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Open Access 15-03-2024 | Magnetic Resonance Imaging | Original Article

Assessment and validation of glottic motion using cone-beam CT and real-time cine MRI

Authors: Seok-Joo Chun, Jaeman Son, Seonghee Kang, Chang Heon Choi, Jung-in Kim, Young-Il Kim, Joo Ho Lee, Jin Ho Kim, Hong-Gyun Wu, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 5/2024

Abstract

Purpose

This study aimed to assess the margin for the planning target volume (PTV) using the Van Herk formula. We then validated the proposed margin by real-time magnetic resonance imaging (MRI).

Methods

An analysis of cone-beam computed tomography (CBCT) data from early glottic cancer patients was performed to evaluate organ motion. Deformed clinical target volumes (CTV) after rigid registration were acquired using the Velocity program (Varian Medical Systems, Palo Alto, CA, USA). Systematic (Σ) and random errors (σ) were evaluated. The margin for the PTV was defined as 2.5 Σ + 0.7 σ according to the Van Herk formula. To validate this margin, we accrued healthy volunteers. Sagittal real-time cine MRI was conducted using the ViewRay system (ViewRay Inc., Oakwood Village, OH, USA). Within the obtained sagittal images, the vocal cord was delineated. The movement of the vocal cord was summed up and considered as the internal target volume (ITV). We then assessed the degree of overlap between the ITV and the PTV (vocal cord plus margins) by calculating the volume overlap ratio, represented as (ITV∩PTV)/ITV.

Results

CBCTs of 17 early glottic patients were analyzed. Σ and σ were 0.55 and 0.57 for left–right (LR), 0.70 and 0.60 for anterior–posterior (AP), and 1.84 and 1.04 for superior–inferior (SI), respectively. The calculated margin was 1.8 mm (LR), 2.2 mm (AP), and 5.3 mm (SI). Four healthy volunteers participated for validation. A margin of 3 mm (AP) and 5 mm (SI) was applied to the vocal cord as the PTV. The average volume overlap ratio between ITV and PTV was 0.92 (range 0.85–0.99) without swallowing and 0.77 (range 0.70–0.88) with swallowing.

Conclusion

By evaluating organ motion by using CBCT, the margin was 1.8 (LR), 2.2 (AP), and 5.3 mm (SI). The margin acquired using CBCT fitted well in real-time cine MRI. Given that swallowing during radiotherapy can result in a substantial displacement, it is crucial to consider strategies aimed at minimizing swallowing and related motion.

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Title: Assessment and validation of glottic motion using cone-beam CT and real-time cine MRI
Authors: Seok-Joo Chun
Jaeman Son
Seonghee Kang
Chang Heon Choi
Jung-in Kim
Young-Il Kim
Joo Ho Lee
Jin Ho Kim
Hong-Gyun Wu, MD, PhD
Publication date: 15-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 5/2024
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-024-02204-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment and validation of glottic motion using cone-beam CT and real-time cine MRI

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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