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Title: Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography

Abstract

Objectives: Abdominal intensity-modulated radiation therapy and proton therapy require quantification of target and organ motion to optimize localization and treatment. Although addressed in adults, there is no available literature on this issue in pediatric patients. We assessed physiologic renal motion in pediatric patients. Methods and Materials: Twenty free-breathing pediatric patients at a median age of 8 years (range, 2-18 years) with intra-abdominal tumors underwent computed tomography simulation and four-dimensional computed tomography acquisition (slice thickness, 3 mm). Kidneys and diaphragms were contoured during eight phases of respiration to estimate center-of-mass motion. We quantified center of kidney mass mobility vectors in three dimensions: anteroposterior (AP), mediolateral (ML), and superoinferior (SI). Results: Kidney motion decreases linearly with decreasing age and height. The 95% confidence interval for the averaged minima and maxima of renal motion in children younger than 9 years was 5-9 mm in the ML direction, 4-11 mm in the AP direction, and 12-25 mm in the SI dimension for both kidneys. In children older than 9 years, the same confidence interval reveals a widening range of motion that was 5-16 mm in the ML direction, 6-17 mm in the AP direction, and 21-52 mm in the SI direction. Although not statisticallymore » significant, renal motion correlated with diaphragm motion in older patients. The correlation between diaphragm motion and body mass index was borderline (r = 0.52, p = 0.0816) in younger patients. Conclusions: Renal motion is age and height dependent. Measuring diaphragmatic motion alone does not reliably quantify pediatric renal motion. Renal motion in young children ranges from 5 to 25 mm in orientation-specific directions. The vectors of motion range from 5 to 52 mm in older children. These preliminary data represent novel analyses of pediatric intra-abdominal organ motion.« less

Authors:
;  [1];  [2]; ; ; ;  [1]
  1. Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN (United States)
  2. Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN (United States)
Publication Date:
OSTI Identifier:
22056229
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 82; Journal Issue: 5; Other Information: Copyright (c) 2012 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; ADULTS; CENTER-OF-MASS SYSTEM; CHILDREN; COMPUTERIZED TOMOGRAPHY; DIAPHRAGM; KIDNEYS; NEOPLASMS; PATIENTS; PEDIATRICS; PROTONS; RADIOTHERAPY; RESPIRATION; SIMULATION

Citation Formats

Pai Panandiker, Atmaram S., E-mail: atmaram.pai-panandiker@stjude.org, Sharma, Shelly, Naik, Mihir H, Wu, Shengjie, Hua, Chiaho, Beltran, Chris, Krasin, Matthew J, and Merchant, Thomas E. Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.03.046.
Pai Panandiker, Atmaram S., E-mail: atmaram.pai-panandiker@stjude.org, Sharma, Shelly, Naik, Mihir H, Wu, Shengjie, Hua, Chiaho, Beltran, Chris, Krasin, Matthew J, & Merchant, Thomas E. Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography. United States. https://doi.org/10.1016/J.IJROBP.2011.03.046
Pai Panandiker, Atmaram S., E-mail: atmaram.pai-panandiker@stjude.org, Sharma, Shelly, Naik, Mihir H, Wu, Shengjie, Hua, Chiaho, Beltran, Chris, Krasin, Matthew J, and Merchant, Thomas E. 2012. "Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography". United States. https://doi.org/10.1016/J.IJROBP.2011.03.046.
@article{osti_22056229,
title = {Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography},
author = {Pai Panandiker, Atmaram S., E-mail: atmaram.pai-panandiker@stjude.org and Sharma, Shelly and Naik, Mihir H and Wu, Shengjie and Hua, Chiaho and Beltran, Chris and Krasin, Matthew J and Merchant, Thomas E},
abstractNote = {Objectives: Abdominal intensity-modulated radiation therapy and proton therapy require quantification of target and organ motion to optimize localization and treatment. Although addressed in adults, there is no available literature on this issue in pediatric patients. We assessed physiologic renal motion in pediatric patients. Methods and Materials: Twenty free-breathing pediatric patients at a median age of 8 years (range, 2-18 years) with intra-abdominal tumors underwent computed tomography simulation and four-dimensional computed tomography acquisition (slice thickness, 3 mm). Kidneys and diaphragms were contoured during eight phases of respiration to estimate center-of-mass motion. We quantified center of kidney mass mobility vectors in three dimensions: anteroposterior (AP), mediolateral (ML), and superoinferior (SI). Results: Kidney motion decreases linearly with decreasing age and height. The 95% confidence interval for the averaged minima and maxima of renal motion in children younger than 9 years was 5-9 mm in the ML direction, 4-11 mm in the AP direction, and 12-25 mm in the SI dimension for both kidneys. In children older than 9 years, the same confidence interval reveals a widening range of motion that was 5-16 mm in the ML direction, 6-17 mm in the AP direction, and 21-52 mm in the SI direction. Although not statistically significant, renal motion correlated with diaphragm motion in older patients. The correlation between diaphragm motion and body mass index was borderline (r = 0.52, p = 0.0816) in younger patients. Conclusions: Renal motion is age and height dependent. Measuring diaphragmatic motion alone does not reliably quantify pediatric renal motion. Renal motion in young children ranges from 5 to 25 mm in orientation-specific directions. The vectors of motion range from 5 to 52 mm in older children. These preliminary data represent novel analyses of pediatric intra-abdominal organ motion.},
doi = {10.1016/J.IJROBP.2011.03.046},
url = {https://www.osti.gov/biblio/22056229}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 82,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2012},
month = {Sun Apr 01 00:00:00 EDT 2012}
}