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Original Article

Korean Journal of Medical Physics 2014; 25(3): 167-175

Published online September 30, 2014

Copyright © Korean Society of Medical Physics.

Evaluation of Dose Change by Using the Deformable Image Registration (DIR) on the Intensity Modulated Radiation Therapy (IMRT) with Glottis Cancer

Woo Chul Kim*, Chul Kee Min*, Suk Lee, Sang Hyoun Choi§, Kwang Hwan Cho*, Jae Hong Jung*, Eun Seog Kim*, Seung-Gu Yeo*, Soo-Il Kwon†¶, Kil-Dong Lee†¶

*Department of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan,Department of Medical Physics, Kyonggi University, Suwon, Department of Radiation Oncology, College of Medicine, Korea University, §Research Center for Radiotherapy, Korea Institute of Radiological and Medical Science, Department of Biomedical Engineering and Research Institute of Biomedical Engineering, The Catholic University, Seoul, Department of Electrophysics, Kyonggi University, Suwon, Korea

Received: August 14, 2014; Revised: September 11, 2014; Accepted: September 12, 2014

Abstract

The purpose of this study is to evaluate the variation of the dose which is delivered to the patients with glottis cancer under IMRT (intensity modulated radiation therapy) by using the 3D registration with CBCT (cone beam CT) images and the DIR (deformable image registration) techniques. The CBCT images which were obtained at a one-week interval were reconstructed by using B-spline algorithm in DIR system, and doses were recalculated based on the newly obtained CBCT images. The dose distributions to the tumor and the critical organs were compared with reference. For the change of volume depending on weight at 3 to 5 weeks, there was increased of 1.38∼2.04 kg on average. For the body surface depending on weight, there was decreased of 2.1 mm. The dose with transmitted to the carotid since three weeks was increased compared be more than 8.76% planned, and the thyroid gland was decreased to 26.4%. For the physical evaluation factors of the tumor, PITV, TCI, rDHI, mDHI, and CN were decreased to 4.32%, 5.78%, 44.54%, 12.32%, and 7.11%, respectively. Moreover, Dmax, Dmean, V67.50, and D95 for PTV were increased or decreased to 2.99%, 1.52%, 5.78%, and 11.94%, respectively. Although there was no change of volume depending on weight, the change of body types occurred, and IMRT with the narrow composure margin sensitively responded to such a changing. For the glottis IMRT, the patient’s weight changes should be observed and recorded to evaluate the actual dose distribution by using the DIR techniques, and more the adaptive treatment planning during the treatment course is needed to deliver the accurate dose to the patients.

KeywordsGlottic, Deformable image registration, CBCT, Adaptive radiation therapy

Korean Society of Medical Physics

Vol.35 No.2
June 2024

pISSN 2508-4445
eISSN 2508-4453
Formerly ISSN 1226-5829

Frequency: Quarterly

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