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Journal of Basic and Clinical Health Sciences 2019 , Vol 3 , Issue 1
Correlation Between CT-Simulator and Dynamic Magnetic Resonance Images in Determining The Location of Gross Tumor Volume in Radiotherapy Treatment Planning for Lung Cancer
Sevecen Seyhun Nasir1,Aysegül Yurt2,Nuri Karabay3,Cenk Umay4,Barbaros Aydin4,Ayse Nur Demiral4
1Dr. Lutfi Kırdar Kartal Training and Research State Hospital, Radiation Oncology, İstanbul, Turkey
2Dokuz Eylül University, Medical Physics, İzmir, Turkey
3Dokuz Eylül University, Radiology, İzmir, Turkey
4Dokuz Eylül University, Radiation Oncology, İzmir, Turkey
DOI : 10.30621/jbachs.2019.517 Objective: This study aimed to determine the accuracy of the average tumor location in CT-simulator images and PTV margins in radiotherapy treatment planning by detecting lung tumor mobility in dynamic MRI scans of patients presenting with lung cancer.

Materials and Method: Dynamic MRI examination was performed in 12 lung cancer patients scheduled for 3-dimensional conformal RT (3D-CRT) using CT-simulator. In this study, maximum tumor displacement (CC-MRI, ML-MRI, AP-MRI) was measured that occurred in CC, AP and ML axes in expiratory and inspiratory phases of dynamic MRI. The distance from the upper limit of GTV to the reference line (CC-CT) was measured in CT-simulator images. CC-CT and CCmean-MRI values were compared with the Wilcoxon signed-rank test. Furthermore, correlation of these values was evaluated with Spearman"s correlation test.

Results: In comparison of CC-CT and CCmean-MRI values, no statistically significant difference was detected between CT-simulator and dynamic MRI modalities (p=0.172). In addition, a high level of correlation was found between these two imaging methods (p<0.0001).

Conclusion: In our study, the maximum difference between the mean and the CC distances from the upper limit of GTV to the reference line at inspiration and expiration phases in dynamic MR images was 0.4 cm. In general, it can be concluded that the tumor location detected in CTsimulator and dynamic MRI correlate well. However, tumor mobility during respiration is high particularly for small and/or, peripheral and/or lower lobe tumors; thus for such cases it is recommended to get use of dynamic MRI in radiotherapy treatment planning. Keywords : lung cancer, respiratory motion, radiotherapy, dynamic magnetic resonance imaging, CT-simulator