Observation of different tumor motion magnitude within liver and estimate of internal motion margins in postoperative patients with hepatocellular carcinoma

Zhao, Yuting; Liu, Zhikai; Wu, Qiuwen; Dai, Jianrong; Zhang, Tao; Jia, Angela Y.; Jin, Jing; Wang, Shulian; Li, Yexiong; Wang, Weihu

doi:10.2147/cmar.s147185

Cited by 8 publications

(12 citation statements)

References 46 publications

(52 reference statements)

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“…The magnitude of motion of tumors located in the lower lobe of the liver may be less dependent on diaphragm movement than those in the upper lobe. 17 However, diaphragm motion correlates well with liver tumor motion in other studies. 18 In our study, the diaphragm was used as a surrogate for tumors because liver tumors could not be visualized on CBCT images without fiducial markers.…”

Section: Discussionmentioning

confidence: 69%

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Interfractional diaphragmatic position variation according to stomach volume change during respiratory‐gated radiotherapy for hepatocellular carcinoma

et al. 2021

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Purpose We evaluated the correlation between stomach volume change and interfractional baseline shifts of the diaphragm in image‐guided radiotherapy (IGRT) for hepatocellular carcinoma (HCC). Materials and methods Twenty‐four patients with HCC underwent ten fractions of IGRT, and a total of 240 cone beam computed tomography (CBCT) and on‐board imager (OBI) kV image sets were acquired. These image sets were retrospectively analyzed. Baseline shifts of the diaphragm relative to bone and stomach volume change ratios were evaluated using four‐dimensional simulation CT, kV image, and CBCT images. Associations between baseline shifts and patient physiologic factors were investigated. Results The average baseline shift of the diaphragm in the superior‐inferior (SI) direction was 1.5 mm (standard deviation 4.6 mm), which was higher than the shift in other directions (0.7, 2.0 mm and 0.9, 2.6 mm in right‐left (RL) and anterior‐posterior (AP) directions, respectively). Interfractional baseline shifts of the diaphragm in the SI and AP directions were positively correlated with the stomach volume change ratio (Pearson's r: 0.416 and 0.302, p‐value: <0.001 and <0.001, respectively). Conclusions The interfractional baseline shifts of the diaphragm in the SI and AP directions correlated well with stomach volume changes. Efforts to maintain a constant stomach volume before the simulation and each treatment, such as fasting, may reduce interfractional baseline shifts of liver tumors.

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Section: Discussionmentioning

confidence: 69%

“…First, the diaphragm position may not accurately reflect the location of the liver tumor. The magnitude of motion of tumors located in the lower lobe of the liver may be less dependent on diaphragm movement than those in the upper lobe 17 . However, diaphragm motion correlates well with liver tumor motion in other studies 18 .…”

Section: Discussionmentioning

confidence: 73%

Interfractional diaphragmatic position variation according to stomach volume change during respiratory‐gated radiotherapy for hepatocellular carcinoma

et al. 2021

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“…The CTV included the lymph node drainage area and the next area where lymph node metastasis occurred. To account for respiratory liver motion and setup variations, the CTV was expanded by 0.5 cm in the anterior–posterior and medial–lateral directions, and by 1.0 cm in the craniocaudal direction to form the planning target volume (PTV) (14). The whole liver, normal liver that was defined as the total liver volume minus the GTV, spinal cord, small intestine, colon, stomach, and both kidneys were delineated and three-dimensionally reconstructed.…”

Section: Methodsmentioning

confidence: 99%

Safety and Efficacy of Transcatheter Arterial Chemoembolization Plus Radiotherapy Combined With Sorafenib in Hepatocellular Carcinoma Showing Macrovascular Invasion

