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Radiation Oncology
Published in: Radiation Oncology 1/2017

Open Access 01-12-2017 | Research

Tumor motion changes in stereotactic body radiotherapy for liver tumors: an evaluation based on four-dimensional cone-beam computed tomography and fiducial markers

Authors: Yoshinobu Shimohigashi, Ryo Toya, Tetsuo Saito, Osamu Ikeda, Masato Maruyama, Keisuke Yonemura, Yuji Nakaguchi, Yudai Kai, Yasuyuki Yamashita, Natsuo Oya, Fujio Araki

Published in: Radiation Oncology | Issue 1/2017

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Abstract

Background

For stereotactic body radiation therapy (SBRT) of liver tumors, tumor motion induced by respiration must be taken into account in planning and treatment. We evaluated whether liver tumor motion at the planning simulation represents liver tumor motion during SBRT, and estimated inter- and intrafractional tumor motion changes in patients undergoing liver SBRT.

Methods

Ten patients underwent four-dimensional cone-beam computed tomography (4D-CBCT) image-guided liver SBRT with abdominal compression (AC) and fiducial markers. 4D-CBCT was performed to evaluate liver tumor motion at the planning simulation, pre-, and post-SBRT. The translational distances at the center position of the fiducial markers from all 10 phases on the 4D-CBCT images were measured as the extent of the liver tumor motion in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions. Pearson correlation coefficients were calculated to evaluate the correlation between liver tumor motion of the planning simulation and the mean liver tumor motion of the pre-SBRT. Inter- and intrafractional liver tumor motion changes were measured based on the 4D-CBCT of planning simulation, pre-, and post-SBRT. Significant inter- and intrafractional changes in liver tumor motion were defined as a change of >3 mm.

Results

The mean (± SD) liver tumor motion of the planning simulation 4D-CBCT was 1.7 ± 0.8 mm, 2.4 ± 2.2 mm, and 5.3 ± 3.3 mm, in the LR, AP, and SI directions, respectively. Those of the pre-SBRT 4D-CBCT were 1.2 ± 0.7 mm, 2.3 ± 2.3 mm, and 4.5 ± 3.8 mm, in the LR, AP, and SI directions, respectively. There was a strong significant correlation between liver tumor motion of the planning simulation and pre-SBRT in the LR (R = 0.7, P < 0.01), AP (R = 0.9, P < 0.01), and SI (R = 0.9, P < 0.01) directions. Significant inter- and intrafractional liver tumor motion changes occurred in 10 and 2% of treatment fractions, respectively.

Conclusions

Liver tumor motion at the planning simulation represents liver tumor motion during SBRT. Inter- and intrafractional liver tumor motion changes were small in patients with AC.
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Metadata
Title
Tumor motion changes in stereotactic body radiotherapy for liver tumors: an evaluation based on four-dimensional cone-beam computed tomography and fiducial markers
Authors
Yoshinobu Shimohigashi
Ryo Toya
Tetsuo Saito
Osamu Ikeda
Masato Maruyama
Keisuke Yonemura
Yuji Nakaguchi
Yudai Kai
Yasuyuki Yamashita
Natsuo Oya
Fujio Araki
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-017-0799-7

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