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Vergalasova I, Cai J. A modern review of the uncertainties in volumetric imaging of respiratory-induced target motion in lung radiotherapy. Med Phys 2020; 47:e988-e1008. [PMID: 32506452 DOI: 10.1002/mp.14312] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/15/2020] [Accepted: 05/26/2020] [Indexed: 12/25/2022] Open
Abstract
Radiotherapy has become a critical component for the treatment of all stages and types of lung cancer, often times being the primary gateway to a cure. However, given that radiation can cause harmful side effects depending on how much surrounding healthy tissue is exposed, treatment of the lung can be particularly challenging due to the presence of moving targets. Careful implementation of every step in the radiotherapy process is absolutely integral for attaining optimal clinical outcomes. With the advent and now widespread use of stereotactic body radiation therapy (SBRT), where extremely large doses are delivered, accurate, and precise dose targeting is especially vital to achieve an optimal risk to benefit ratio. This has largely become possible due to the rapid development of image-guided technology. Although imaging is critical to the success of radiotherapy, it can often be plagued with uncertainties due to respiratory-induced target motion. There has and continues to be an immense research effort aimed at acknowledging and addressing these uncertainties to further our abilities to more precisely target radiation treatment. Thus, the goal of this article is to provide a detailed review of the prevailing uncertainties that remain to be investigated across the different imaging modalities, as well as to highlight the more modern solutions to imaging motion and their role in addressing the current challenges.
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Affiliation(s)
- Irina Vergalasova
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Jing Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Brandner ED, Chetty IJ, Giaddui TG, Xiao Y, Huq MS. Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology. Med Phys 2017; 44:2595-2612. [PMID: 28317123 DOI: 10.1002/mp.12227] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/23/2017] [Accepted: 03/10/2017] [Indexed: 12/11/2022] Open
Abstract
The efficacy of stereotactic body radiotherapy (SBRT) has been well demonstrated. However, it presents unique challenges for accurate planning and delivery especially in the lungs and upper abdomen where respiratory motion can be significantly confounding accurate targeting and avoidance of normal tissues. In this paper, we review the current literature on SBRT for lung and upper abdominal tumors with particular emphasis on addressing respiratory motion and its affects. We provide recommendations on strategies to manage motion for different, patient-specific situations. Some of the recommendations will potentially be adopted to guide clinical trial protocols.
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Affiliation(s)
- Edward D Brandner
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC CancerCenter, Pittsburgh, PA, 15232, USA
| | - Indrin J Chetty
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Tawfik G Giaddui
- Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Ying Xiao
- Imaging and Radiation Oncology Core (IROC), University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - M Saiful Huq
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC CancerCenter, Pittsburgh, PA, 15232, USA
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Baba F, Tanaka S, Nonogaki Y, Hasegawa S, Nishihashi M, Ayakawa S, Yamada M, Shibamoto Y. Effects of audio coaching and visual feedback on the stability of respiration during radiotherapy. Jpn J Radiol 2016; 34:572-8. [DOI: 10.1007/s11604-016-0560-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/30/2016] [Indexed: 01/25/2023]
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Pollock S, Keall R, Keall P. Breathing guidance in radiation oncology and radiology: A systematic review of patient and healthy volunteer studies. Med Phys 2016; 42:5490-509. [PMID: 26328997 DOI: 10.1118/1.4928488] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The advent of image-guided radiation therapy has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion irregularities is the use of breathing guidance systems during imaging and treatment. These systems aim to facilitate regular respiratory motion which in turn improves image quality and radiation treatment accuracy. A review of such research has yet to be performed; it was therefore their aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. METHODS From August 1-14, 2014, the following online databases were searched: Medline, Embase, PubMed, and Web of Science. Results of these searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with preferred reporting items for systematic reviews and meta-analyses. Reference lists of included articles, and repeat authors of included articles, were hand-searched. RESULTS The systematic search yielded a total of 480 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. These 27 articles detailed the intervention of breathing guidance strategies in controlled studies assessing its impact on such outcomes as breathing regularity, image quality, target coverage, and treatment margins, recruiting either healthy adult volunteers or patients with thoracic or abdominal lesions. In 21/27 studies, significant (p < 0.05) improvements from the use of breathing guidance were observed. CONCLUSIONS There is a trend toward the number of breathing guidance studies increasing with time, indicating a growing clinical interest. The results found here indicate that further clinical studies are warranted that quantify the clinical impact of breathing guidance, along with the health technology assessment to determine the advantages and disadvantages of breathing guidance.
