Determination of respiratory motion for distal esophagus cancer using four-dimensional computed tomography
Determination of respiratory motion for distal esophagus cancer using four-dimensional computed tomography
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DOI：
10.1016/j.ijrobp.2007.05.031
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发表时间：
2008-01-01
影响因子：
7
通讯作者：
Liao, Zhongxing
中科院分区：
文献类型：
--
作者：
Yaremko, Brian P.;Guerrero, Thomas M.;Liao, Zhongxing
目的：应用四维CT(4D CT)研究食道癌远端原发灶的运动特征。方法与材料：选择31例食道癌患者，行呼吸门控4D CT扫描，制定治疗计划。可变形图像配准用于将全呼气运动的大体肿瘤体积(GTV)映射到全吸气CT图像，从而能够定量评估每个体素的位移。结果：平均(SE)潮气量为608(73)mL。呼气量为64.3(10.7)m L，吸气量为64.1(10.7)m L，差异无统计学意义(P>0.05)。肿瘤在x方向的平均运动为0.006.13(绝对值的平均值)，y方向为0.2 3(0.0 1)cm(前方)，z方向为0.71(0.0 2)cm(下方)。肿瘤运动与潮气量相关。比较肿瘤在横隔膜上和横隔膜下的运动对平均净移位有显著意义(p=0.014)，横隔膜下的运动大于横隔膜上的运动。从累积分布来看，95%的肿瘤径向移动小于0.80 cm，低于1.75 cm。结论：4DCT可评价原发性食管瘤的运动情况。根据这项研究的结果，当4D CT不可用时，在我们的研究人群中，径向边缘0.8厘米，轴向边缘+/-1.8厘米将为95%的病例提供肿瘤运动覆盖。(C)2008年爱思唯尔公司。
Purpose: To investigate the motion characteristics of distal esophagus cancer primary tumors using four-dimensional computed tomography (4D CT).Methods and Materials: Thirty-one consecutive patients treated for esophagus cancer who received respiratory-gated 4D CT imaging for treatment planning were selected. Deformable image registration was used to map the full expiratory motion gross tumor volume (GTV) to the full-inspiratory CT image, allowing quantitative assessment of each voxel's displacement. These displacements were correlated with patient tumor and respiratory characteristics.Results: The mean (SE) tidal volume was 608 (73) mL. The mean GTV volume was 64.3 (10.7) mL on expiration and 64.1 (10.7) mL on inspiration (no significant difference). The mean tumor motion in the x-direction was 0.13 (0.006) cm (average of absolute values), in the y-direction 0.23 (0.01) cm (anteriorly), and in the z-direction 0.71 (0.02) cm (inferiorly). Tumor motion correlated with tidal volume. Comparison of tumor motion above vs. below the diaphragm was significant for the average net displacement (p = 0.014), motion below the diaphragm was greater than above. From the cumulative distribution 95% of the tumors moved less than 0.80 cm radially and 1.75 cm inferiorly.Conclusions: Primary esophagus tumor motion was evaluated with 4D CT. According to the results-of this study, when 4D CT is not available, a radial margin of 0.8 cm and axial margin of +/- 1.8 cm would provide tumor motion coverage for 95% of the cases in our study population. (c) 2008 Elsevier Inc.