Cranio-Caudal Movements of the Liver, Pancreas and Kidneys in Respiration

Suramo, I; Pãivänsalo, M.; Myllylä, Vilho V.

doi:10.1177/028418518402500208

Cited by 247 publications

(158 citation statements)

References 7 publications

(1 reference statement)

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“…Respiration-induced craniocaudal, lateral, and anteroposterior motions have been observed (1). Motion in the craniocaudal direction is the most significant of the three, with translations of the liver ranging from 10 to 26 mm during quiet respiration and larger translations, as much as 55-60 mm, seen during deep respiration (1,4). In addition, Shirato et al (5) reported anteroposterior motions ranging from 4 to 8 mm, along with motions of 5-9 mm in the lateral axis.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Biofeedback during CT-guided Procedures

Locklin

Yanof

Luk

et al. 2007

Journal of Vascular and Interventional Radiology

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PURPOSE-Respiratory motion can be a complicating factor during image-guided interventions. The ability to reproduce breath-holds may facilitate safer needle-based procedures. The purpose of this study was to evaluate if respiratory biofeedback decreased variability among breath-holds and if the signals from the respiratory bellows belt can be used to measure target motion. MATERIALS AND METHODS-In phase 1 of the study, a respiratory bellows belt was applied to patients before image-guided interventional procedures. Belt stretch from respiratory motion was converted into voltage readings and displayed on a monitor as biofeedback. Patients were asked to perform inspiratory, expiratory, and midcycle breath-holds with and without the biofeedback. The variability in voltage readings between breath-holds with and without biofeedback was compared. In phase 2, the respiratory bellows belt was used during computed tomography (CT)-guided procedures with the patients blinded to the biofeedback. Voltage readings and CT series numbers were recorded as patients were asked to hold their breath during scans. The variability of CT z-axis targets was compared with the variability of voltage readings.RESULTS-A significant decrease in variability was found during expiratory breath-holds (P = . 0083) with trends toward significance with midcycle and inspiratory breath-holds. A positive correlation (Kendall τ = 0.5; P = .024) was shown between CT z-axis and belt stretch variability in subjects who received smaller doses of moderate sedation compared with those who received larger doses or general anesthesia.CONCLUSIONS-Biofeedback may help the patient to have a more consistent breath-hold. The belt could decrease the error and unpredictability from craniocaudal motion of targets during imageguided interventions.PATIENT respiratory motion can be a complicating factor when targeting a tumor for computed tomography (CT)-guided interventional procedures. Respiration-induced motion during the normal breathing cycle can result in significant shifts in tumor position, especially near the diaphragm, in the lung and abdomen (1). Consistent and reproducible breath-holds could reduce procedure time and the number of needle manipulations, promoting a safer procedure. Without a documented measure of their breath-hold position in the respiratory cycle, the patient cannot be expected to precisely reproduce similar pre-and intraprocedural breathholds. The air bellows belt measures chest wall or abdomen excursion and provides patients with visual biofeedback during their respiratory cycle.Address correspondence to J.K.L., National Institutes of Health, Building 10, Room 1C367A, 9000 Rockville Pike, Bethesda, MD 20892; E-mail: locklinj@cc.nih.gov. NIH Public Access MATERIALS AND METHODSIn the present study, a tool consisting of an air bellows belt (Philips Medical Systems, Cleveland, OH) attached to a visual feedback system shown to patients was evaluated for its ability to assist patients to more precisely reproduce preprocedural breath-hold...

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Section: Discussionmentioning

confidence: 99%

Respiratory Biofeedback during CT-guided Procedures

Locklin

Yanof

Luk

et al. 2007

Journal of Vascular and Interventional Radiology

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“…The liver motion is more complicated, as it is the most movable abdominal organ (Suramo et al, 1983), and does not have a fixed relationship to the skin surface or the surrounding organs (Clifford et al, 2002;Siva et al, 2013), although they are related by ligaments or membranes (O'Rahilly and Müller, 1983). Thus, the liver can be subject to both sliding and free discontinuous motion ( Fig.…”

Section: D Ct Liver Images Datasetmentioning

confidence: 99%

Multiresolution eXtended Free-Form Deformations (XFFD) for non-rigid registration with discontinuous transforms

