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Journal of Radiation Oncology

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Open Access 01-12-2018 | Original Research

Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT

Authors: Ulrika Björeland, Joakim Jonsson, Magnus Alm, Lars Beckman, Tufve Nyholm, Camilla Thellenberg-Karlsson

Published in: Journal of Radiation Oncology | Issue 4/2018

Abstract

Objectivities

The aim of this study was to evaluate inter-fraction movements of lymph node regions that are commonly included in the pelvic clinical target volume (CTV) for high-risk prostate cancer patients. We also aimed to evaluate if the movements affect the planning target volumes.

Methods

Ten prostate cancer patients were included. The patients underwent six MRI scans, from treatment planning to near end of treatment. The CTV movements were analyzed with deformable registration technique with the CTV divided into sections. The validity of the deformable registration was assessed by comparing the results for individual lymph nodes that were possible to identify in all scans.

Results

Using repetitive MRI, measurements showed that areas inside the CTV (lymph nodes) in some extreme cases were as mobile as the prostate and not fixed to the bones. The lymph node volumes closest to the prostate did not tend to follow the prostate motion. The more cranial lymph node volumes moved less, but still independently, and they were not necessarily fixed to the pelvic bones. In 95% of the cases, the lymph node motion in the R-L direction was 2–4 mm, in the A-P direction 2–7 mm, and in the C-C direction 2–5 mm depending on the CTV section.

Conclusion

Lymph nodes and prostate were most mobile in the A-P direction, followed by the C-C and R-L directions. This movement should be taken into account when deciding the margins for the planning target volumes (PTV).

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Title: Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT
Authors: Ulrika Björeland
Joakim Jonsson
Magnus Alm
Lars Beckman
Tufve Nyholm
Camilla Thellenberg-Karlsson
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Radiation Oncology / Issue 4/2018
Print ISSN: 1948-7894
Electronic ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-018-0366-3

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Objectivities

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Conclusion

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