Stereotactic body radiation therapy planning for liver tumors using functional images from dual-energy computed tomography

Purpose This study aimed to generate a functional image of the liver using dual-energy computed tomography (DECT) and a functional-image-based stereotactic body radiation therapy plan to minimize the dose to the volume of the functional liver (Vfl). Material and methods A normalized iodine density (NID) map was generated for fifteen patients with liver tumors. The volume of liver with an NID Results FLR showed a significantly strong correlation with FIB-4 (r = −0.71, p 0.05). For Vfl, F-VMAT plans achieved lower V5Gy (122.4 ± 31.7 vs 181.1 ± 57.3 cc), V10Gy (44.4 ± 22.2 vs 98.2 ± 33.3 cc), V15Gy (22.6 ± 20.3 vs 49.8 ± 33.7 cc), V20Gy (11.6 ± 14.1 vs 24.9 ± 25.1 cc), and Dmean (3.9 ± 2.3 vs 5.8 ± 3.0 Gy) values than the C-VMAT plans (p Conclusions The functional image derived from DECT was successfully used, allowing for a reduction in the dose to the Vfl without compromising target coverage.