Document Detail

Tumor and normal tissue motion in the thorax during respiration: Analysis of volumetric and positional variations using 4D CT.
MedLine Citation:
PMID:  17189078     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To investigate temporospatial variations of tumor and normal tissue during respiration in lung cancer patients.
METHODS AND MATERIALS: In 14 patients, gross tumor volume (GTV) and normal tissue structures were manually contoured on four-dimensional computed tomography (4D-CT) scans. Structures were evaluated for volume changes, centroid (center of mass) motion, and phase dependence of variations relative to inspiration. Only volumetrically complete structures were used for analysis (lung in 2, heart in 8, all other structures in >10 patients).
RESULTS: During respiration, the magnitude of contoured volumes varied up to 62.5% for GTVs, 25.5% for lungs, and 12.6% for hearts. The range of maximum three-dimensional centroid movement for individual patients was 1.3-24.0 mm for GTV, 2.4-7.9 mm for heart, 5.2-12.0 mm for lungs, 0.3-5.5 mm for skin markers, 2.9-10.0 mm for trachea, and 6.6-21.7 mm for diaphragm. During respiration, the centroid positions of normal structures varied relative to the centroid position of the respective GTV by 1.5-8.1 mm for heart, 2.9-9.3 mm for lungs, 1.2-9.2 mm for skin markers, 0.9-7.1 mm for trachea, and 2.7-16.4 mm for diaphragm.
CONCLUSION: Using 4D-CT, volumetric changes, positional alterations as well as changes in the position of contoured structures relative to the GTV were observed with large variations between individual patients. Although the interpretation of 4D-CT data has considerable uncertainty because of 4D-CT artifacts, observer variations, and the limited acquisition time, the findings might have a significant impact on treatment planning.
Elisabeth Weiss; Krishni Wijesooriya; S Vaughn Dill; Paul J Keall
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  67     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-25     Completed Date:  2007-02-01     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  296-307     Citation Subset:  IM    
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MeSH Terms
Diaphragm / radiography
Heart / radiography*
Lung / radiography*
Lung Neoplasms / radiography*,  radiotherapy
Tomography, X-Ray Computed / methods*
Trachea / radiography
Grant Support

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