Implications of Respiratory Motion as Measured by Four-Dimensional Computed Tomography for Radiation Treatment Planning of Esophageal Cancer

Patel, Abhijit A.; Wolfgang, John A.; Niemierko, Andrzej; Hong, Theodore S.; Yock, Torunn I.; Choi, Noah C.

doi:10.1016/j.ijrobp.2008.12.060

Cited by 68 publications

(60 citation statements)

References 22 publications

(21 reference statements)

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“…Other studies have reported that tumors in the distal esophagus had higher mobility compared with those in the middle and upper esophagus (9,10,15,17). The aim of the present study was to investigate the displacement differences between the superior and inferior ends of tumors located in the upper-middle thoracic esophagus in three directions.…”

Section: Discussionmentioning

confidence: 86%

“…Hashimoto et al (10) also found that the mean range of motion of fiducial markers inserted into the esophageal wall was 3.5±1.8 mm, 8.3±3.8 and 4.0±2.6 mm, respectively, for the medio-lateral, cranio-caudal and AP directions. Furthermore, a study by Patel et al (15) using time-resolved 4D-CT revealed that the peak-to-peak displacements of all primary tumors in the SI, AP and LR dimensions were 0.80±0.45, 0.28±0.20 and 0.22±0.23 cm, respectively. The results of the present study were concordant with those determined in the abovementioned studies, while the magnitude of motion in the SI direction (5.00 mm) determined by the present study was smaller.…”

Section: Discussionmentioning

confidence: 96%

“…Thus, it is not recommended to set differential ITV margins based on different parts of the tumor for mid-upper esophageal cancer. Several studies have previously reported directional displacement differences in primary esophageal cancer (6,10,15). Zhao et al (6) studied tumors located at the GEJ using respiratory-induced target motions by 4D-CT and recommended margins of 1.0 cm (left), 0.8 cm (right), 1.1 cm (anterior), 0.6 cm (posterior), 1.0 cm (superior) and 1.6 cm (inferior).…”

Section: Discussionmentioning

confidence: 99%

“…Our results demonstrated that no significant differences in displacement were found between the upper and lower clips in the LR, SI and AP directions and, thus, differential ITV margins based on different parts of the tumor are not recommended. Previous studies have investigated the displacement of tumors in various parts of the esophagus with conflicting results (9,10,(15)(16)(17). For example, in a study by Lorchel et al (16), 8 patients that presented with esophageal malignancies underwent two conventional spiral CT scans during breath-hold procedure under spirometric control, and no association of tumor motion with anatomical location was observed.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, tumors located at the upper and middle thoracic esophagus were assessed, while it has been previously confirmed that tumors located in the distal esophagus are more mobile (9,10,(15)(16)(17). Therefore, a further exploratory study was performed by placing a third clip at the lower thoracic esophagus at 2 cm above the non-neoplastic GEJ to preliminarily determine whether displacement differences between the upper and lower ends of the tumor may also occur if the distal end of the tumor is located near the GEJ.…”

Section: Introductionmentioning

confidence: 93%

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Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

Qiu

Wen

et al. 2016

Molecular and Clinical Oncology

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Abstract. In the present study, clips were used as markers to evaluate displacement differences between proximal and distal ends of esophageal tumors and to test whether their internal target volume (ITV) margins should be determined separately. A total of 23 patients with mid-upper thoracic esophageal squamous-cell carcinoma, a tumor length of ≤8 cm and an esophageal lumen suitable for endoscopic ultrasonography were recruited for the present study. Clips were implanted endoscopically at the proximal and distal ends of the esophageal tumor (upper and lower clips). In a further exploratory study on 16 of the patients, a third clip was placed at the distal esophagus 2 cm above the gastro-esophageal junction (GEJ) (cardiac clip). The clips were contoured for all 10 phases of the four-dimensional computed tomography and the maximum displacements of the clip centroids among different breathing phases in left-right (LR), superior-inferior (SI) and anterior-posterior (AP) directions were marked as x, y and z, respectively. The ITV margins that covered 95% of the LR, SI and AP motion were 2.89, 5.00 and 2.36 mm, respectively. Axial displacement (y) was greater than radial displacement (x, z; P<0.05). It was also revealed that LR(x), SI(y) and AP(z) displacement of cardiac clips was greater than that of upper or lower clips (P<0.05). Differences in the axial and radial displacement of the upper and lower clips indicated that axial and radial ITV margins should be determined separately. However, further study is required on patients in whom the distal tumor end is located in proximity to the GEJ.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