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Affiliation(s)
- Sean Pollock
- Radiation Physics Laboratory, University of Sydney, Sydney 2050, Australia
| | - Robyn Keall
- Central School of Medicine, University of Sydney, Sydney 2050, Australia and Hammond Care, Palliative Care and Supportive Care Service, Greenwich 2065, Australia
| | - Paul Keall
- Radiation Physics Laboratory, University of Sydney, Sydney 2050, Australia
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Anetai Y, Sumida I, Takahashi Y, Yagi M, Mizuno H, Ota S, Suzuki O, Tamari K, Seo Y, Ogawa K. A concept for classification of optimal breathing pattern for use in radiotherapy tracking, based on respiratory tumor kinematics and minimum jerk analysis. Med Phys 2016; 43:3168-3177. [DOI: 10.1118/1.4951731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Nguyen VNV, Ellerbusch DC, Cetnar AJ, James JA, Wang B. Implementation of an in-house visual feedback system for motion management during radiation therapy. J Appl Clin Med Phys 2016; 17:421-427. [PMID: 26894353 PMCID: PMC5690230 DOI: 10.1120/jacmp.v17i1.5817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/04/2015] [Accepted: 08/18/2015] [Indexed: 12/25/2022] Open
Abstract
In this Technical Note, we describe an in‐house video goggles feedback system assembled using several commercially available products. This goggle video feedback system is currently being used at University of Louisville and Mayo Clinic for both CT simulation and linac treatment delivery. The setup details, including specific recommendations, are provided, along with an alternative option for using the video goggles system. PACS number: 07.07Hj
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Anetai Y, Sumida I, Takahashi Y, Yagi M, Ota S, Mizuno H, Ogawa K. Reference respiratory waveforms by minimum jerk model analysis. Med Phys 2015; 42:5066-74. [DOI: 10.1118/1.4927557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Abstract
In this review, image guidance and motion management in radiotherapy for lung cancer is discussed. Motion characteristics of lung tumours and image guidance techniques to obtain motion information are elaborated. Possibilities for management of image guidance and motion in the various steps of the treatment chain are explained, including imaging techniques and beam delivery techniques. Clinical studies using different motion management techniques are reviewed, and finally future directions for image guidance and motion management are outlined.
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Affiliation(s)
- S S Korreman
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
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Huguet F, Yorke ED, Davidson M, Zhang Z, Jackson A, Mageras GS, Wu AJ, Goodman KA. Modeling Pancreatic Tumor Motion Using 4-Dimensional Computed Tomography and Surrogate Markers. Int J Radiat Oncol Biol Phys 2015; 91:579-87. [DOI: 10.1016/j.ijrobp.2014.10.058] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/09/2014] [Accepted: 10/10/2014] [Indexed: 10/24/2022]
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Four-dimensional computed tomography based respiratory-gated radiotherapy with respiratory guidance system: analysis of respiratory signals and dosimetric comparison. BIOMED RESEARCH INTERNATIONAL 2014; 2014:306021. [PMID: 25276775 PMCID: PMC4170707 DOI: 10.1155/2014/306021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/13/2014] [Accepted: 08/15/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the effectiveness of respiratory guidance system in 4-dimensional computed tomography (4 DCT) based respiratory-gated radiation therapy (RGRT) by comparing respiratory signals and dosimetric analysis of treatment plans. METHODS The respiratory amplitude and period of the free, the audio device-guided, and the complex system-guided breathing were evaluated in eleven patients with lung or liver cancers. The dosimetric parameters were assessed by comparing free breathing CT plan and 4 DCT-based 30-70% maximal intensity projection (MIP) plan. RESULTS The use of complex system-guided breathing showed significantly less variation in respiratory amplitude and period compared to the free or audio-guided breathing regarding the root mean square errors (RMSE) of full inspiration (P = 0.031), full expiration (P = 0.007), and period (P = 0.007). The dosimetric parameters including V(5 Gy), V(10 Gy), V(20 Gy), V(30 Gy), V(40 Gy), and V(50 Gy) of normal liver or lung in 4 DCT MIP plan were superior over free breathing CT plan. CONCLUSIONS The reproducibility and regularity of respiratory amplitude and period were significantly improved with the complex system-guided breathing compared to the free or the audio-guided breathing. In addition, the treatment plan based on the 4D CT-based MIP images acquired with the complex system guided breathing showed better normal tissue sparing than that on the free breathing CT.
