Effect of the respiratory cycle on mediastinal and lung dimensions in Hodgkin's disease. Implications for radiotherapy gated to respiration

Journal Article · Tue Sep 15 04:00:00 EDT 1987 · Cancer (Philadelphia); (United States)

DOI:https://doi.org/10.1002/1097-0142(19870915)60:6<1232::AID-CNCR2820600612>3.0.CO;2-F· OSTI ID:6074057

Willett, C G; Linggood, R M; Stracher, M A; Goitein, M; Doppke, K; Kushner, D C; Morris, T; Pardy, J; Carroll, R

Changes in mediastinal and lung dimensions during respiration were studied to assess the potential of radiotherapy gated to respiration to minimize normal tissue irradiation. Twelve patients with mediastinal Hodgkin's disease were assessed using chest radiographs and thoracic computed tomography (CT) scans both during quiet breathing and at maximum inspiration in the standing, supine, and prone positions. A simple measure of the bulk of mediastinal disease, the ratio of the width of mediastinal mass to thoracic diameter, was determined from posteroanterior (PA) chest radiographs. The volumes of mediastinum, irradiated and protected lung if anteroposterior (AP) and PA mantle fields were used were determined from sequential thoracic CT scans and three-dimensional treatment planning and compared at quiet breathing and deep inspiration. The mediastinal width to thoracic diameter ratio decreased from quiet breathing to deep inspiration an average of 3%, 9%, and 11% for the standing, supine, and prone positions, respectively. Lung volumes as measured from the thoracic CT scans showed that on average, 8% more lung was protected at deep inspiration than at quiet breathing, independent of treatment position. The maximum increase in the percentage of protected lung from quiet breathing to deep inspiration was seen in patients with extensive mediastinal adenopathy suggesting that radiotherapy gated to respiration may be most advantageous in the subset of patients.

• Research Organization: Massachusetts General Hospital, Boston
• OSTI ID: 6074057
• Journal Information: Cancer (Philadelphia); (United States), Journal Name: Cancer (Philadelphia); (United States) Vol. 60:6; ISSN CANCA
• Country of Publication: United States
• Language: English

Related Subjects

550602* -- Medicine-- External Radiation in Diagnostics-- (1980-)
550603 -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOMEDICAL RADIOGRAPHY
BODY
BODY AREAS
CHEST
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DIMENSIONS
DISEASES
HODGKINS DISEASE
INJURIES
LUNGS
LYMPHOMAS
MEDIASTINUM
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
POSITIONING
RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
RADIOTHERAPY
RESPIRATION
RESPIRATORY SYSTEM
THERAPY
TOMOGRAPHY