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Title: Reduction of Respiratory Liver Tumor Motion by Abdominal Compression in Stereotactic Body Frame, Analyzed by Tracking Fiducial Markers Implanted in Liver

Abstract

Purpose: To investigate in a three-dimensional framework the effectiveness and reproducibility of reducing the respiratory motion of liver tumors using abdominal compression in a stereotactic body frame. Methods and Materials: A total of 12 patients with liver tumors, who were treated with stereotactic body radiotherapy, were included in this study. These patients had three gold fiducial markers implanted in the healthy liver tissue surrounding the tumor. Fluoroscopic videos were acquired on the planning day and before each treatment fraction to visualize the motion of the fiducial markers during free breathing and varying levels of abdominal compression. Software was developed to track the fiducial markers and measure their excursions. Results: Abdominal compression reduced the patient group median excursion by 62% in the craniocaudal and 38% in the anteroposterior direction with respect to the median free-breathing excursions. In the left-right direction, the median excursion increased 15% (maximal increase 1.6 mm). The median residual excursion was 4.1 mm in the craniocaudal, 2.4 mm in the anteroposterior, and 1.8 mm in the left-right direction. The mean excursions were reduced by compression to <5 mm in all patients and all directions, with two exceptions (craniocaudal excursion reduction of 20.5 mm to 7.4 mm and ofmore » 21.1 mm to 5.9 mm). The residual excursions reproduced well during the treatment course, and the craniocaudal excursions measured on the treatment days were never significantly ({alpha} = 0.05) greater than on the planning days. Fine tuning the compression did not considerably change the excursion on the treatment days. Conclusions: Abdominal compression effectively reduced liver tumor motion, yielding small and reproducible excursions in three dimensions. The compression level established at planning could have been safely used on the treatment days.« less

Authors:
 [1]; ; ; ; ;  [1]
  1. Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)
Publication Date:
OSTI Identifier:
21124332
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 71; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2008.03.010; PII: S0360-3016(08)00487-2; Copyright (c) 2008 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; COMPUTER CODES; IMAGES; LIVER; NEOPLASMS; PARTICLE TRACKS; PATIENTS; RADIOTHERAPY

Citation Formats

Wunderink, Wouter, Mendez Romero, Alejandra, Kruijf, Willy de, Boer, Hans de, Levendag, Peter, and Heijmen, Ben. Reduction of Respiratory Liver Tumor Motion by Abdominal Compression in Stereotactic Body Frame, Analyzed by Tracking Fiducial Markers Implanted in Liver. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.03.010.
Wunderink, Wouter, Mendez Romero, Alejandra, Kruijf, Willy de, Boer, Hans de, Levendag, Peter, & Heijmen, Ben. Reduction of Respiratory Liver Tumor Motion by Abdominal Compression in Stereotactic Body Frame, Analyzed by Tracking Fiducial Markers Implanted in Liver. United States. https://doi.org/10.1016/j.ijrobp.2008.03.010
Wunderink, Wouter, Mendez Romero, Alejandra, Kruijf, Willy de, Boer, Hans de, Levendag, Peter, and Heijmen, Ben. 2008. "Reduction of Respiratory Liver Tumor Motion by Abdominal Compression in Stereotactic Body Frame, Analyzed by Tracking Fiducial Markers Implanted in Liver". United States. https://doi.org/10.1016/j.ijrobp.2008.03.010.
@article{osti_21124332,
title = {Reduction of Respiratory Liver Tumor Motion by Abdominal Compression in Stereotactic Body Frame, Analyzed by Tracking Fiducial Markers Implanted in Liver},
author = {Wunderink, Wouter and Mendez Romero, Alejandra and Kruijf, Willy de and Boer, Hans de and Levendag, Peter and Heijmen, Ben},
abstractNote = {Purpose: To investigate in a three-dimensional framework the effectiveness and reproducibility of reducing the respiratory motion of liver tumors using abdominal compression in a stereotactic body frame. Methods and Materials: A total of 12 patients with liver tumors, who were treated with stereotactic body radiotherapy, were included in this study. These patients had three gold fiducial markers implanted in the healthy liver tissue surrounding the tumor. Fluoroscopic videos were acquired on the planning day and before each treatment fraction to visualize the motion of the fiducial markers during free breathing and varying levels of abdominal compression. Software was developed to track the fiducial markers and measure their excursions. Results: Abdominal compression reduced the patient group median excursion by 62% in the craniocaudal and 38% in the anteroposterior direction with respect to the median free-breathing excursions. In the left-right direction, the median excursion increased 15% (maximal increase 1.6 mm). The median residual excursion was 4.1 mm in the craniocaudal, 2.4 mm in the anteroposterior, and 1.8 mm in the left-right direction. The mean excursions were reduced by compression to <5 mm in all patients and all directions, with two exceptions (craniocaudal excursion reduction of 20.5 mm to 7.4 mm and of 21.1 mm to 5.9 mm). The residual excursions reproduced well during the treatment course, and the craniocaudal excursions measured on the treatment days were never significantly ({alpha} = 0.05) greater than on the planning days. Fine tuning the compression did not considerably change the excursion on the treatment days. Conclusions: Abdominal compression effectively reduced liver tumor motion, yielding small and reproducible excursions in three dimensions. The compression level established at planning could have been safely used on the treatment days.},
doi = {10.1016/j.ijrobp.2008.03.010},
url = {https://www.osti.gov/biblio/21124332}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 71,
place = {United States},
year = {Tue Jul 01 00:00:00 EDT 2008},
month = {Tue Jul 01 00:00:00 EDT 2008}
}