{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:47:00Z","timestamp":1791647220330,"version":"4.3.4"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"\n Purpose:<\/jats:title>\n Respiratory-induced tumor motion is a major challenge in lung cancer (LC) radiotherapy. Four-dimensional computed tomography (4D-CT) using a maximum intensity projection (MIP) dataset is a commonly used and time-efficient method to generate internal target volume (ITV). This study compared ITV delineation using MIP or tumor delineation on all phases of the respiratory cycle.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n Thirty consecutive patients of LC who underwent 4D-CT from January 2014 to March 2017 were included. ITV delineation was done using MIP (ITV\n MIP<\/jats:sub>\n ) and all ten phases of the respiratory cycle (ITV\n 10Phases<\/jats:sub>\n ). Both volumes were analyzed using matching index (MI). It is the ratio of the intersection of two volumes to the union of two volumes. A paired sample\n t<\/jats:italic>\n -test was used for statistical analysis, and\n P<\/jats:italic>\n < 0.05 was considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The mean \u00b1 standard deviation volume of ITV\n 10Phases<\/jats:sub>\n was significantly larger compared to ITV\n MIP<\/jats:sub>\n (134 cc \u00b1 39.1 vs. 113 cc \u00b1 124.2,\n P<\/jats:italic>\n = 0.000). The mean MI was 0.75 (range 0.57\u20130.88). The mean volume of ITV\n 10Phases<\/jats:sub>\n not covered by ITV\n MIP<\/jats:sub>\n was 26.33 cc (23.5%) and vice versa was 5.51 cc (6.1%). The mean MI was 0.73 for tumors close to the mediastinum, chest wall, and diaphragm. MI was not different between tumors \u22645 cm and >5 cm. The average time required for delineation was 9 and 96 min, respectively. The center of mass of two ITVs differed by 0.01 cm.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n ITV using MIP is significantly smaller and may miss a tumor compared to ITV delineation in 10 phases of 4D-CT. However, the time required is significantly less with MIP. Caution should be exercised in tumors proximity to the mediastinum, chest wall, and diaphragm.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmp.jmp_65_20","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T05:59:00Z","timestamp":1628315940000},"page":"59-65","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Is Maximum Intensity Projection an Optimal Approach for Internal Target Volume Delineation in Lung 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