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Goossens S, Senny F, Lee JA, Janssens G, Geets X. Assessment of tumor motion reproducibility with audio-visual coaching through successive 4D CT sessions. J Appl Clin Med Phys 2014; 15:4332. [PMID: 24423834 PMCID: PMC5711223 DOI: 10.1120/jacmp.v15i1.4332] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 08/13/2013] [Accepted: 07/30/2013] [Indexed: 12/25/2022] Open
Abstract
This study aimed to compare combined audio-visual coaching with audio coaching alone and assess their respective impact on the reproducibility of external breathing motion and, one step further, on the internal lung tumor motion itself, through successive sessions. Thirteen patients with NSCLC were enrolled in this study. The tumor motion was assessed by three to four successive 4D CT sessions, while the breathing signal was measured from magnetic sensors positioned on the epigastric region. For all sessions, the breathing was regularized with either audio coaching alone (AC, n = 5) or combined with a real-time visual feedback (A/VC, n = 8) when tolerated by the patients. Peak-to-peak amplitude, period and signal shape of both breathing and tumor motions were first measured. Then, the correlation between the respiratory signal and internal tumor motion over time was evaluated, as well as the residual tumor motion for a gated strategy. Although breathing and tumor motions were comparable between AC and AV/C groups, A/VC approach achieved better reproducibility through sessions than AC alone (mean tumor motion of 7.2 mm ± 1 vs. 8.6 mm ± 1.8 mm, and mean breathing motion of 14.9 mm ± 1.2 mm vs. 13.3mm ± 3.7 mm, respectively). High internal/external correlation reproducibility was achieved in the superior-inferior tumor motion direction for all patients. For the anterior posterior tumor motion direction, better correlation reproducibility has been observed when visual feedback has been used. For a displacement-based gating approach, A/VC might also be recommended, since it led to smaller residual tumor motion within clinically relevant duty cycles. This study suggests that combining real-time visual feedback with audio coaching might improve the reproducibility of key characteristics of the breathing pattern, and might thus be considered in the implementation of lung tumor radiotherapy.
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Affiliation(s)
- Samuel Goossens
- Catholic University of Louvain, Saint-Luc University Hospital.
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Wang L, Chen X, Lin MH, Xue J, Lin T, Fan J, Jin L, Ma CM. Evaluation of the cone beam CT for internal target volume localization in lung stereotactic radiotherapy in comparison with 4D MIP images. Med Phys 2013; 40:111709. [DOI: 10.1118/1.4823785] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Li F, Li J, Zhang Y, Xu M, Shang D, Fan T, Liu T, Shao Q. Geometrical differences in gross target volumes between 3DCT and 4DCT imaging in radiotherapy for non-small-cell lung cancer. JOURNAL OF RADIATION RESEARCH 2013; 54:950-6. [PMID: 23564841 PMCID: PMC3766289 DOI: 10.1093/jrr/rrt017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 02/06/2013] [Accepted: 02/08/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to explore the characteristic of 3DCT scanning phases and estimate the comparative amount of respiration motion information included in 3DCT and 4DCT by comparing the volumetric and positional difference between the volumes from 3DCT and 4DCT for the radiotherapy of non-small-cell lung cancer (NSCLC). A total of 28 patients with NSCLC sequentially underwent 3DCT and 4DCT simulation scans of the thorax during free breathing. The 4DCT images with respiratory signal data were reconstructed and sorted into 10 phases throughout a respiratory cycle. GTV-3D from 3DCT, GTV-0%, GTV-20%, GTV-50% and GTV-70% from end-inspiration, mid-expiration, end-expiration and mid-inspiration of 4DCT, and the internal GTV (IGTV-10) from the fused phase of 4DCT were delineated based on the 50% phase image, respectively. The differences in the position, size, matching index (MI) and degree of inclusion (DI) for different volumes were evaluated. The variation in the centroid shifts of GTV-0% and GTV-3D, GTV-20% and GTV-3D, GTV-50% and GTV-3D, and GTV-90% and GTV-3D in the 3D direction was not significant (P = 0.990). The size ratios of GTV-0%, GTV-20%, GTV-50%, GTV-70% and IGTV-10 to GTV-3D were 0.94 ± 0.18, 0.95 ± 0.18, 0.98 ± 0.15, 1.00 ± 0.18 and 1.60 ± 0.55, respectively. DIs of GTV-3D in IGTV-10, and IGTV-10 in GTV-3D were 0.88 ± 0.14 and 0.59 ± 0.16 (P < 0.001). The 3DCT scanning phases are irregular. The CTV-to-ITV expansion should be isotropic when defining the ITV on the 3DCT. The internal GTV derived from 4DCT cannot completely include the GTV from 3DCT. An additional margin may be required when defining the ITV-based 4DCT.
