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Title: SU-D-207A-06: Pediatric Abdominal Organ Motion Quantified Via a Novel 4D MRI Method

Abstract

Purpose: To develop a 4D MRI method for assessing respiration-induced abdominal organ motion in children receiving radiation therapy. Methods: A 4D MRI using internal image-based respiratory surrogate has been developed and implemented on a clinical scanner (1.5T Siemens Avanto). Ten patients (younger group: N=6, 2–5 years, anesthetized; older group: N=4, 11–15 years) with neuroblastoma, Wilm’s tumor rhabdomyosarcoma, or desmoplastic small round cell tumor received free breathing 4D MRI scans for treatment planning. Coronal image slices of the entire abdomen were retrospectively constructed in 10 respiratory phases. A B-spline deformable registration (Metz et al. 2011) was performed on 4D datasets to automatically derive motion trajectories of selected anatomical landmarks, including the dome and the center of the liver, and the superior edges of kidneys and spleen. The extents of the motion in three dimensions (anteroposterior, AP; mediolateral, ML; superoinferior, SI) and the correlations between organ motion trajectories were quantified. Results: The 4D MRI scans were successfully performed in <20 minutes for all patients without the use of any external device. Organ motion extents were larger in adolescents (kidneys: 3–13 mm SI, liver and spleen: 6–18 mm SI) than in younger children (kidneys:<3mm in all directions; liver and spleen: 1–8 mm SI,more » 1–5 mm ML and AP). The magnitude of respiratory motion in some adolescents may warrant special motion management. Motion trajectories were not synchronized across selected anatomical landmarks, particularly in the ML and AP directions, indicating inter- and intra-organ variations of the respiratory-induced motion. Conclusion: The developed 4D MRI acquisition and motion analysis methods provide a non-ionizing, non-invasive approach to automatically measure the organ motion trajectory in the pediatric abdomen. It is useful for defining ITV and PRV, monitoring changes in target motion patterns during the treatment course, and studying interplay effects in proton scanning.« less

Authors:
; ; ; ; ;  [1]
  1. St. Jude Children’s Research Hospital, Memphis, TN (United States)
Publication Date:
OSTI Identifier:
22624397
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; ABDOMEN; ADOLESCENTS; CHILDREN; CONNECTIVE TISSUE; CORRELATIONS; DATASETS; IMAGES; KIDNEYS; LIVER; NMR IMAGING; PATIENTS; PEDIATRICS; RADIOTHERAPY; RHABDOMYOSARCOMAS; SPLEEN

