Li Q, Tong Y, Yin Y, Cheng P, Gong G. Definition of the margin of major coronary artery bifurcations during radiotherapy with electrocardiograph-gated 4D-CT.
Phys Med 2018;
49:90-94. [PMID:
29866348 DOI:
10.1016/j.ejmp.2018.05.008]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/03/2018] [Accepted: 05/06/2018] [Indexed: 10/16/2022] Open
Abstract
PURPOSE
The aim was to measure the cardiac motion-induced displacements of major coronary artery bifurcations utilizing electrocardiography (ECG)-gated four-dimensional computed tomography (4D-CT) and to determine the margin of coronary artery bifurcations.
METHODS
Thirty-seven female patients who underwent retrospective ECG-gated 4D-CT in inspiratory breath hold (IBH) were enrolled. The left main coronary artery bifurcation (LM), the obtuse marginal branch bifurcation (OM), the first diagonal branch bifurcation (D1), the second diagonal branch bifurcation (D2), the caudal portion of the left anterior descending branch (APX), the first right ventricular artery bifurcation (V) and the acute marginal branch bifurcation (AM) were contoured. The center of the contour of the coronary arterial bifurcations at end systole was defined as the standard, and the margin were then calculated.
RESULTS
The margin in the left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) coordinates were as follows: LM 3, 3, and 3 mm; D1 6, 3, and 3 mm; D2 3, 3, and 3 mm; APX 4, 4, and 4 mm; OM 4, 6, and 5 mm; V 6, 8, and 7 mm; and AM 6, 8, and 7 mm, respectively.
CONCLUSION
Coronary artery bifurcations should be considered a separate organ at risk (OAR), and different margin should be provided due to the differences resulting from motion displacement. The maximum margin in the LR, CC, and AP coordinates of left coronary artery bifurcations were 6, 6, and 5 mm, and those of the right coronary artery bifurcations were 6, 8, and 7 mm, respectively.
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