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Title: Interfractional Reproducibility in Pancreatic Position Based on Four-Dimensional Computed Tomography

Abstract

Purpose: To assess the interfractional positional variation of the pancreas using four-dimensional computed tomography (4D-CT) and to determine the suitable phase of respiration for dose delivery methods to account for pancreatic tumor motion. Methods and Materials: Fifteen patients with pancreatic cancer were enrolled in this study. For each patient, 4D-CT scans were performed at CT simulation and three times during the course of treatment. Regions of interest were set to the intrapancreatic bile ducts as a surrogate for pancreatic position. The centroids of the regions of interest were calculated at end-inhalation and end-exhalation of the respiration phase. The ranges of respiratory motion and interfractional positional variation were evaluated in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions. Results: The medians of respiratory motion were 1.1 mm (range, 0.0-9.8 mm), 1.5 mm (range, 0.0-7.0 mm), and 5.0 mm (range, 0.0-12.5 mm) in the LR, AP, and SI directions, respectively. The means {+-} SDs of the interfractional positional variation at end-inhalation were 0.9 {+-} 5.1 mm (range, -9.2 to 15.6 mm), -1.9 {+-} 3.9 mm (range, -12.8 to 6.4 mm), and -1.3 {+-} 6.9 mm (range, -15.0 to 13.7 mm) and those at end-exhalation were 0.0 {+-} 3.1 mm (range, -7.0more » to 5.3 mm), -1.2 {+-} 3.9 mm (range, -11.2 to 6.7 mm), and 0.1 {+-} 3.2 mm (range, -9.9 to 5.1 mm) in the LR, AP, and SI directions, respectively. The SDs of the interfractional positional variation in the LR and SI directions were significantly larger at end-inhalation than at end-exhalation (LR, p < 0.001; SI, p < 0.001). Conclusions: The ranges of respiratory motion during the course of treatment and the interfractional positional variation were not negligible. The interfractional positional reproducibility was higher at end-exhalation than at end-inhalation under free breathing.« less

Authors:
 [1];  [2]; ; ;  [2];  [3]; ;  [2];  [1];  [2]
  1. Department of Nuclear Engineering, Graduate School of Engineering, Kyoto University, Kyoto (Japan)
  2. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto (Japan)
  3. Clinical Radiology Service Division, Kyoto University Hospital, Kyoto (Japan)
Publication Date:
OSTI Identifier:
21587659
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.10.020; PII: S0360-3016(10)03441-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The 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; BILIARY TRACT; CAT SCANNING; EXHALATION; INHALATION; NEOPLASMS; PANCREAS; RADIATION DOSES; RESPIRATION; SIMULATION; BODY; CLEARANCE; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DOSES; ENDOCRINE GLANDS; EXCRETION; GLANDS; INTAKE; ORGANS; TOMOGRAPHY

Citation Formats

Shiinoki, Takehiro, Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp, Nakamura, Mitsuhiro, Nakamura, Akira, Matsuo, Yukinori, Nakata, Manabu, Sawada, Akira, Mizowaki, Takashi, Itoh, Akio, and Hiraoka, Masahiro. Interfractional Reproducibility in Pancreatic Position Based on Four-Dimensional Computed Tomography. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.10.020.
Shiinoki, Takehiro, Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp, Nakamura, Mitsuhiro, Nakamura, Akira, Matsuo, Yukinori, Nakata, Manabu, Sawada, Akira, Mizowaki, Takashi, Itoh, Akio, & Hiraoka, Masahiro. Interfractional Reproducibility in Pancreatic Position Based on Four-Dimensional Computed Tomography. United States. doi:10.1016/j.ijrobp.2010.10.020.
Shiinoki, Takehiro, Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp, Nakamura, Mitsuhiro, Nakamura, Akira, Matsuo, Yukinori, Nakata, Manabu, Sawada, Akira, Mizowaki, Takashi, Itoh, Akio, and Hiraoka, Masahiro. Mon . "Interfractional Reproducibility in Pancreatic Position Based on Four-Dimensional Computed Tomography". United States. doi:10.1016/j.ijrobp.2010.10.020.
@article{osti_21587659,
title = {Interfractional Reproducibility in Pancreatic Position Based on Four-Dimensional Computed Tomography},
author = {Shiinoki, Takehiro and Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp and Nakamura, Mitsuhiro and Nakamura, Akira and Matsuo, Yukinori and Nakata, Manabu and Sawada, Akira and Mizowaki, Takashi and Itoh, Akio and Hiraoka, Masahiro},
abstractNote = {Purpose: To assess the interfractional positional variation of the pancreas using four-dimensional computed tomography (4D-CT) and to determine the suitable phase of respiration for dose delivery methods to account for pancreatic tumor motion. Methods and Materials: Fifteen patients with pancreatic cancer were enrolled in this study. For each patient, 4D-CT scans were performed at CT simulation and three times during the course of treatment. Regions of interest were set to the intrapancreatic bile ducts as a surrogate for pancreatic position. The centroids of the regions of interest were calculated at end-inhalation and end-exhalation of the respiration phase. The ranges of respiratory motion and interfractional positional variation were evaluated in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions. Results: The medians of respiratory motion were 1.1 mm (range, 0.0-9.8 mm), 1.5 mm (range, 0.0-7.0 mm), and 5.0 mm (range, 0.0-12.5 mm) in the LR, AP, and SI directions, respectively. The means {+-} SDs of the interfractional positional variation at end-inhalation were 0.9 {+-} 5.1 mm (range, -9.2 to 15.6 mm), -1.9 {+-} 3.9 mm (range, -12.8 to 6.4 mm), and -1.3 {+-} 6.9 mm (range, -15.0 to 13.7 mm) and those at end-exhalation were 0.0 {+-} 3.1 mm (range, -7.0 to 5.3 mm), -1.2 {+-} 3.9 mm (range, -11.2 to 6.7 mm), and 0.1 {+-} 3.2 mm (range, -9.9 to 5.1 mm) in the LR, AP, and SI directions, respectively. The SDs of the interfractional positional variation in the LR and SI directions were significantly larger at end-inhalation than at end-exhalation (LR, p < 0.001; SI, p < 0.001). Conclusions: The ranges of respiratory motion during the course of treatment and the interfractional positional variation were not negligible. The interfractional positional reproducibility was higher at end-exhalation than at end-inhalation under free breathing.},
doi = {10.1016/j.ijrobp.2010.10.020},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 80,
place = {United States},
year = {2011},
month = {8}
}