Patient-specific respiratory motion management using lung tumors vs fiducial markers for real-time tumor-tracking stereotactic body radiotherapy

Tanabe, Yoshinori; Kiritani, Michiru; Deguchi, Tomomi; Hira, Nanami; Tomimoto, Syouta

doi:10.1016/j.phro.2022.12.002

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…The positional relationship between the fiducial marker and tumor can also be altered by respiratory motion. In SBRT with a fiducial marker, the respiratory motion of the lung tumor and marker implanted near the tumor have been shown to be slightly different [ 15 , 23 , 24 ]. From their analysis of SBRT for lung tumors with SyncTraX, Tanabe et al .…”

Section: Discussionmentioning

confidence: 99%

“…From their analysis of SBRT for lung tumors with SyncTraX, Tanabe et al . suggested that differences in respiratory motion between the tumor and fiducial marker can cause slight uncertainty in RTRT [ 15 ]. Although similar studies are not available for liver tumors, the respiratory motion of the tumor and fiducial marker in the liver may differ.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, if the isocenter is located away from the fiducial marker, real-time marker recognition during SBRT may be difficult, because the marker may be located outside the FOV. This limitation has been described previously [ 14 , 15 ]. Moreover, considering the respiratory motion of the fiducial marker, our institutional practice recommends that the 3D position of the marker should be within approximately 4 and 6 cm from the isocenter for SyncTraX and SyncTraX FX4, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Real-time tumor-tracking radiotherapy with SyncTraX for primary liver tumors requiring isocenter shift

Uchinami,

Miyamoto,

Abo

et al. 2023

Journal of Radiation Research

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The SyncTraX series enables real-time tumor-tracking radiotherapy through the real-time recognition of a fiducial marker using fluoroscopic images. In this system, the isocenter should be located within approximately 5–7.5 cm from the marker, depending on the version, owing to the limited field of view. If the marker is placed away from the tumor, the isocenter should be shifted toward the marker. This study aimed to investigate stereotactic body radiotherapy (SBRT) outcomes of primary liver tumors treated with SyncTraX in cases where the isocenter was shifted marginally or outside the planning target volume (PTV). Twelve patients with 13 liver tumors were included in the analysis. Their isocenter was shifted toward the marker and was placed marginally or outside the PTV. The prescribed doses were generally 40 Gy in four fractions or 48 Gy in eight fractions. The overall survival (OS) and local control (LC) rates were calculated using the Kaplan–Meier method. All patients completed the scheduled SBRT. The median distance between the fiducial marker and PTV centroid was 56.0 (interquartile range [IQR]: 52.7–66.7) mm. By shifting the isocenter toward the marker, the median distance between the marker and isocenter decreased to 34.0 (IQR: 33.4–39.7) mm. With a median follow-up period of 25.3 (range: 6.9–70.0) months, the 2-year OS and LC rates were 100.0% (95% confidence interval: 100–100). An isocenter shift makes SBRT with SyncTraX feasible in cases where the fiducial marker is distant from the tumor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Real-time tumor-tracking radiotherapy with SyncTraX for primary liver tumors requiring isocenter shift

Uchinami,

Miyamoto,

Abo

et al. 2023

Journal of Radiation Research

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“…The flowchart of this study is shown in Figure 1. Cross-correlation analysis was used to evaluate the change of occlusal plane profiles for positioning error 11 , and PSNR was used to evaluate the displacement of the thin fault zone by positioning error 10, 12 . DIR was used to evaluate the displacement of the structure by positioning errors 13 .…”

Section: Equipment and Reference Imagingmentioning

confidence: 99%

Objective evaluation method using multiple image analyses for panoramic radiography improvement

Imajo

Tanabe

Nakamura

et al. 2023

Polish Journal of Medical Physics and Engineering

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Introduction In the standardization of panoramic radiography quality, the education and training of beginners on panoramic radiographic imaging are important. We evaluated the relationship between positioning error factors and multiple image analysis results for reproducible panoramic radiography. Material and methods Using a panoramic radiography system and a dental phantom, reference images were acquired on the Frankfurt plane along the horizontal direction, midsagittal plane along the left–right direction, and for the canine on the forward–backward plane. Images with positioning errors were acquired with 1–5 mm shifts along the forward– backward direction and 2–10° rotations along the horizontal (chin tipped high/low) and vertical (left–right side tilt) directions on the Frankfurt plane. The cross-correlation coefficient and angle difference of the occlusion congruent plane profile between the reference and positioning error images, peak signal-to-noise ratio (PSNR), and deformation vector value by deformable image registration were compared and evaluated. Results The cross-correlation coefficients of the occlusal plane profiles showed the greatest change in the chin tipped high images and became negatively correlated from 6° image rotation (r = −0.29). The angle difference tended to shift substantially with increasing positioning error, with an angle difference of 8.9° for the 10° chin tipped low image. The PSNR was above 30 dB only for images with a 1-mm backward shift. The positioning error owing to the vertical rotation was the largest for the deformation vector value. Conclusions Multiple image analyses allow to determine factors contributing to positioning errors in panoramic radiography and may enable error correction. This study based on phantom imaging can support the education of beginners regarding panoramic radiography.

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A novel objective method for discriminating pathological and physiological colorectal uptake in the lower abdominal region using whole-body dynamic 18F-FDG-PET

et al. 2023

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Patient-specific respiratory motion management using lung tumors vs fiducial markers for real-time tumor-tracking stereotactic body radiotherapy

Cited by 7 publications

References 22 publications

Real-time tumor-tracking radiotherapy with SyncTraX for primary liver tumors requiring isocenter shift

Real-time tumor-tracking radiotherapy with SyncTraX for primary liver tumors requiring isocenter shift

Objective evaluation method using multiple image analyses for panoramic radiography improvement

A novel objective method for discriminating pathological and physiological colorectal uptake in the lower abdominal region using whole-body dynamic 18F-FDG-PET

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