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Affiliation(s)
- Fengxing Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Jianbin Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Yingjie Zhang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Min Xu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Dongping Shang
- Big Bore CT Room, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Tingyong Fan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Tonghai Liu
- Big Bore CT Room, Shandong Cancer Hospital and Institute, Jinan 250117, China
| | - Qian Shao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117, China
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Ge J, Santanam L, Noel C, Parikh PJ. Planning 4-Dimensional Computed Tomography (4DCT) Cannot Adequately Represent Daily Intrafractional Motion of Abdominal Tumors. Int J Radiat Oncol Biol Phys 2013; 85:999-1005. [DOI: 10.1016/j.ijrobp.2012.09.014] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/10/2012] [Accepted: 09/14/2012] [Indexed: 11/28/2022]
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Hugo GD, Rosu M. Advances in 4D radiation therapy for managing respiration: part I - 4D imaging. Z Med Phys 2012; 22:258-71. [PMID: 22784929 PMCID: PMC4153750 DOI: 10.1016/j.zemedi.2012.06.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 06/14/2012] [Accepted: 06/18/2012] [Indexed: 11/21/2022]
Abstract
Techniques for managing respiration during imaging and planning of radiation therapy are reviewed, concentrating on free-breathing (4D) approaches. First, we focus on detailing the historical development and basic operational principles of currently-available "first generation" 4D imaging modalities: 4D computed tomography, 4D cone beam computed tomography, 4D magnetic resonance imaging, and 4D positron emission tomography. Features and limitations of these first generation systems are described, including necessity of breathing surrogates for 4D image reconstruction, assumptions made in acquisition and reconstruction about the breathing pattern, and commonly-observed artifacts. Both established and developmental methods to deal with these limitations are detailed. Finally, strategies to construct 4D targets and images and, alternatively, to compress 4D information into static targets and images for radiation therapy planning are described.
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Affiliation(s)
- Geoffrey D Hugo
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Shirato H, Onimaru R, Ishikawa M, Kaneko JI, Takeshima T, Mochizuki K, Shimizu S, Umegaki K. Real-time 4-D radiotherapy for lung cancer. Cancer Sci 2012; 103:1-6. [PMID: 21954991 PMCID: PMC11164145 DOI: 10.1111/j.1349-7006.2011.02114.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Respiratory motion considerably influences dose distribution, and thus clinical outcomes in radiotherapy for lung cancer. Breath holding, breath coaching, respiratory gating with external surrogates, and mathematical predicting models all have inevitable uncertainty due to the unpredictable variations of internal tumor motion. The amplitude of the same tumor can vary with standard deviations > 5 mm occurring in 23% of T1-2N0M0 non-small cell lung cancers. Residual motion varied 1-6 mm (95th percentile) for the 40% duty cycle of respiratory gating with external surrogates. The 4-D computed tomography is vulnerable to problems relating to the external surrogates. Real-time 4-D radiotherapy (4DRT), where the temporal changes in anatomy during the delivery of radiotherapy are explicitly considered in real time, is emerging as a new method to reduce these known sources of uncertainty. Fluoroscopic, real-time tumor-tracking technology using internal fiducial markers near the tumor has ± 2 mm accuracy, and has achieved promising clinical results when used with X-ray therapy. Instantaneous irradiation based on real-time verification of internal fiducial markers is considered the minimal requisite for real-time 4DRT of lung cancers at present. Real-time tracking radiotherapy using gamma rays from positron emitters in tumors is in the preclinical research stage, but has been successful in experiments in small animals. Real-time tumor tracking via spot-scanning proton beam therapy has the capability to cure large lung cancers in motion, and is expected to be the next-generation real-time 4DRT.
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Affiliation(s)
- Hiroki Shirato
- Department of Radiation Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
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Muirhead R, van der Weide L, van Sornsen de Koste JR, Cover KS, Senan S. Use of megavoltage cine-images for studying intra-thoracic motion during radiotherapy for locally advanced lung cancer. Radiother Oncol 2011; 99:155-60. [PMID: 21621867 DOI: 10.1016/j.radonc.2011.05.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 05/17/2011] [Accepted: 05/17/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Use of planning 4-dimensional CT (4DCT) scans often permits use of smaller target volumes for thoracic tumors but this assumes a reproducible pattern of motion during radiotherapy. We compared cranio-caudal (CC) motion on MV cine-images acquired during treatment with that seen on planning 4DCT. METHODS AND MATERIALS A pre-programmable respiratory motion phantom and a software tool for motion assessment were used to validate the use of MV cine-images for motion detection. MV cine-images acquired in 20 patients with node-positive lung cancer were analyzed using the same software. Intra-fraction CC motion on 6 MV cine-images from each patient was compared with CC motion on their planning 4DCT. RESULTS Software-based motion measurement on MV cine-images from the phantom corresponded to actual motion. Mean CC motion of primary tumor, carina and hilus on 4DCT was 7.3mm (range 2-13.8mm), 6.8mm (1.8-21.2) and 11.0mm (4.2-15.1), respectively. Corresponding intra-fraction motion on MV cine was 4.1mm (0.6-13.6mm); 2.7mm (0-10mm) and 6.0mm (1.8-14.4mm), respectively. The tumor, hilus and carina could be tracked in 95%, 88% and 38% of the MV cine-images, respectively. CONCLUSIONS Intra-fraction motion can be reliably measured using MV-cine images from a phantom. Motion discrepancies identified on MV cine-images can identify patients in whom planning 4DCT scans are not representative.