Hua

Pozo

Taylor

et al. 2017

Medical Image Analysis

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Image registration is an essential technique to obtain point correspondences between anatomical structures from different images. Conventional nonrigid registration methods assume a continuous and smooth deformation field throughout the image. However, the deformation field at the interface of different organs is not necessarily continuous, since the organs may slide over or separate from each other. Therefore, imposing continuity and smoothness ubiquitously would lead to artifacts and increased errors near the discontinuity interface.In computational mechanics, the eXtended Finite Element Method (XFEM) was introduced to handle discontinuities without using computational meshes that conform to the discontinuity geometry. Instead, the interpolation bases themselves were enriched with discontinuous functional terms. Borrowing this concept, we propose a multiresolution eXtented Free-Form Deformation (XFFD) framework that seamlessly integrates within and extends the standard Free-Form Deformation (FFD) approach. Discontinuities are incor- Preprint submitted to ElsevierOctober 18, 2016 porated by enriching the B-spline basis functions coupled with extra degrees of freedom, which are only introduced near the discontinuity interface. In contrast with most previous methods, restricted to sliding motion, no ad hoc penalties or constraints are introduced to reduce gaps and overlaps. This allows XFFD to describe more general discontinuous motions. In addition,we integrate XFFD into a rigorously formulated multiresolution framework by introducing an exact parameter upsampling method.The proposed method has been evaluated in two publicly available datasets:4D pulmonary CT images from the DIR-Lab dataset and 4D CT liver datasets.The XFFD achieved a Target Registration Error (TRE) of 1.17 ± 0.85 mm in the DIR-lab dataset and 1.94 ± 1.01 mm in the liver dataset, which significantly improves on the performance of the state-of-the-art methods handling discontinuities.

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“…Eight publications where found describing kidney motion under deep breathing (19)(20)(21)(22) or from breath hold instructions (21,(23)(24)(25)(26). No external devices were used on the abdomen.…”

Section: Kidney Motion During Deep Breathing/breath Holdmentioning

confidence: 99%

A Review of Kidney Motion under Free, Deep and Forced-Shallow Breathing Conditions: Implications for Stereotactic Ablative Body Radiotherapy Treatment

Pham

Kron

Foroudi

et al. 2014

Technol Cancer Res Treat

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Motion management strategies are important during stereotactic ablative body radiotherapy for abdominal targets. The kidney is a mobile retroperitoneal organ that moves with respiration. A review of the literature was performed to investigate the reported degree of kidney motion associated with various breathing conditions. A structured search was performed using Medline from January 1970 to May 2013 for all publications describing cranial-caudal kidney motion. Relevance to radiotherapy practice was reviewed based on any breathing instructions and/or immobilization equipment that could affect breathing pattern. Studies were categorized under three types of breathing conditions: Forced-shallow, breath-hold/ deep and free. A total of 25 publications were identified describing cranial-caudal kidney motion with a combined total of 415 participants. Three publications described forced-shallow breathing using prone positioning or abdominal compression plates. Prone positioning, compared to supine positioning, did little to minimise kidney motion, however use of compression plates can result in kidney motion of less than 5 mm. Eight publications described deep breathing/breath hold techniques that showed average kidney motion ranging between 10 mm-40 mm. Fifteen publications investigated kidney motion under free breathing with the majority reporting mean motion of less than 10 mm. Kidney movement of up to 8.1 mm in the anterior posterior direction and 6.2 mm laterally were reported with no indications that breathing technique can influence the extent of this motion. In summary, kidney movement is complex and consideration should be made to ensure that motion management strategies provide the desired radiotherapy benefit. There are limited publications on the effectiveness of abdominal compression on reducing kidney motion which warrant further investigation in this area.

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Cranio-Caudal Movements of the Liver, Pancreas and Kidneys in Respiration

Cited by 247 publications

References 7 publications

Respiratory Biofeedback during CT-guided Procedures

Respiratory Biofeedback during CT-guided Procedures

Multiresolution eXtended Free-Form Deformations (XFFD) for non-rigid registration with discontinuous transforms

A Review of Kidney Motion under Free, Deep and Forced-Shallow Breathing Conditions: Implications for Stereotactic Ablative Body Radiotherapy Treatment

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