Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion

Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion

Abstract Background To determine the optimal volume of barium for oesophageal localisation on cone-beam CT (CBCT) for locally-advanced non-small cell lung cancers (NSCLC) and quantify the interfraction oesophageal movement relative to tumour. Methods Twenty NSCLC patients with mediastinal and/or hil...

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Autores principales: Katrina Woodford, Vanessa Panettieri, Jeremy D. Ruben, Sidney Davis, Trieumy Tran Le, Stephanie Miller, Sashendra Senthi
Formato: article
Lenguaje:EN
Publicado: BMC 2021
Materias:
Oesophagus
Barium
Contrast
IGRT
Interfraction motion
CBCT
Medical physics. Medical radiology. Nuclear medicine
R895-920
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Acceso en línea:https://doaj.org/article/50c0e4ca84ad4f0d8f85892bbfb833d4
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spelling oai:doaj.org-article:50c0e4ca84ad4f0d8f85892bbfb833d42021-11-21T12:14:14ZOesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion10.1186/s13014-021-01946-81748-717Xhttps://doaj.org/article/50c0e4ca84ad4f0d8f85892bbfb833d42021-11-01T00:00:00Zhttps://doi.org/10.1186/s13014-021-01946-8https://doaj.org/toc/1748-717XAbstract Background To determine the optimal volume of barium for oesophageal localisation on cone-beam CT (CBCT) for locally-advanced non-small cell lung cancers (NSCLC) and quantify the interfraction oesophageal movement relative to tumour. Methods Twenty NSCLC patients with mediastinal and/or hilar disease receiving radical radiotherapy were recruited. The first five patients received 25 ml of barium prior to their planning CT and alternate CBCTs during treatment. Subsequent five patient cohorts, received 15 ml, 10 ml and 5 ml. Six observers contoured the oesophagus on each of the 107 datasets and consensus contours were created. Overall 642 observer contours were generated and interobserver contouring reproducibility was assessed. The kappa statistic, dice coefficient and Hausdorff Distance (HD) were used to compare barium-enhanced CBCTs and non-enhanced CBCTs. Oesophageal displacement was assessed using the HD between consensus contours of barium-enhanced CBCTs and planning CTs. Results Interobserver contouring reproducibility was significantly improved in barium-enhanced CBCTs compared to non-contrast CBCTs with minimal difference between barium dose levels. Only 10 mL produced a significantly higher kappa (0.814, p = 0.008) and dice (0.895, p = 0.001). The poorer the reproducibility without barium, the greater the improvement barium provided. The median interfraction HD between consensus contours was 4 mm, with 95% of the oesophageal displacement within 15 mm. Conclusions 10 mL of barium significantly improves oesophageal localisation on CBCT with minimal image artifact. The oesophagus moves substantially and unpredictably over a course of treatment, requiring close daily monitoring in the context of hypofractionation.Katrina WoodfordVanessa PanettieriJeremy D. RubenSidney DavisTrieumy Tran LeStephanie MillerSashendra SenthiBMCarticleOesophagusBariumContrastIGRTInterfraction motionCBCTMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENRadiation Oncology, Vol 16, Iss 1, Pp 1-10 (2021)
institution DOAJ
collection DOAJ
language EN
topic Oesophagus
Barium
Contrast
IGRT
Interfraction motion
CBCT
Medical physics. Medical radiology. Nuclear medicine
R895-920
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle Oesophagus
Barium
Contrast
IGRT
Interfraction motion
CBCT
Medical physics. Medical radiology. Nuclear medicine
R895-920
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Katrina Woodford
Vanessa Panettieri
Jeremy D. Ruben
Sidney Davis
Trieumy Tran Le
Stephanie Miller
Sashendra Senthi
Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion
description Abstract Background To determine the optimal volume of barium for oesophageal localisation on cone-beam CT (CBCT) for locally-advanced non-small cell lung cancers (NSCLC) and quantify the interfraction oesophageal movement relative to tumour. Methods Twenty NSCLC patients with mediastinal and/or hilar disease receiving radical radiotherapy were recruited. The first five patients received 25 ml of barium prior to their planning CT and alternate CBCTs during treatment. Subsequent five patient cohorts, received 15 ml, 10 ml and 5 ml. Six observers contoured the oesophagus on each of the 107 datasets and consensus contours were created. Overall 642 observer contours were generated and interobserver contouring reproducibility was assessed. The kappa statistic, dice coefficient and Hausdorff Distance (HD) were used to compare barium-enhanced CBCTs and non-enhanced CBCTs. Oesophageal displacement was assessed using the HD between consensus contours of barium-enhanced CBCTs and planning CTs. Results Interobserver contouring reproducibility was significantly improved in barium-enhanced CBCTs compared to non-contrast CBCTs with minimal difference between barium dose levels. Only 10 mL produced a significantly higher kappa (0.814, p = 0.008) and dice (0.895, p = 0.001). The poorer the reproducibility without barium, the greater the improvement barium provided. The median interfraction HD between consensus contours was 4 mm, with 95% of the oesophageal displacement within 15 mm. Conclusions 10 mL of barium significantly improves oesophageal localisation on CBCT with minimal image artifact. The oesophagus moves substantially and unpredictably over a course of treatment, requiring close daily monitoring in the context of hypofractionation.
format article
author Katrina Woodford
Vanessa Panettieri
Jeremy D. Ruben
Sidney Davis
Trieumy Tran Le
Stephanie Miller
Sashendra Senthi
author_facet Katrina Woodford
Vanessa Panettieri
Jeremy D. Ruben
Sidney Davis
Trieumy Tran Le
Stephanie Miller
Sashendra Senthi
author_sort Katrina Woodford
title Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion
title_short Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion
title_full Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion
title_fullStr Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion
title_full_unstemmed Oesophageal IGRT considerations for SBRT of LA-NSCLC: barium-enhanced CBCT and interfraction motion
title_sort oesophageal igrt considerations for sbrt of la-nsclc: barium-enhanced cbct and interfraction motion
publisher BMC
publishDate 2021
url https://doaj.org/article/50c0e4ca84ad4f0d8f85892bbfb833d4
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