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Four-dimensional cone-beam computed tomography-guided radiotherapy for gastric lymphoma

Japanese Journal of Radiology volume 36, pages 159–163 (2018)Cite this article

Abstract

Purpose

We describe a treatment method with four-dimensional cone-beam computed tomography (4D-CBCT)-guided radiotherapy for gastric lymphoma.

Materials and methods

We performed image-guided radiotherapy (IGRT) with 15 fractions for a gastric mucosa-associated lymphoid tissue lymphoma patient, using 4D-CBCT. The stomach was delineated based on 4D-CT images. For image guidance, an automatic registration between planning CT and 4D-CBCT images was performed based on the bony anatomy (bone matching), followed by manual registration based on the stomach in 4D-CBCT images of all 10 phases (4D matching). We calculated the covering ratio (CR) with variable stomach-to-planning target volume (PTV) margins, based on the images of all phases [CR (%) = the number of covering phases/all 150 phases × 100].

Results

The patient underwent radiotherapy (RT) as scheduled, without any significant adverse effects. The appropriate PTV margins (CR ≥ 95%) were 25 mm (CR 99.3%) and 15 mm (CR 98.7%) for bone and 4D matching, respectively.

Conclusion

4D matching using 4D-CBCT is appropriate for IGRT of gastric lymphomas.

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Author information

Affiliations

  1. Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Ryo Toya, Tetsuo Saito, Tomohiko Matsuyama, Takahiro Watakabe & Natsuo Oya

  2. Department of Radiological Technology, Kumamoto University Hospital, Kumamoto, Japan

    Yoshinobu Shimohigashi, Yohei Yotsuji & Yudai Kai

  3. Department of Diagnostic Radiology, Kumamoto University Hospital, Kumamoto, Japan

    Yasuyuki Yamashita

Authors
  1. Ryo Toya
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  2. Tetsuo Saito
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  3. Yoshinobu Shimohigashi
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  4. Yohei Yotsuji
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  5. Tomohiko Matsuyama
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  6. Takahiro Watakabe
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  7. Yudai Kai
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  8. Yasuyuki Yamashita
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  9. Natsuo Oya
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Corresponding author

Correspondence to Ryo Toya.

Ethics declarations

Ethical statement

Informed consent for the treatment and images used in the analysis were obtained from the patient. Institutional review board approval was not obtained because it is not required by the institution for this type of technical note.

Conflict of interest

The authors declare that they have no conflict of interest.

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Cite this article

Toya, R., Saito, T., Shimohigashi, Y. et al. Four-dimensional cone-beam computed tomography-guided radiotherapy for gastric lymphoma. Jpn J Radiol 36, 159–163 (2018). https://doi.org/10.1007/s11604-017-0698-8

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  • DOI: https://doi.org/10.1007/s11604-017-0698-8

Keywords

  • Gastric lymphoma
  • Four-dimensional cone-beam computed tomography
  • Image-guided radiotherapy
  • Internal target volume
  • Respiratory motion