The spine and carina as a surrogate for target registration in cone-beam CT imaging verification in locally advanced lung cancer radiotherapy

		N = 40
Gender	Female	16 (40 %)
	Male	24 (60 %)
Age (years)	Median (range)	67 (53–81)
	RUL	15 (37.5%)
	RML	3 (7.5%)
Tumour location*	RLL	7 (17.5%)
	LUL	8 (20%)
	LLL	8 (20%)
Central (C)/	C	17 (42.5%)
peripheral (P) tumour location**	P	22 (55%)
Histology	NSCLC	31 (77.5%)
	SCLC	9 (22.5%)
	De novo lung cancer	32 (80%)
	Local progression	1 (2.5%)
Disease treated	Local recurrence reirradiation	2 (5%)
	Regional recurrence	1 (2.5%)
	Locoregional recurrence reirradiation	4 (10%)
	Concurrent chemotherapy	13 (32.5%)
Systemic treatment	Sequential chemotherapy	16 (40%)
	Target therapy	1 (2.5%)
	None	10 (25%)
	T0	1 (2.5%)
	T1	4 (10%)
Tumour (T) stage	T2	14 (35%)
	T3	8 (20%)
	T4	13 (32.5%)
	N0	9 (22.5%)
Lymph nodes (N)	N1	1 (2.5%)
stage	N2	14 (35%)
	N3	16 (40%)
Fractionation	Conventional	37 (92.5%)
	Hypofractionation	3 (7.5%)
Radiation technique	VMAT	40 (100%)

[i] * In one patient, two synchronous tumours were treated (RUL and LUL).

**In one patient, only the lymph nodes were treated (regional recurrence).

LLL = left lower lobe; LUL = left upper lobe; NSCLC = non-small cell cancer; RML = right middle lobe; RLL = right lower lobe; RUL = right upper lobe; SCLC = small cell lung cancer; VMAT = volumetric modulated arc therapy

Spine to target **(A)** and carina to target **(B)** registration set-up deviation in the lateral (LAT), longitudinal (LONG) and vertical (VRT) directions.

Table 2

Mean set-up deviation difference (DD) comparison according to spine/target vs. carina/target registration

Fraction	Spine/target	Carina/target	DD	p value	Spine/target	Carina/target	DD	p value	Spine/target	Carina/target	DD	p value
1^st	1.28	0.90	0.38	NS	2.65	1.80	0.85	NS	1.20	1.43	-0.23	NS
10^th	1.30	1.08	0.22	NS	2.03	1.53	0.50	NS	1.68	1.10	0.58	0.04
15^th	1.48	1.08	0.4	NS	2.38	1.65	0.73	0.05	1.38	1.38	0	NS
20^th	1.53	1.05	0.48	NS	2.73	2.15	0.58	NS	1.2	1.43	-0.23	NS
All measurements	1.39	1.03	0.37	0.003	2.44	1.78	0.66	0.002	1.36	1.33	0.03	NS

[i] DD = deviation difference; LAT = lateral; LONG = longitudinal; NS = non-significant (p>0.05); target = primary tumour and lymph nodes; VRT = vertical

Table 3

Spine/target registration deviation according to tumour location

	Central	Peripheral		Central	Peripheral		Central	Peripheral
1^st	0.71	1.77	0.048	1.18	3.91	0.002	1.12	1.32	NS
10^th	0.76	1.77	0.008	1.53	2.41	NS	1.41	1.86	0.017
15^th	1.47	1.55	NS	2.59	2.32	NS	1.35	1.45	NS
20^th	1.94	1.27	NS	2.29	3.14	NS	1.29	1.09	NS

[i] LAT = lateral; LONG = longitudinal; NS = non significant (p>0.05); target = primary tumour and lymph nodes; VRT = vertical

Table 4

Carina/target registration deviation according to tumour location

Fraction	LAT mean (mm)		*p value*	LONG mean (mm)		*p value*	VERT mean (mm)		*p value*
	Central	Peripheral		Central	Peripheral		Central	Peripheral
1^st	0.65	1.14	NS	1.65	2.00	NS	1.06	1.77	NS
10^th	0.53	1.55	0.002	1.18	1.86	0.041	0.82	1.32	NS
15^th	0.71	1.41	0.049	1.00	2.23	0.027	0.88	1.77	NS
20^th	1.00	1.14	NS	0.94	3.14	0.019	0.88	1.82	NS

[i] LAT = lateral, LONG = longitudinal, NS = non significant (p>0.05); VRT = vertical; target = primary tumour and lymph nodes

Articles in this issue

DOI: https://doi.org/10.2478/raon-2022-0048 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 86 - 94

Submitted on: May 8, 2022

Accepted on: Oct 19, 2022

Published on: Mar 22, 2023

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

locally advanced lung cancer,

volumetric image verification,

tumour registration,

carina registration,

spine registration,

adaptive radiotherapy

Related subjects:

Medicine,

Clinical medicine,

Radiology

© 2023 Jasna But-Hadzic, Karmen Strljic, Valerija Zager Marcius, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 57 (2023): Issue 1 (March 2023)

The spine and carina as a surrogate for target registration in cone-beam CT imaging verification in locally advanced lung cancer radiotherapy

Figures & Tables

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Table 1

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Table 2

Table 3

Table 4

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