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: Contribution to journalArticlepeer-review

7 Scopus citations


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 (TLV 20, HFLV 20, TLV 15, HFLV 15, TLV 10, HFLV 10, TLV 5, HFLV 5), 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), HFLV 20 (mean reduction, 1.9%), TLV 20 (mean reduction, 1.5%), TLV 15 (mean reduction, 1.7%), and TLV 10 (mean reduction, 2.1%). P-values of the above comparisons are less than 0.05 using the Wilcoxon signed rank test. For HFLV 15, HFLV 10, TLV 5, and HTLV 5, 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 (US)
Pages (from-to)389-396
Number of pages8
JournalMedical Dosimetry
Issue number4
StatePublished - 2011
Externally publishedYes


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

ASJC Scopus subject areas

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


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