Cine-Magnetic Resonance Imaging Assessment of Intrafraction Motion for Prostate Cancer Patients Supine or Prone With and Without a Rectal Balloon

Vargas, Carlos; Saito, Anneyuko I.; Hsi, W. C.; Indelicato, Daniel J.; Falchook, Aaron D.; Zengm, Qingguo; Oliver, Kenneth; Keole, Sameer R.; Dempsey, Jim

doi:10.1097/coc.0b013e31819fdf7c

Cited by 55 publications

(38 citation statements)

References 26 publications

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“…Formal analysis of random and systematic variation was not performed in this study because the only repeated analysis is for the same patient in a different position. In the paper by Vargas et al, ( 17 ) random variation was correlated to the standard deviations (as in our Table 2) and systematic variations to the vector means (as in our Table 1). Finally, we did not attempt to assess the dosimetric consequences of the long‐term or short‐term displacements.…”

Section: Discussionsupporting

confidence: 62%

“…1 and 2, comparing both positions. Vargas et al ( 17 ) applied automatic deformable segmentation of the prostate to seven patients in prone and supine positions to identify centroid motion in the sagittal plane using 4‐minute cine magnetic resonance imaging at 0.4 Hz. The Vargas study found mean displacements in the SI and AP planes similar to our results, but its mean SDs were considerably larger than the values we report in Table 2, and Vargas and colleagues found the SDs in the AP plane to be much greater than in the SI plane, compared to our finding of similar magnitude between the two planes.…”

Section: Discussionmentioning

confidence: 99%

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Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Butler

Merrick

Reed

et al. 2013

J Applied Clin Med Phys

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Implanted radiofrequency transponders were used for real‐time monitoring of the intrafraction prostate displacement between patients in the prone position and the same patients in the supine position. Thirteen patients had three transponders implanted transperineally and were treated prone with a custom‐fitted thermoplastic immobilization device. After collecting data from the last fraction, patients were realigned in the supine position and the displacements of the transponders were monitored for 5–7 minutes. Fourier transforms were applied to the data from each patient to determine periodicity and its amplitude. To remove auto correlation from the stream of displacement data, the distribution of short‐term and long‐term velocity components were calculated from Poincaré plots of paired sequential vector displacements. The mean absolute displacement was significantly greater prone than supine in the superior–inferior (SI) plane (1.2±0.6mm vs. 0.6±0.4mm, p=0.015), but not for the lateral or anterior–posterior (AP) planes. Displacements were least in the lateral direction. Fourier analyses showed the amplitude of respiratory oscillations was much greater for the SI and AP planes in the prone versus the supine position. Analysis of Poincaré plots confirmed greater short‐term variance in the prone position, but no difference in the long‐term variance. The centroid of the implanted transponders was offset from the treatment isocenter by > 5 mm for 1.9% of the time versus 0.8% of the time for supine. These results confirmed significantly greater net intrafraction prostate displacement of patients in the prone position than in the supine position, but most of the difference was due to respiration‐induced motion that was most pronounced in the SI and AP directions. Because the respiratory motion remained within the action threshold and also within our 5 mm treatment planning margins, there is no compelling reason to choose one treatment position over the other.PACS number: 87.50.st

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Butler

Merrick

Reed

et al. 2013

J Applied Clin Med Phys

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“…However, when an ERC is not used, the prone position may be a better alternative for some men. Imaging patients in the prone position can result in higher respiratory motion artifacts but may be necessary to facilitate comfort for certain patients [45,46]. MR imaging of the prostate begins with a low-resolution 3-plane localizer 'scout.'…”

Section: Protocolsmentioning

confidence: 99%

Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation

et al. 2015

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The use of multiparametric MRI scans for the evaluation of men with prostate cancer has increased dramatically and is likely to continue expanding as new developments come to practice. However, it has not yet gained the same level of acceptance of other imaging tests. Partly, this is because of the use of suboptimal protocols, lack of standardization, and inadequate patient preparation. In this manuscript, we describe several practical aspects of prostate MRI that may facilitate the implementation of new prostate imaging programs or the expansion of existing ones.

