving 20 Gy (V20Gy). Results: The FB system improved the target coverage by increasing Dmean (75.87(T)-76.08(G)-77.49(FB)Gy). Target coverage was slightly more homogeneous, too (HI: 0.17(T and G)-0.15(FB)). But the lung was better protected with the tracking system (V20Gy: 3.82(T)-4.96(G)-6.34(FB)%). Conclusions: Every technique provides plans with a good target coverage and lung protection. While irradiation with free-breathing increases doses to GTV, irradiation with the tracking technique spares better the lung but can dramatically increase the treatment complexity.
Publication Reports of Practical Oncology and Radiotherapy: Journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology
Volume 24
Issue 1
Pages 97-104
Date 2019 Jan-Feb
Journal Abbr Rep Pract Oncol Radiother
Language eng
DOI 10.1016/j.rpor.2018.11.003
ISSN 1507-1367
Short Title Tracking, gating, free-breathing, which technique to use for lung stereotactic treatments?
Library Catalog PubMed
Extra PMID: 30532657 PMCID: PMC6261085
Tags Dosimetric comparison, Free-breathing, Gating, Lung SBRT, nonvisible, review, Revue, Tracking
Date Added 2019/01/04 - 11:24:06
Date Modified 2019/12/11 - 18:32:53
Notes and Attachments PubMed entry (Attachment)


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