Evidence of Limited Motion of the Prostate by Carefully Emptying the Rectum as Assessed by Daily MVCT Image Guidance with Helical Tomotherapy

Fiorino, Claudio; Muzio, N. Di; Broggi, S.; Cozzarini, C.; Maggiulli, Eleonora; Alongi, Filippo; Valdagni, Riccardo; Fazio, Ferruccio; Calandrino, R.

doi:10.1016/j.ijrobp.2008.01.048

Cited by 70 publications

(66 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some studies have noted that dietary recommendations, rectal preparation and bladder filling protocols in prostate radiotherapy could decrease the interfractional variations. [26][27] Similarly, we showed that the similar protocols minimize the variations in displacement and deformation of prostate bed, bladder, and rectum with daily kV-CBCT IGRT. 30 Gill et al investigated SV motion with cinematic magnetic resonance imaging in real time.…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Evaluation of Interfractional Movement of the Seminal Vesicle and Dose Variations with IGRT Throughout the Prostate Cancer Radiotherapy.

Ergen¹

2016

UHOD

View full text Add to dashboard Cite

To validate the actual cumulative doses delivered to the seminal vesicle (SV) depending on the organ movement using kV-Cone Beam CT (kV-CBCT) datasets acquired during prostate image-guided radiation therapy. Ten patients with intermediate risk prostate cancer treated with IMRT were included in this study. Both the prostate and the first 2 cm of the SV were included in the CTV. PTV margin was 8 mm in all directions except posterior, where it was 5 mm. Sixteen kV-CBCT scans per patient were used for assessments. After each kV-CBCT was matched with the planning CT based on prostate, the SV were recontoured as proximal, distal SV and both of them together (the whole SV). Actual delivered doses to the SV were assessed by means of DVH. The variations in certain dosevolume parameters were analyzed using the Student's test. Systematic and random errors of the SV and margins were assessed using the van-Herk formula. We observed that the SV movement in the anterior-posterior direction was significantly more compared to superior-inferior and left-right direction. The dose volume variations for the whole SV (D98%, D50%, D2%) and the distal SV (D98%, D95%, D50%) were significantly different than the planned doses. However, both the whole SV and the distal SV received the prescribed dose. Although it seems that there is a need to give larger margin to the SV in posterior direction, the actual cumulative doses delivered to SV throughout the treatment were within the prescribed dose.Keywords: Image guided radiation therapy, Interfraction motions, kV-CBCT, Prostate cancer, Seminal vesicle ÖZET Prostat kanseri Radyoterapisi Sırasında Fraksiyonlar Arası Seminal Vezikül Hareketleri ve Doz Değişimlerinin IGRT ile DeğerlendirilmesiBu çalışmanın amacı, kV-Cone Beam CT (kV-CBCT) ile görüntü kılavuzluğunda prostat kanseri radyoterapisinde organ hareketine bağlı olarak seminal veziküllerin aldığı kümülatif dozların doğruluğunun değerlendirilmesidir. Çalışmamıza IMRT tekniği ile tedavi edilmiş orta risk prostat kanserli on hasta dahil edilmiştir. Prostat ve seminal vesiküllerin ilk 2 cm'lik bölümü CTV'ye dahil edilmiştir. Prostat ve SV'e posterior yönden 5 mm, diğer yönlerden 8 mm PTV marjı verilmiştir. Her hastadan 16 kV-CBCT alınmış ve SV'ye verilen marjın yeterli olup olmadığını saptamak için seçilen kV-CBCT görüntüleri ile planlama BT görüntüleri prostat referans alınarak offline eşleştirilmiştir. Seminal veziküller, proksimal-distal SV şeklinde ayrı ayrı ve her ikisi birlikte tüm SV olacak şekilde yeniden konturlanmıştır. Seminal veziküllerin aldığı doz DVH yardımı ile değerlendirilmiştir. Doz volüm histogramındaki değişiklikler Student test ile analiz edilmiştir. Sistematik ve random hatalar van-Herk formülü ile değerlendirilerek gerekli emniyet marjları bulunmuştur. Seminal vezikül hareketinin alt-üst ve sağ-sol yöne kıyasla ön-arka eksende daha fazla olduğu görülmüştür. Tüm SV için (D98% D50,% D2%) ve distal SV için doz volüm değişiklikleri (D98% D95,% D50%) planlanan dozlardan önemli ölçüde farklı bulunmuştur. Bununla bir...

show abstract

Section: Discussionmentioning

confidence: 92%

“…[22][23][24][25][26][27] In addition, most of the studies concluded that the displacement of SV is more than prostate. Online and offline corrections are helpful to eliminate set-up uncertainties and to reduce systematic errors.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Interfractional Movement of the Seminal Vesicle and Dose Variations with IGRT Throughout the Prostate Cancer Radiotherapy.

Ergen¹

2016

UHOD

View full text Add to dashboard Cite

show abstract

“…The analysis of MVCT data of 21 low-risk TOMO-SIB patients showed evidence of very limited motion of the prostate [12] relative to bony anatomy. This surprising result was mainly due to the practice of instructing patients in emptying the rectum by daily rectal enema and, secondarily, prescribing a ''full'' bladder.…”

Section: Image-guidance: Organ Motion Assessed By Daily Mvctmentioning

confidence: 98%

“…: patient to the toilet, air emptying after catheter stimulation). These procedures were found to further reduce the impact of prostate motion: the systematic and random errors for organ motion (relative to bony anatomy) were 0.44/1.3 mm and 0.34/0.9 mm respectively without and with the application of post-MVCT rectal emptying procedures [12]. The intrinsic uncertainty of the system in assessing prostate position was assessed with a number of experiments on phantoms to estimate the BM accuracy that was found within 0.6 mm (1 SD).…”

Section: Image-guidance: Organ Motion Assessed By Daily Mvctmentioning

confidence: 99%

“…Data referred to 21 low-risk patients were recently reviewed [12]. In order to assess the intrinsic uncertainty of our two-step matching strategy (BM'DV), we also compared the prostate shift assessed with BM'DV with the match based on intra-prostatic calcifications (used as ''natural markers'') on 20 randomly chosen MVCTs of 5 patients.…”

Section: Pelvic Nodes Tomotherapymentioning

confidence: 99%

See 1 more Smart Citation