See 3 more Smart Citations

Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

Qiu

Wen

et al. 2016

Molecular and Clinical Oncology

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Analysis of left ventricle regional myocardial motion for cardiac radioablation

Poon,

Thompson,

Deyell

et al. 2024

J Applied Clin Med Phys

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PurposeLeft ventricle (LV) regional myocardial displacement due to cardiac motion was assessed using cardiovascular magnetic resonance (CMR) cine images to establish region‐specific margins for cardiac radioablation treatments.MethodsCMR breath‐hold cine images and LV myocardial tissue contour points were analyzed for 200 subjects, including controls (n = 50) and heart failure (HF) patients with preserved ejection fraction (HFpEF, n = 50), mid‐range ejection fraction (HFmrEF, n = 50), and reduced ejection fraction (HFrEF, n = 50). Contour points were divided into segments according to the 17‐segment model. For each patient, contour point displacements were determined for the long‐axis (all 17 segments) and short‐axis (segments 1–12) directions. Mean overall, tangential (longitudinal or circumferential), and normal (radial) displacements were calculated for the 17 segments and for each segment level.ResultsThe greatest overall motion was observed in the control group—long axis: 4.5 ± 1.2 mm (segment 13 [apical anterior] epicardium) to 13.8 ± 3.0 mm (segment 6 [basal anterolateral] endocardium), short axis: 4.3 ± 0.8 mm (segment 9 [mid inferoseptal] epicardium) to 11.5 ± 2.3 mm (segment 1 [basal anterior] endocardium). HF patients exhibited lesser motion, with the smallest overall displacements observed in the HFrEF group—long axis: 4.3 ± 1.7 mm (segment 13 [apical anterior] epicardium) to 10.6 ± 3.4 mm (segment 6 [basal anterolateral] endocardium), short axis: 3.9 ± 1.3 mm (segment 8 [mid anteroseptal] epicardium) to 7.4 ± 2.8 mm (segment 1 [basal anterior] endocardium).ConclusionsThis analysis provides an estimate of epicardial and endocardial displacement for the 17 segments of the LV for patients with normal and impaired LV function. This reference data can be used to establish treatment planning margin guidelines for cardiac radioablation. Smaller margins may be used for patients with higher degree of impaired heart function, depending on the LV segment.

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PET motion correction in context of integrated PET/MR: Current techniques, limitations, and future projections

et al. 2017

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Patient motion is an important consideration in modern PET image reconstruction. Advances in PET technology mean motion has an increasingly important influence on resulting image quality. Motion-induced artifacts can have adverse effects on clinical outcomes, including missed diagnoses and oversized radiotherapy treatment volumes. This review aims to summarize the wide variety of motion correction techniques available in PET and combined PET/CT and PET/MR, with a focus on the latter. A general framework for the motion correction of PET images is presented, consisting of acquisition, modeling, and correction stages. Methods for measuring, modeling, and correcting motion and associated artifacts, both in literature and commercially available, are presented, and their relative merits are contrasted. Identified limitations of current methods include modeling of aperiodic and/or unpredictable motion, attaining adequate temporal resolution for motion correction in dynamic kinetic modeling acquisitions, and maintaining availability of the MR in PET/MR scans for diagnostic acquisitions. Finally, avenues for future investigation are discussed, with a focus on improvements that could improve PET image quality, and that are practical in the clinical environment.

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Implications of Respiratory Motion as Measured by Four-Dimensional Computed Tomography for Radiation Treatment Planning of Esophageal Cancer

Cited by 68 publications

References 22 publications

Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

Analysis of left ventricle regional myocardial motion for cardiac radioablation

PET motion correction in context of integrated PET/MR: Current techniques, limitations, and future projections

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