Synchronous monitoring of external/internal respiratory motion: validity of respiration-gated radiotherapy for liver tumors

Nishioka, Takeshi; Nishioka, Seiko; Kawahara, Masaki; Tanaka, Shigeru; Shirato, Hiroki; Nishi, Ken; Hiromura, Tadao

doi:10.1007/s11604-009-0332-5

Cited by 18 publications

(13 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It automatically tracks 3-dimensional implanted marker motion using four room-mounted fluoroscopy systems and enables treatment when the marker is within a user-set window. RTRT was used in lung tumor treatments 6 and investigation of external –internal motion correlation for free-breathing liver patients 7 . Fluoroscopy dose is a limitation 17 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Kilovoltage Imaging of Implanted Fiducials to Monitor Intrafraction Motion With Abdominal Compression During Stereotactic Body Radiation Therapy for Gastrointestinal Tumors

Yorke

Xiong

Han

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose/Objective To assess intrafraction respiratory motion using a commercial kilovoltage imaging system for abdominal tumor patients with implanted fiducials and breathing constrained by pneumatic compression during stereotactic body radiotherapy (sbrt). Methods and Materials A pneumatic compression belt limited respiratory motion in 19 patients with radiopaque fiducials in or near their tumor during sbrt for abdominal tumors. Kilovoltage images were acquired at 5–6 sec intervals during treatment using a commercial system. Intrafractional fiducial displacements were measured using in-house software. The dosimetric effect of the observed displacements was calculated for three sessions for each patient. Results Intrafraction displacement patterns varied between patients and between individual treatment sessions. Averaged over 19 patients, 73 sessions, 7.6% of craniocaudal displacements exceeded 0.5 cm and 1.2% exceeded 0.75 cm. The calculated single session dose to 95% of gross tumor volume (GTVD95) differed from planned by an average of −1.2% (−11.1%−4.8%) but only for 4 patients was total 3-session calculated GTVD95 over 3% different from planned Conclusions Our pneumatic compression limited intrafractional abdominal target motion, maintained target position established at setup, and was moderately effective in preserving coverage. Commercially available intrafractional imaging is useful for surveillance but can be made more effective and reliable.

show abstract

Section: Discussionmentioning

confidence: 99%

“…But automatic fiducial detection with automatic correction or alerts when fiducials are outside tolerances is a preferable solution. Such features exist (CyberKnife™ (radiographic) and Calypso™ (non-radiographic)) but not radiographically on conventional linacs to provide fiducial-based tracking using a robust internal signal 6,7,15 .…”

Section: Discussionmentioning

confidence: 99%

Kilovoltage Imaging of Implanted Fiducials to Monitor Intrafraction Motion With Abdominal Compression During Stereotactic Body Radiation Therapy for Gastrointestinal Tumors

Yorke

Xiong

Han

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

show abstract

“…This is why liver motion characterization studies have been largely performed with the markers in the past, 11,12,17 including with the RTRT system in Japan. 4,5,[21][22][23][24][25] For the RTRT system, using fluoroscopic imaging with multiple x-rays, the precise 3D marker positions can be extracted near real-time with submillimeter accuracy. Another predominant feature is that it is able to track/verify such information at all/most time during treatment.…”

Section: Iva 3d Motion Trackingmentioning

confidence: 99%

“…Stereotactic body radiation therapy (SBRT) of liver cancer is technically challenging. 1 Similar to lung cancer, there's a significant interfractional and intrafractional organ motion induced by respiration [2][3][4][5] and that radiation tolerance of normal liver is very low. [6][7][8] The former necessitates a use of larger margin, while the latter discourages it.…”

Section: Introductionmentioning

confidence: 99%

Liver motion during cone beam computed tomography guided stereotactic body radiation therapy

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Moreover, the baseline shift of respiration (exhale fluctuation) is not a rare phenomenon and needs to be taken into consideration for individualized precise 4D radiotherapy. 54,55 Therefore, AV biofeedback can be a solution to reduce the baseline shift ( Fig. 5).…”

Section: Ivd Trajectory Of Target Motion In 4d Pet Imagesmentioning

confidence: 99%

The impact of audio-visual biofeedback on 4D PET images: Results of a phantom study

et al. 2012

View full text Add to dashboard Cite

Purpose: Irregular breathing causes motion blurring artifacts in 4D PET images. Audiovisual (AV) biofeedback has been demonstrated to improve breathing regularity. To investigate the hypothesis that, compared with free breathing, motion blurring artifacts are reduced with AV biofeedback, the authors performed the first experimental phantom-based quantification of the impact of AV biofeedback on 4D PET image quality. Methods: The authors acquired 4D PET dynamic phantom images with AV biofeedback and free breathing by moving a phantom programmed with AV biofeedback trained and free breathing respiratory traces of ten healthy subjects. The authors also acquired stationary phantom images for reference. The phantom was cylindrical with six hollow sphere targets (10, 13, 17, 22, 28, and 37 mm in diameter). The authors quantified motion blurring using the target diameter, Dice coefficient and recovery coefficient (RC) metrics to estimate the effect of motion. Results: The average increase in target diameter for AV biofeedback was 0:661:6 mm ð4:7 6 13%Þ, which was significantly (p < 0:001) smaller than for free breathing 1:3 6 2:2 mm ð9:1 6 19%Þ. The average Dice coefficient for AV biofeedback was 0:9060:07, which was significantly (p < 0:001) larger than for free breathing (0:8860:10). The RCs for AV biofeedback were consistently higher than those for free breathing and comparable to those for stationary targets. However, for RCs the impact of target sizes was more dominant than that of motion. In addition, the authors observed large variations in the results with respect to target sizes, subject traces and respiratory bins due to partial volume effects and respiratory motion irregularity. Conclusions:The results indicate that AV biofeedback can significantly reduce motion blurring artifacts and may facilitate improved identification and localization of lung tumors in 4D PET images. The results justify proceeding with clinical studies to quantify the impact of AV biofeedback on 4D PET image quality and tumor detectability.

show abstract

Synchronous monitoring of external/internal respiratory motion: validity of respiration-gated radiotherapy for liver tumors

Abstract: Liver tumors may be suitable for respiration-gated radiotherapy, and they may become curable with 4D radiotherapy.

Cited by 18 publications

References 8 publications

Kilovoltage Imaging of Implanted Fiducials to Monitor Intrafraction Motion With Abdominal Compression During Stereotactic Body Radiation Therapy for Gastrointestinal Tumors

Kilovoltage Imaging of Implanted Fiducials to Monitor Intrafraction Motion With Abdominal Compression During Stereotactic Body Radiation Therapy for Gastrointestinal Tumors

Liver motion during cone beam computed tomography guided stereotactic body radiation therapy

The impact of audio-visual biofeedback on 4D PET images: Results of a phantom study

Contact Info

Product

Resources

About