Analysis of target doses on various tissues in treatment of lung cancer: A simulation study

The success indicator of radiotherapy planning is that it can deliver a precise and maximum dose to the tumor, and at the same time, health tissues receive a minimum dose. The success can be achieved by understanding the density of the organs that go into the treatment beams because the dose distribution was directly affected by tissue inhomogeneity. Therefore, the study aimed to evaluate the tissue density of DICOM images and the homogeneity of the distribution of dose from treatment planning in lung cancer using 3D Slicer-SlicerRT. The method used in the study was used 3 data of CT and RT - Structures data from The Cancer Imaging Archive (TCIA), NSCLC-Radiomics with a diagnosis of stage IIIB squamous cell carcinoma, the location of right cancer, and only one nodule. The calculation of tissue density values using segment statistics in 3D Slicer was based on CT-DICOM information. While the treatment planning was built using 3D Slicer-SlicerRT with a prescription of 60 Gy/30 fractions. Treatment design used six fields, and optimization was done by combining a gantry angle and beam weight. The results represented that the calculation of tissue density was following the reference standard and relative electron density for each organ. Besides, the study had successfully designed a treatment planning system using 3D Slicer-SlicerRT that fulfilled the total dose standard, was excellent for OAR sparing, and had a homogeneity index for patient data ID 1 until 4 with values of 0.252, 0.009, 0.007, and 0.007, respectively.