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Objectives  To investigate the impacts of the different three-dimensional CT (3DCT) scanning modes on the GTV delineation for solitary pulmonary lesion (SPL) based on four-dimensional CT (4DCT), and to evaluate the feasibility of using the spiral CT scan in CT simulation.    Materials and methods  Twenty-one patients with SPL underwent axial CT scan, spiral CT scan and 4DCT simulation scan during free-breathing, respectively. The same clinical radiation oncologist delineated the gross tumor volume (GTV) under the same CT window setting. GTV A  and GTV S  were created from the axial and spiral images, respectively. ITV MIP  was created from the maximum intensity projection (MIP) reconstructed 4D images. The target volumes and position between GTV A , GTV S  and ITV MIP  were compared. The matching index (MI) between GTV A  and GTV S , and the correlation between MI and GTV S  were evaluated.    Results  ITV MIP  was significantly larger than GTV A  and GTV S  ( p   s   = 0.000). The ratios of ITV MIP  to GTV A  and GTV S  were 1.57 ± 0.54 and 1.66 ± 0.61, respectively. There was no significant difference between GTV A  and GTV S ( p  = 0.16). A comparison of the centroidal positions in x, y, and z directions for GTV A , GTV S  and GTV 4Dmip  showed no significant difference ( p  x  = 0.17,  p  y  = 0.40,  p   z   = 0.48). Additionally, there was no difference between distances from the centroidal positions of GTV A  and GTV S  to the origin of coordinates ( p  = 0.51). MI between GTV A  and GTV S  was 0.41 ± 0.24 (range 0–0.89), and it was positively correlated with the tumor volume ( r  = 0.64,  p  = 0.002).    Conclusion  There was no impact on the volume or centroidal position of GTV by the axial scan or spiral scan in 3DCT simulation for SPL. MI between GTV A  and GTV S  was small. A positively correlation was found between MI and GTV S . Relative to axial scanning mode, spiral CT scan was more timesaving and more efficient, it was feasible in 3DCT simulation for SPL.

A comparison of the different 3D CT scanning modes on the GTV delineation for the solitary pulmonary lesion