et al. 2019

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The safety and efficacy of transcatheter arterial chemoembolization (TACE) plus intensity-modulated radiotherapy (IMRT) combined with sorafenib in hepatocellular carcinoma (HCC) showing macrovascular invasion (MVI) remain controversial. The records of 63 patients with HCC showing MVI, who underwent IMRT plus TACE combined with (28 participants; Group A) or without (35 participants; Group B) sorafenib from 2015 to 2018, were retrospectively reviewed to assess the progression-free survival (PFS), overall survival (OS), and treatment-associated toxicity. The median PFS was longer in Group A (13.6 months) than in Group B (9.2 months), and still significant after propensity score matching (PSM). However, the median OS was similar in the two groups (19.0 vs. 15.2 months, P = 0.094 before PSM; P = 0.204 after PSM). The grade 3 hematologic and hepatic toxicity was present in 10 (15.9%) and 7 (11.1%) patients, respectively. The incidence of skin reaction, hand-foot syndrome, and diarrhea, all grade 1–2 adverse events, was significantly higher in Group A than in Group B. No patient experienced grade 4 or 5 toxicity, and radiation-induced liver disease was also not observed. TACE plus IMRT combined with sorafenib showed a good safety profile and clinical benefit in patients with HCC having MVI.

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“…Respiratory management has long been a crucial issue in radiotherapy (1)(2)(3)(4)(5). All tumor sites in the thorax and abdomen are affected by respiratory motion (6).…”

Section: Introductionmentioning

confidence: 99%

Machine learning for predicting accuracy of lung and liver tumor motion tracking using radiomic features

Li¹,

Zhang²,

Song³

et al. 2023

Quant Imaging Med Surg

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Background: Internal tumor motion is commonly predicted using external respiratory signals. However, the internal/external correlation is complex and patient-specific. The purpose of this study was to develop various models based on the radiomic features of computed tomography (CT) images to predict the accuracy of tumor motion tracking using external surrogates and to find accurate and reliable tracking algorithms.Methods: Images obtained from a total of 108 and 71 patients pathologically diagnosed with lung and liver cancers, respectively, were examined. Real-time position monitoring motion was fitted to tumor motion, and samples with fitting errors greater than 2 mm were considered positive. Radiomic features were extracted from internal target volumes of average intensity projections, and cross-validation least absolute shrinkage and selection operator (LassoCV) was used to conduct feature selection. Based on the radiomic features, a total of 26 separate models (13 for the lung and 13 for the liver) were trained and tested. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to assess performance.Relative standard deviation was used to assess stability.Results: Thirty-three and 22 radiomic features were selected for the lung and liver, respectively. For the lung, the AUC varied from 0.848 (decision tree) to 0.941 [support vector classifier (SVC), logistic regression]; sensitivity varied from 0.723 (extreme gradient boosting) to 0.848 [linear support vector classifier (linearSVC)]; specificity varied from 0.834 (gaussian naive bayes) to 0.936 [multilayer perceptron (MLP), wide and deep (W&D)]; and MLP and W&D had better performance and stability than the median. For the liver, the AUC varied from 0.677 [light gradient boosting machine (Light)] to 0.892 (logistic regression); sensitivity varied from 0.717 (W&D) to 0.862 (MLP); specificity varied from 0.566 (Light) to 0.829 (linearSVC); and logistic regression, MLP, and SVC had better performance and stability than the median.Conclusions: Respiratory-sensitive radiomic features extracted from CT images of lung and liver tumors were proved to contain sufficient information to establish an external/internal motion relationship. We developed a rapid and accurate method based on radiomics to classify the accuracy of monitoring a patient's external surface for lung and liver tumor tracking. Several machine learning algorithms-in particular, MLP-demonstrated excellent classification performance and stability.

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Observation of different tumor motion magnitude within liver and estimate of internal motion margins in postoperative patients with hepatocellular carcinoma

Cited by 8 publications

References 46 publications

Interfractional diaphragmatic position variation according to stomach volume change during respiratory‐gated radiotherapy for hepatocellular carcinoma

Interfractional diaphragmatic position variation according to stomach volume change during respiratory‐gated radiotherapy for hepatocellular carcinoma

Safety and Efficacy of Transcatheter Arterial Chemoembolization Plus Radiotherapy Combined With Sorafenib in Hepatocellular Carcinoma Showing Macrovascular Invasion

Machine learning for predicting accuracy of lung and liver tumor motion tracking using radiomic features

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