Helical tomotherapy planning for lung cancer based on ventilation magnetic resonance imaging

Jing Cai, Robert McLawhorn, Tallisa A. Altes, Eduard de Lange, Paul W. Read, James M. Larner, Stanley H. Benedict, Ke Sheng

Research output: Journal article publicationJournal articleAcademic researchpeer-review

9 Citations (Scopus)


To investigate the feasibility of lung ventilation-based treatment planning, computed tomography and hyperpolarized (HP) helium-3 (He-3) magnetic resonance imaging (MRI) ventilation images of 6 subjects were coregistered for intensity-modulated radiation therapy planning in Tomotherapy. Highly-functional lungs (HFL) and less-functional lungs (LFL) were contoured based on their ventilation image intensities, and a cylindrical planning-target-volume was simulated at locations adjacent to both HFL and LFL. Annals of an anatomy-based plan (Plan 1) and a ventilation-based plan (Plan 2) were generated. The following dosimetric parameters were determined and compared between the 2 plans: percentage of total/HFL volume receiving ≥20 Gy, 15 Gy, 10 Gy, and 5 Gy (TLV20, HFLV20, TLV15, HFLV15, TLV10, HFLV10, TLV5, HFLV5), mean total/HFL dose (MTLD/HFLD), maximum doses to all organs at risk (OARs), and target dose conformality. Compared with Plan 1, Plan 2 reduced mean HFLD (mean reduction, 0.8 Gy), MTLD (mean reduction, 0.6 Gy), HFLV20(mean reduction, 1.9%), TLV20(mean reduction, 1.5%), TLV15(mean reduction, 1.7%), and TLV10(mean reduction, 2.1%). P-values of the above comparisons are less than 0.05 using the Wilcoxon signed rank test. For HFLV15, HFLV10, TLV5, and HTLV5, Plan 2 resulted in lower values than plan 1 but the differences are not significant (P-value range, 0.063-0.219). Plan 2 did not significantly change maximum doses to OARs (P-value range, 0.063-0.563) and target conformality (P = 1.000). HP He-3 MRI of patients with lung disease shows a highly heterogeneous ventilation capacity that can be utilized for functional treatment planning. Moderate but statistically significant improvements in sparing functional lungs were achieved using helical tomotherapy plans.
Original languageEnglish
Pages (from-to)389-396
Number of pages8
JournalMedical Dosimetry
Issue number4
Publication statusPublished - 7 Mar 2011
Externally publishedYes


  • Functional planning
  • Helical Tomotherapy
  • Hyperpolarized He-3
  • Lung cancer
  • Ventilation MRI

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Oncology
  • Radiology Nuclear Medicine and imaging


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