Four-dimensional measurement of the displacement of metal clips or postoperative surgical staples during 320-multislice computed tomography scanning of gastric cancer

Radiation Oncology

Keiichi Nakagawa¹  Kuni Ohtomo¹  Masaaki Akahane¹  Kenji Ino¹  Akihiro Haga¹  Akira Sakumi¹  Wataru Takahashi¹  Kae Okuma¹  Hideomi Yamashita¹ 

[1] Departments of Radiology, University of Tokyo Hospital, Tokyo, Japan

关键词: Respiratory motion;    Internal margin;    Gastric cancer;    Four-dimension computed tomography;    Intra-fraction motion;   

Others  :  1155419
DOI  :  10.1186/1748-717X-7-137

 received in 2012-04-19, accepted in 2012-07-17,  发布年份 2012

【 摘 要 】

Purpose

To investigate the respiratory motion of metal clips or surgical staples placed in the gastric wall for planning of radiation therapy in gastric cancer patients.

Methods

This study examined 15 metal markers in the gastric walls of 12 patients with gastric cancer treated with external-beam photon RT. Motion assessment was analyzed in 41 respiratory phases covering 20 s acquired with computed tomography (CT) in the RT position using 320-multislice CT. The intra-fraction displacement was assessed in the cranio-caudal (CC), antero-posterior (AP), and right-left (RL) directions.

Results

Motion in the CC direction showed a very strong correlation (R² > 0.7) with the respiratory curve in all 15 markers. The mean (+/− SD) intra-fractional gastric motion (maximum range of displacement) was 12.5 (+/− 3.4) mm in the CC, 8.3 (+/− 2.2) mm in the AP, and 5.5 (+/− 3.0) mm in the RL direction. No significant differences in magnitude of motion were detected in the following: a) among the upper (n = 6), middle (n = 4), and lower (n = 5) stomach regions; b) between metal clips (n = 5) and surgical staples (n = 10); and c) between full (n = 9) and empty (n = 6) stomachs.

Conclusions

Motion in primary gastric tumor was evaluated with 320-multislice CT. According to this study, the 95th percentile values from the cumulative distributions of the RL, AP, and CC direction were 6.3 mm, 9.0 mm, and 13.6 mm, respectively.

【 授权许可】

   
2012 Yamashita et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1 .

Figure 2 .

【 参考文献 】

• [1]Daqson LA, Sharpe MB: Image-guided radiotherapy: rationale, benefits, and limitations. Lancet Oncol 2006, 7:848-858.
• [2]Yamashita H, Kida S, Sakumi A, et al.: Four-dimensional measurement of the displacement of internal fiducial markers during 320-multislice computed tomography scanning of thoracic esophageal cancer. Int J Radiat Oncol Biol Phys 2011, 79:588-595.
• [3]Yamashita H, Okuma K, Tada K, et al.: Four-dimensional measurement of the displacement of internal fiducial and skin markers during 320-multislice computed tomography scanning of breast cancer. Int J Radiat Oncol Biol Phys 2011. Epub ahead of print
• [4]Coolens C, Breen S, Purdie TG, et al.: Implementation and characterization of a 320-slice volumetric CT scanner for simulation in radiation oncology. Med Phys 2009, 36:5120-5127.
• [5]Speight R, Sykes J, Lindsay R, et al.: The evaluation of a deformable image registration segmentation technique for semi-automating internal target volume (ITV) production from 4DCT images of lung stereotactic body radiotherapy (SBRT) patients. Radiother Oncol 2011, 98:277-283.
• [6]Cuijpers JP, Verbakel WF, Slotman BJ, Senan S: A novel simple approach for incorporation of respiratory motion in stereotactic treatments of lung tumors. Radiother Oncol 2010, 97(3):443-8. Epub 2010 Nov 1
• [7]Xi M, Liu MZ, Zhang L, et al.: How many sets of 4DCT images are sufficient to determine internal target volume for liver radiotherapy? Radiother Oncol 2009, 92:255-259.
• [8]Park JC, Park SH, Kim JH, et al.: Four-dimensional cone-beam computed tomography and digital tomosynthesis reconstructions using respiratory signals extracted from transcutaneously inserted metal markers for liver SBRT. Med Phys 2011, 38:1028-1036.
• [9]Case RB, Moseley DJ, Sonke JJ, et al.: Interfraction and intrafraction changes in amplitude of breathing motion in stereotactic liver radiotherapy. Int J Radiat Oncol Biol Phys 2010, 77:918-925.
• [10]Minn AY, Schellenberg D, Maxim P, et al.: Pancreatic tumor motion on a single planning 4D-CT does not correlate with intrafraction tumor motion during treatment. Am J Clin Oncol 2009, 32:364-368.
• [11]Bissonnette JP, Franks KN, Purdie TG, et al.: Quantifying interfraction and intrafraction tumor motion in lung stereotactic body radiotherapy using respiration-correlated cone beam computed tomography. Int J Radiat Oncol Biol Phys 2009, 75:688-695.
• [12]Wysocka B, Kassam Z, Lockwood G, et al.: Interfraction and respiratory organ motion during conformal radiotherapy in gastric cancer. Int J Radiat Oncol Biol Phys 2010, 77:53-59.
• [13]Smalley SR, Gunderson L, Tepper J, et al.: Gastric surgical adjuvant radiotherapy consensus report: rationale and treatment implementation. Int J Radiat Oncol Biol Phys 2002, 52:283-293.
• [14]Watanabe M, Isobe K, Takisima H, et al.: Intrafractional gastric motion and interfractional stomach deformity during radiation therapy. Radiother Oncol 2008, 87:425-431.
• [15]Rietzel E, Liu AK, Doppke KP, et al.: Design of 4D treatment planning target volumes. Int J Radiat Oncol Biol Phys 2006, 66:287-295.
• [16]van Sornsen de Koste JR, Senan S, Kleynen CE, et al.: Renal mobility during uncoached quiet respiration: An analysis of 4DCT scans. Int J Radiat Oncol Biol Phys 2006, 64:799-803.
• [17]Brandner ED, Wu A, Chen H, et al.: Abdominal organ motion measured using 4D CT. Int J Radiat Oncol Biol Phys 2006, 65:554-560.
• [18]Brandner ED, Heron D, Wu A, et al.: Localizing moving targets and organs using motion-managed CTs. Med Dosim 2006, 31:134-140.
• [19]Mori S, Hara R, Yanagi T, et al.: Four-dimensional measurement of intrafractional respiratory motion of pancreatic tumors using a 256 multi-slice CT scanner. Radiother Oncol 2009, 92:231-237.