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Affiliation(s)
- Rebecca Muirhead
- Department of Radiation Oncology, VU Medical Centre, Amsterdam, The Netherlands.
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Dieterich S, Cavedon C, Chuang CF, Cohen AB, Garrett JA, Lee CL, Lowenstein JR, d'souza MF, Taylor DD, Wu X, Yu C. Report of AAPM TG 135: Quality assurance for robotic radiosurgery. Med Phys 2011; 38:2914-36. [DOI: 10.1118/1.3579139] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Noel CE, Parikh PJ. Effect of mid-scan breathing changes on quality of 4DCT using a commercial phase-based sorting algorithm. Med Phys 2011; 38:2430-8. [DOI: 10.1118/1.3574872] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mutaf YD, Scicutella CJ, Michalski D, Fallon K, Brandner ED, Bednarz G, Huq MS. A simulation study of irregular respiratory motion and its dosimetric impact on lung tumors. Phys Med Biol 2011; 56:845-59. [DOI: 10.1088/0031-9155/56/3/019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Extra-cranial Stereotactic Radiation Therapy (ESRT) in the treatment of inoperable stage 1 & 2 non-small-cell lung cancer patients with highly mobile tumours: a literature review. JOURNAL OF RADIOTHERAPY IN PRACTICE 2010. [DOI: 10.1017/s1460396910000105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractObjective: Extra-cranial Stereotactic Radiation Therapy (ESRT) techniques and equipment utilised in the treatment of Stage 1 or 2 inoperable non-small-cell lung cancer (NSCLC); accounting for Respiratory Induced Tumour Motion (RITM).Methods: A narrative review of current world literature.Results: Four main strategies are employed to address RITM: (1) tumour movement minimisation/immobilisation; (2) integration of respiratory movements into planning; (3) respiratory-gating techniques; and (iv) tumour-tracking techniques.Discussion: Analysis of data gathered suggests that due to inherent difficulties with respiratory function, combined with co-morbidities and the level of dose escalation facilitated by ESRT: techniques that do not require patient ability to comply are more likely to be effective with a wider range of patients. Similarly, treatment planning must incorporate accurate four-dimensional (4D) data to ensure target coverage, although setup and verification should be controlled to smaller margins for error.Conclusion: The disparate nature of reporting methods restricts statistical comparison. However, this paper suggests that the ESRT technique using abdominal compression (AC), free-breathing respiratory-gating (FBRG), 4D computed tomography (4DCT) planning, combined with daily on board kV cone beam computed tomography (CBCT) imaging for setup and target verification, is a possible candidate for further treatment regime assessments in large multi-centre trials.
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Cai J, McLawhorn R, Read PW, Larner JM, Yin FF, Benedict SH, Sheng K. Effects of breathing variation on gating window internal target volume in respiratory gated radiation therapya). Med Phys 2010; 37:3927-34. [DOI: 10.1118/1.3457329] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Pepin EW, Wu H, Sandison GA, Langer M, Shirato H. Site-specific volumetric analysis of lung tumour motion. Phys Med Biol 2010; 55:3325-37. [DOI: 10.1088/0031-9155/55/12/005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Nakamura M, Narita Y, Matsuo Y, Narabayashi M, Nakata M, Sawada A, Mizowaki T, Nagata Y, Hiraoka M. Effect of Audio Coaching on Correlation of Abdominal Displacement With Lung Tumor Motion. Int J Radiat Oncol Biol Phys 2009; 75:558-63. [DOI: 10.1016/j.ijrobp.2008.11.070] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 11/17/2008] [Accepted: 11/22/2008] [Indexed: 11/16/2022]
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Nakamura M, Narita Y, Sawada A, Matsugi K, Nakata M, Matsuo Y, Mizowaki T, Hiraoka M. Impact of motion velocity on four-dimensional target volumes: A phantom study. Med Phys 2009; 36:1610-7. [PMID: 19544777 DOI: 10.1118/1.3110073] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Mitsuhiro Nakamura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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