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“…However, it has recently become clear that prostate motion occurs in accordance with the respiratory cycle (2)(3)(4)(5). Therefore, the respiratory-induced motion of the prostate may be considered a factor in locating and reducing intrafraction motion during treatment planning.…”

Section: Introductionmentioning

confidence: 99%

“…In particular, it has been shown, using implanted radiopaque prostate markers and fluoroscopy, that ventilatory movement in the prostate is substantial in the prone position (2)(3)(4). A study using cine-magnetic resonance imaging (cine-MRI) also demonstrated that the amplitude of the respiratory-induced motion in the supine position is smaller than that in the prone position (5).…”

Section: Introductionmentioning

confidence: 99%

Can a Belly Board Reduce Respiratory-Induced Prostate Motion in the Prone Position? — Assessed by Cine-Magnetic Resonance Imaging

Terashima

Nakamura

Shioyama

et al. 2013

Technol Cancer Res Treat

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The purpose of this study is to evaluate the real-time respiratory motion of the prostate and surrounding tissues/organs in the supine and prone positions and to investigate, using cine-MRI, whether a belly board can reduce respiratory-induced motion in the prone position. Cine-MRI scans were made of 13 volunteers in the supine and prone positions on a flat board and in two different prone positions using a belly board. Images in cine mode were recorded for 20 seconds. For each session, the points of interest (POIs) were located at the apex, base, mid-anterior surface and mid-posterior surface of the prostate; the tip of the seminal vesicle; the pubic symphysis; and the sacrum. The maximum range and standard deviation (SD) of the displacement from the mean value were calculated. The SDs for each of the four different positions were compared using a paired t-test. Respiratory-induced prostate motion was significantly larger in the prone position than in the supine position.However, when a belly board was used in the prone position, motion in the prostate and surrounding tissues/organs was significantly reduced. There were no significant differences between the two different positions using a belly board in any of the POIs.Key words: Prostate cancer; Radiotherapy; Intrafraction motion; Cine-MRI; Belly board. IntroductionAlthough it is well known that the prostate position varies in response to changes in bladder and rectal filling (1), respiratory-induced motion of the prostate has not traditionally been considered in prostate cancer radiotherapy. However, it has recently become clear that prostate motion occurs in accordance with the respiratory cycle (2-5). Therefore, the respiratory-induced motion of the prostate may be considered a factor in locating and reducing intrafraction motion during treatment planning.In the published literature, variations have been shown in the results between the use of the prone and supine positions for prostate cancer radiotherapy. Several authors have demonstrated that the rectal irradiation dose was reduced in the prone position (6, 7), though it may be that the daily setup reproducibility is less accurate for the prone position, primarily due to systematic setup variations (7). In particular, it has been shown, using implanted radiopaque prostate markers and fluoroscopy, that ventilatory movement in the prostate is substantial in the prone position (2-4). A study using cine-magnetic resonance imaging (cine-MRI) also demonstrated that the amplitude of the respiratory-induced motion in the supine position is smaller than that in the prone position (5).

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Cine-Magnetic Resonance Imaging Assessment of Intrafraction Motion for Prostate Cancer Patients Supine or Prone With and Without a Rectal Balloon

Abstract: Intrafraction prostate motion was found dependent on time, patient position, and the use of a rectal balloon. Relatively stable positions can be obtained for 4 minutes or less especially in the supine position with a rectal balloon.

Cited by 55 publications

References 26 publications

Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Intrafraction displacement of prone versus supine prostate positioning monitored by real‐time electromagnetic tracking

Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation

Can a Belly Board Reduce Respiratory-Induced Prostate Motion in the Prone Position? — Assessed by Cine-Magnetic Resonance Imaging

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