Magnitude and influencing factors of respiration-induced liver motion during abdominal compression in patients with intrahepatic tumors

Abstract

PurposeThe purpose of this study was to use 4-dimensional-computed tomography (4D-CT) to evaluate respiration-induced liver motion magnitude and influencing factors in patients with intrahepatic tumors undergoing abdominal compression.MethodsFrom January 2012 to April 2016, 99 patients with intrahepatic tumors were included in this study. They all underwent 4D-CT to assess respiratory liver motion. This was performed during abdominal compression in 53 patients and during free-breathing (no abdominal compression) in 46 patients. We defined abdominal compression as being effective in managing the breath amplitude if respiration-induced liver motion in the cranial-caudal (CC) direction during compression was ≤5 mm and as being ineffective if >5 mm of motion was observed. Gender, age, body mass index (BMI), transarterial chemoembolization history, liver resection history, tumor area, tumor number, and tumor size (diameter) were determined. Multivariate logistic regression analysis was used to analyze influencing factors associated with a breath amplitude ≤5 mm in the CC direction.ResultsThe mean respiration-induced liver motion during abdominal compression in the left-right (LR), CC, anterior-posterior (AP), and 3-dimensional vector directions was 2.9 ± 1.2 mm, 5.3 ± 2.2 mm, 2.3 ± 1.1 mm and 6.7 ± 2.1 mm, respectively. Univariate analysis indicated that gender and BMI significantly affected abdominal compression effectiveness (both p < 0.05). Multivariate analysis confirmed these two factors as significant predictors of effective abdominal compression: gender (p = 0.030) and BMI (p = 0.006). There was a strong correlation between gender and compression effectiveness (odds ratio [OR] = 7.450) and an even stronger correlation between BMI and compression effectiveness (OR = 10.842).ConclusionsThe magnitude of respiration-induced liver motion of patients with intrahepatic carcinoma undergoing abdominal compression is affected by gender and BMI, with abdominal compression being less effective in men and overweight patients.

Definition of internal target volumes based on planar X‐ray fluoroscopic images for lung and hepatic stereotactic body radiation therapy. Comparison to inhale/exhale CT technique

“…The results obtained are compared with those of IECT. Although many studies investigated the tumor movement with different devices and methods, [17][18][19][20][21][22][23] as far as we know, there are no previous works comparing IECT with other methods for the definition of ITV. In addition, FI may be useful even when a 4DCT system is available since FI allows studying multiple breathing cycles and obtaining curves of position vs. time.…”

Exploration of Superior Modality: Safety and Efficacy of Hypofractioned Image-Guided Intensity Modulated Radiation Therapy in Patients with Unresectable but Confined Intrahepatic Hepatocellular Carcinoma

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The dosimetric impact of replacing the TG-43 algorithm by model based dose calculation for liver brachytherapy

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