Semiautomatic technique for defining the internal gross tumor volume of lung tumors close to liver/spleen cupola by 4D-CT

Pietro Mancosu, Roberto Sghedoni, Valentino Bettinardi, Mark Anthony Aquilina, Piera Navarria, Giovanni Mauro Cattaneo, Nadia Di Muzio, Luca Cozzi, Marta Scorsetti

Research output: Contribution to journalArticlepeer-review


Purpose: It has been shown that in cases of lung tumors close to the liver cupola, the four dimensional (4D)-CT postprocessing maximum intensity projection (MIP) algorithm does not fully recover the radiotherapy internal gross tumor volume (IGTV). In this work, a semiautomatic technique was evaluated by which the residual IGTV that was not included into the IGTV by MIP algorithm was actually added. Methods: A moving phantom and five selected patients were considered. The various IGTVs produced by the semiautomatic approach were compared to those generated by 4D-CT manual contouring. Results: In all cases, the radiation oncologist qualitatively concurred with the semiautomatic IGTV. A quantitative difference in volume of 2.6% was found in the phantom study, whereas a mean difference of 0.1±4.6% was obtained in the patient studies. Conclusions: A semiautomatic technique to include the residual part of IGTV covered by liver/spleen cupola when using MIP algorithm was validated on phantom and on selected patients, revealing the possibility of defining the IGTV for patients with lesions located near liver/spleen cupola by performing only the contours on the MIP series.

Original languageEnglish
Pages (from-to)4572-4576
Number of pages5
JournalMedical Physics
Issue number9
Publication statusPublished - Sep 2010


  • internal gross tumor volume-IGTV
  • internal target volume-ITV
  • lung node, radiotherapy-RT
  • maximum intensity projection-MIP

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)


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