{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T04:26:19Z","timestamp":1692851179961},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This work evaluated a new radiotherapy target\u2010generating framework (the \u03b1Target algorithm) for creating internal target volumes for lung SBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nineteen patients previously treated with definitive intent SBRT to the lung were identified from a clinical database. For each patient's 4DCT simulation scan, deformable image registration was used between phases of the scan in order to generate voxelized models of motion for 35 individual gross tumor volumes. These motion models were then used with a new implementation of a previously described target\u2010generating algorithm to create new internal target volumes (\u03b1ITVs). The resulting \u03b1ITVs were analyzed with respect to their volume and the coverage they provided each tumor voxel per that voxel's motion model. The clinically used ITVs were similarly analyzed, and were then compared to the \u03b1ITVs using paired Student's <jats:italic>t<\/jats:italic>\u2010tests. In addition, isotropic margins were added to the \u03b1ITVs in order to determine the largest margin magnitude that could be added without exceeding the volume of the clinical ITVs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The \u03b1ITVs increased the target coverage provided to each tumor's 5th\u2010percentile\u2010most\u2010covered\u2010voxel an average of 50.3% compared to the clinical ITVs (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). At the same time, the \u03b1ITVs had volumes that were, on average, 31.4% smaller (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). The differences in volume were large enough that, on average, an extra 2\u00a0mm isotropic margin could be added to the \u03b1ITV before it had a volume greater than the clinical ITV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The \u03b1Target algorithm can generate more effective lung SBRT internal target volumes that provide greater coverage with smaller volumes. In combination with numerous other advantages of the framework, this effectiveness makes the \u03b1Target algorithm a powerful new method for advanced IGRT or adaptive radiotherapy techniques.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.15323","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T11:14:40Z","timestamp":1635851680000},"page":"7623-7631","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of an automatic, uncertainty model\u2010guided, target\u2010generating algorithm to lung stereotactic body radiotherapy"],"prefix":"10.1002","volume":"48","author":[{"given":"Adam D.","family":"Yock","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Knutson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Osmundson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"International Commission on Radiation Units and Measurements.ICRU Report 50. 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