Citation Formats

Uh, J, Krasin, MJ, Lucas, JT, Tinkle, C, Merchant, TE, and Hua, C. SU-D-207A-06: Pediatric Abdominal Organ Motion Quantified Via a Novel 4D MRI Method. United States: N. p., 2016. Web. doi:10.1118/1.4955653.
Uh, J, Krasin, MJ, Lucas, JT, Tinkle, C, Merchant, TE, & Hua, C. SU-D-207A-06: Pediatric Abdominal Organ Motion Quantified Via a Novel 4D MRI Method. United States. doi:10.1118/1.4955653.
Uh, J, Krasin, MJ, Lucas, JT, Tinkle, C, Merchant, TE, and Hua, C. 2016. "SU-D-207A-06: Pediatric Abdominal Organ Motion Quantified Via a Novel 4D MRI Method". United States. doi:10.1118/1.4955653.
@article{osti_22624397,
title = {SU-D-207A-06: Pediatric Abdominal Organ Motion Quantified Via a Novel 4D MRI Method},
author = {Uh, J and Krasin, MJ and Lucas, JT and Tinkle, C and Merchant, TE and Hua, C},
abstractNote = {Purpose: To develop a 4D MRI method for assessing respiration-induced abdominal organ motion in children receiving radiation therapy. Methods: A 4D MRI using internal image-based respiratory surrogate has been developed and implemented on a clinical scanner (1.5T Siemens Avanto). Ten patients (younger group: N=6, 2–5 years, anesthetized; older group: N=4, 11–15 years) with neuroblastoma, Wilm’s tumor rhabdomyosarcoma, or desmoplastic small round cell tumor received free breathing 4D MRI scans for treatment planning. Coronal image slices of the entire abdomen were retrospectively constructed in 10 respiratory phases. A B-spline deformable registration (Metz et al. 2011) was performed on 4D datasets to automatically derive motion trajectories of selected anatomical landmarks, including the dome and the center of the liver, and the superior edges of kidneys and spleen. The extents of the motion in three dimensions (anteroposterior, AP; mediolateral, ML; superoinferior, SI) and the correlations between organ motion trajectories were quantified. Results: The 4D MRI scans were successfully performed in <20 minutes for all patients without the use of any external device. Organ motion extents were larger in adolescents (kidneys: 3–13 mm SI, liver and spleen: 6–18 mm SI) than in younger children (kidneys:<3mm in all directions; liver and spleen: 1–8 mm SI, 1–5 mm ML and AP). The magnitude of respiratory motion in some adolescents may warrant special motion management. Motion trajectories were not synchronized across selected anatomical landmarks, particularly in the ML and AP directions, indicating inter- and intra-organ variations of the respiratory-induced motion. Conclusion: The developed 4D MRI acquisition and motion analysis methods provide a non-ionizing, non-invasive approach to automatically measure the organ motion trajectory in the pediatric abdomen. It is useful for defining ITV and PRV, monitoring changes in target motion patterns during the treatment course, and studying interplay effects in proton scanning.},
doi = {10.1118/1.4955653},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The purpose of this study is to propose a new concept of four-dimensional (4D) cone-beam CT (CBCT) reconstruction for non-periodic organ motion using the Time-ordered Chain Graph Model (TCGM), and to compare the reconstructed results with the previously proposed methods, the total variation-based compressed sensing (TVCS) and prior-image constrained compressed sensing (PICCS). Methods: CBCT reconstruction method introduced in this study consisted of maximum a posteriori (MAP) iterative reconstruction combined with a regularization term derived from a concept of TCGM, which includes a constraint coming from the images of neighbouring time-phases. The time-ordered image series were concurrently reconstructed in themore » MAP iterative reconstruction framework. Angular range of projections for each time-phase was 90 degrees for TCGM and PICCS, and 200 degrees for TVCS. Two kinds of projection data, an elliptic-cylindrical digital phantom data and two clinical patients’ data, were used for reconstruction. The digital phantom contained an air sphere moving 3 cm along longitudinal axis, and temporal resolution of each method was evaluated by measuring the penumbral width of reconstructed moving air sphere. The clinical feasibility of non-periodic time-ordered 4D CBCT reconstruction was also examined using projection data of prostate cancer patients. Results: The results of reconstructed digital phantom shows that the penumbral widths of TCGM yielded the narrowest result; PICCS and TCGM were 10.6% and 17.4% narrower than that of TVCS, respectively. This suggests that the TCGM has the better temporal resolution than the others. Patients’ CBCT projection data were also reconstructed and all three reconstructed results showed motion of rectal gas and stool. The result of TCGM provided visually clearer and less blurring images. Conclusion: The present study demonstrates that the new concept for 4D CBCT reconstruction, TCGM, combined with MAP iterative reconstruction framework enables time-ordered image reconstruction with narrower time-window.« less
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  • Purpose: To investigate the effectiveness of different abdominal compression levels on tumor and organ motion during stereotactic body radiotherapy of lower lobe lung and liver tumors using four-dimensional (4D)-CT scan analysis. Methods and Materials: Three 4D-CT scans were acquired for 10 patients first using with no compression and then compared with two different levels of abdominal compression. The position of the tumor and various organs were defined at the peak inspiratory and expiratory phases and compared to determine the maximum motion. Results: Mean ({+-}SD) medium compression force (MC) and high compression force (HC) were 47.6 {+-} 16.0 N and 90.7more » {+-} 27.1 N, respectively. Mean overall tumor motion was 13.6 mm (2{sigma} [2 sigma] 11.5-15.6), 8.3 mm (2{sigma} 6.0-10.5), and 7.2 mm (2{sigma} 5.4-9.0) for no compression, MC, and HC, respectively. A significant difference in the control of both superior-inferior (SI) and overall motion of tumors was seen with the application of MC and HC when compared with no compression (p < 0.0001 for both). High compression force improved SI and overall tumor motion compared with MC, but this was only significant for SI motion (p = 0.04 and p = 0.06). Significant control of organ motion was only seen in the pancreas (p = 0.01). Conclusions: Four-dimensional CT shows significant control of both lower lobe lung and liver tumors using abdominal compression. High levels of compression improve SI tumor motion when compared with MC.« less
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