Four-Dimensional Computed Tomography Scan Analysis of Tumor and Organ Motion at Varying Levels of Abdominal Compression During Stereotactic Treatment of Lung and Liver

Heinzerling, J.H.; Anderson, John F.; Papież, Lech; Boike, Thomas; Chien, Stanley; Zhang, Geoffrey; Abdulrahman, Ramzi; Timmerman, Robert

doi:10.1016/j.ijrobp.2007.12.023

Cited by 182 publications

(142 citation statements)

References 41 publications

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“…Three publications were found describing forced-shallow breathing achieved from either the use of a compression device (15)(16)(17) or from prone positioning (16,17). A summary of the mean and range of superior-inferior kidney motion is described in Table I.…”

Section: Kidney Motion During Forced-shallow Breathingmentioning

confidence: 99%

“…The use of a stereotactic body frame with a compression plate at a moderate setting to dampen abdominal motion was investigated by Heinzerling et al (15). The authors showed that this equipment was able to create a mean reduction in lung and liver tumor motion of 37.5% compared to free breathing (p 5 0.0001).…”

Section: Kidney Motion During Forced-shallow Breathingmentioning

confidence: 99%

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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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Section: Kidney Motion During Forced-shallow Breathingmentioning

confidence: 99%

Section: Kidney Motion During Forced-shallow Breathingmentioning

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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“…2,3 Several techniques can be used to manage tumor motion, such as active breath control, abdominal compression, respiratory gating and real-time tumor tracking. [4][5][6][7][8][9] In this study, we used the respiratory gating technique with an external surrogate placed on the patient's abdominal wall associated with implanted fiducial markers to manage liver motion. 5,10 The aim of this technique is to limit the radiation exposure during specific phases of the breathing cycle and to create a correlation model between the internal target motion and the external surrogate (skin surface), and finally to control the radiation beam delivery thanks to the external surrogate signal.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of reproducibility of tumor repositioning during multiple breathing cycles for liver stereotactic body radiotherapy treatment

Bedos

Riou

Aillères

et al. 2017

Reports of Practical Oncology & Radiotherapy

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a b s t r a c tAim: To evaluate the tumor repositioning during gated volumetric modulated arc therapy (VMAT) for liver stereotactic body radiotherapy(SBRT) treatment using implanted fiducial markers and intrafraction kilovoltage (kV) images acquired during dose delivery. Materials and methods:Since 2012, 47 liver cancer patients with implanted fiducial markers were treated using the gated VMAT technique with a Varian Truebeam STx linear accelerator.The fiducial markers were implanted inside or close to the tumor target before treatment simulation. They were defined at the maximum inhalation and exhalation phases on a 4-dimensionnal computed tomography (4DCT) acquisition. During the treatment, kV images were acquired just before the beam-on at each breathing cycle at maximum exhalation and inhalation phases to verify the fiducial markers positions. For the five first fractions of treatment in the first ten consecutive patients, a total of 2705 intrafraction kV images were retrospectively analyzed to assess the differences between expected and actual positions of the fiducial markers along the cranio-caudal (CC) direction during the exhalation phase. Results:The mean absolute intrafractional fiducial marker deviation along the CC direction was 1.0 mm at the maximum exhalation phase. In 99%, 95% and 90% cases, the fiducial marker deviations were ≤4.5 mm, 2.8 mm and 2.2 mm, respectively. Conclusion:Intrafraction kV images allowed us to ensure the consistency of tumor repositioning during treatment. In 99% cases, the fiducial marker deviations were ≤4.5 mm corresponding to our 5 mm treatment margin. This margin seems to be well-adapted to the gated VMAT SBRT treatment in liver disease.

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“…( 20 ) Abdominal compression ( 10 ) was applied to all patients to reduce respiratory motion. A bellows system coupled to our 16‐slice Brilliance Big Bore CT scanner (Philips Healthcare, Andover, MD) was used to monitor the patients' respiratory motion for subsequent amplitude‐based sorting.…”

Section: Methodsmentioning

confidence: 99%

A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac‐based systems

Ding

Chang

Haslam

et al. 2010

J Applied Clin Med Phys

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The aim of this study is to compare the dosimetric characteristics of robotic and conventional linac‐based SBRT techniques for lung cancer, and to provide planning guidance for each modality. Eight patients who received linac‐based SBRT were retrospectively included in this study. A dose of 60 Gy given in three fractions was prescribed to each target. The Synchrony Respiratory Tracking System and a 4D dose calculation methodology were used for CyberKnife and linac‐based SBRT, respectively, to minimize respiratory impact on dose calculation. Identical image and contour sets were used for both modalities. While both modalities can provide satisfactory target dose coverage, the dose to GTV was more heterogeneous for CyberKnife than for linac planning/delivery in all cases. The dose to 1000 cc lung was well below institutional constraints for both modalities. In the high dose region, the lung dose depended on tumor size, and was similar between both modalities. In the low dose region, however, the quality of CyberKnife plans was dependent on tumor location. With anteriorly‐located tumors, the CyberKnife may deliver less dose to normal lung than linac techniques. Conversely, for posteriorly‐located tumors, CyberKnife delivery may result in higher doses to normal lung. In all cases studied, more monitor units were required for CyberKnife delivery for given prescription. Both conventional linacs and CyberKnife provide acceptable target dose coverage while sparing normal tissues. The results of this study provide a general guideline for patient and treatment modality selection based on dosimetric, tumor and normal tissue sparing considerations.PACS numbers: 87.53.Ly, 87.55.dk.

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Four-Dimensional Computed Tomography Scan Analysis of Tumor and Organ Motion at Varying Levels of Abdominal Compression During Stereotactic Treatment of Lung and Liver

Cited by 182 publications

References 41 publications

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

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

Evaluation of reproducibility of tumor repositioning during multiple breathing cycles for liver stereotactic body radiotherapy treatment

A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac‐based systems

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