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Title: Is a Single Respiratory Correlated 4D-CT Study Sufficient for Evaluation of Breathing Motion?

Abstract

Purpose: Respiratory correlated computed tomography has been shown to be effective for evaluation of breathing-induced motion of pulmonary tumors. This study investigated whether a single four-dimensional CT study (4D-CT) is representative and sufficient for treatment planning in stereotactic body radiotherapy (SBRT). Methods and Materials: Four repeated helical 4D-CT studies were acquired every 10 min for 10 patients with 14 pulmonary metastases. Patients remained immobilized in a stereotactic body frame (SBF) for 30 min; abdominal compression was applied to seven patients. Using amplitude based sorting, eight phases equally distributed over the breathing cycle were reconstructed for each 4D-CT study. Tumor position was defined in a total of 406 CT series and variability of breathing motion and mean tumor position were evaluated. Results: Peak-to-peak tumor motion was 9.9 mm {+-} 6.8 mm (mean {+-} standard deviation) and 9.0 mm {+-} 7.4 mm at time point 0 min (t{sub 0}) and t{sub 30}, respectively. In one patient with poor pulmonary function, continuous increase of breathing motion from 17.4 mm at t{sub 0} to 28.3 mm at t{sub 30} was seen. In five and two lesions, respectively, a drift of the mean tumor position greater than 3 mm and 5 mm was observed. Amore » borderline significance was calculated for larger tumor position variability in midventilation phases compared with peak-ventilation phases of the breathing cycle (p = 0.08). Conclusion: Treatment planning based on a single 4D-CT study is reliable for the majority of patients. Increased intrafractional uncertainties were seen for patients with poor pulmonary function and with tumors located in the lower lobe.« less

Authors:
 [1];  [1];  [1];  [1];  [1];  [1]
  1. Department of Radiation Oncology, Julius-Maximilians University of Wuerzburg, Wuerzburg (Germany)
Publication Date:
OSTI Identifier:
20951577
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 67; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.11.025; PII: S0360-3016(06)03519-X; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AMPLITUDES; CARCINOMAS; COMPRESSION; COMPUTERIZED TOMOGRAPHY; ERRORS; LUNGS; METASTASES; PATIENTS; RESPIRATION

Citation Formats

Guckenberger, Matthias, Wilbert, Juergen, Meyer, Juergen, Baier, Kurt, Richter, Anne, and Flentje, Michael. Is a Single Respiratory Correlated 4D-CT Study Sufficient for Evaluation of Breathing Motion?. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.11.025.
Guckenberger, Matthias, Wilbert, Juergen, Meyer, Juergen, Baier, Kurt, Richter, Anne, & Flentje, Michael. Is a Single Respiratory Correlated 4D-CT Study Sufficient for Evaluation of Breathing Motion?. United States. https://doi.org/10.1016/j.ijrobp.2006.11.025
Guckenberger, Matthias, Wilbert, Juergen, Meyer, Juergen, Baier, Kurt, Richter, Anne, and Flentje, Michael. 2007. "Is a Single Respiratory Correlated 4D-CT Study Sufficient for Evaluation of Breathing Motion?". United States. https://doi.org/10.1016/j.ijrobp.2006.11.025.
@article{osti_20951577,
title = {Is a Single Respiratory Correlated 4D-CT Study Sufficient for Evaluation of Breathing Motion?},
author = {Guckenberger, Matthias and Wilbert, Juergen and Meyer, Juergen and Baier, Kurt and Richter, Anne and Flentje, Michael},
abstractNote = {Purpose: Respiratory correlated computed tomography has been shown to be effective for evaluation of breathing-induced motion of pulmonary tumors. This study investigated whether a single four-dimensional CT study (4D-CT) is representative and sufficient for treatment planning in stereotactic body radiotherapy (SBRT). Methods and Materials: Four repeated helical 4D-CT studies were acquired every 10 min for 10 patients with 14 pulmonary metastases. Patients remained immobilized in a stereotactic body frame (SBF) for 30 min; abdominal compression was applied to seven patients. Using amplitude based sorting, eight phases equally distributed over the breathing cycle were reconstructed for each 4D-CT study. Tumor position was defined in a total of 406 CT series and variability of breathing motion and mean tumor position were evaluated. Results: Peak-to-peak tumor motion was 9.9 mm {+-} 6.8 mm (mean {+-} standard deviation) and 9.0 mm {+-} 7.4 mm at time point 0 min (t{sub 0}) and t{sub 30}, respectively. In one patient with poor pulmonary function, continuous increase of breathing motion from 17.4 mm at t{sub 0} to 28.3 mm at t{sub 30} was seen. In five and two lesions, respectively, a drift of the mean tumor position greater than 3 mm and 5 mm was observed. A borderline significance was calculated for larger tumor position variability in midventilation phases compared with peak-ventilation phases of the breathing cycle (p = 0.08). Conclusion: Treatment planning based on a single 4D-CT study is reliable for the majority of patients. Increased intrafractional uncertainties were seen for patients with poor pulmonary function and with tumors located in the lower lobe.},
doi = {10.1016/j.ijrobp.2006.11.025},
url = {https://www.osti.gov/biblio/20951577}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 67,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2007},
month = {Sun Apr 01 00:00:00 EDT 2007}
}