SU-E-T-174: Evaluation of the Optimal Intensity Modulated Radiation Therapy Plans Done On the Maximum and Average Intensity Projection CTs




To determine the difference in coverage between plans done on average intensity projection and maximum intensity projection CT data sets for lung patients and to establish correlations between different factors influencing the coverage.


For six lung cancer patients, 10 phases of equal duration through the respiratory cycle, the maximum and average intensity projections (MIP and AIP) from their 4DCT datasets were obtained. MIP and AIP datasets had three GTVs delineated (GTVaip — delineated on AIP, GTVmip — delineated on MIP and GTVfus — delineated on each of the 10 phases and summed up). From the each GTV, planning target volumes (PTV) were then created by adding additional margins. For each of the PTVs an IMRT plan was developed on the AIP dataset. The plans were then copied to the MIP data set and were recalculated.


The effective depths in AIP cases were significantly smaller than in MIP (p < 0.001). The Pearson correlation coefficient of r = 0.839 indicates strong degree of positive linear relationship between the average percentage difference in effective depths and average PTV coverage on the MIP data set. The V2 0 Gy of involved lung depends on the PTV coverage. The relationship between PTVaip mean CT number difference and PTVaip coverage on MIP data set gives r = 0.830. When the plans are produced on MIP and copied to AIP, r equals −0.756.


The correlation between the AIP and MIP data sets indicates that the selection of the data set for developing the treatment plan affects the final outcome (cases with high average percentage difference in effective depths between AIP and MIP should be calculated on AIP). The percentage of the lung volume receiving higher dose depends on how well PTV is covered, regardless of on which set plan is done.