What is the effect of IV contrast on dosimetry for thoracic RT planning?

If a non-contrast CT is not performed at CT simulation or otherwise not useable, can you plan on the contrast CT or must you re-simulate for cancers near the heart (e.g., esophageal)? Is it acceptable/advisable to substitute normal vessel density in the areas of contrast?

Answer from: Radiation Oncologist at Academic Institution

The requirement for a non-contrast CT or manual region overrides of HU prior to calculation for lung IMRT was the subject of much debate when I came to Wash U. So, we ran a simple prospective trial where we scanned 8 patients with and without contrast.Intuitively, contrast scans provided better targ...

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Radiation Oncologist at Multicare Radiation Therapy
Years ago, a similar study was published with simi...

Radiation Oncologist at Beaumont Health System
I imagine that there is even less effect with VMAT...

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What is the effect of IV contrast on dosimetry for thoracic RT planning?

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