Determination of ventilatory liver movement via radiographic evaluation of diaphragm position
Determination of ventilatory liver movement via radiographic evaluation of diaphragm position
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DOI：
10.1016/s0360-3016(01)01649-2
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发表时间：
2001-09-01
影响因子：
7
通讯作者：
Ten Haken, R
中科院分区：
文献类型：
--
作者：
Balter, JM;Dawson, LA;Ten Haken, R
目的：为了确定估计的准确性推断通过观察横膈膜偏移放射images.Methods和材料：8例局灶性肝癌铂栓塞微线圈植入在他们的肝脏肝动脉插管输送区域化疗。这些患者接受了透视检查，在此期间，正常的呼吸运动被记录在录像带上。将呼吸运动的影像数字化，并记录隔膜和线圈的相对投影位置。对于6名患者，在治疗期间还采集了每日X线片。回顾性测量线圈的位置后，采取的隔膜对齐与肝脏的上级部分的数字重建radiographs.Results：线圈运动4.9至30.4毫米，观察在正常呼吸。在整个呼吸周期中，隔膜位置准确跟踪了前上线圈位移（总体σ 1.04 mm）。线圈移动的范围由隔膜移动的范围预测，精度为2.09 mm（sigma）。对于隔膜下方9.8 cm的线圈，使用隔膜位置测量线圈移动时观察到的最大误差为3.8 mm。然而，线圈距隔膜顶部的距离与预测肝脏漂移的误差没有显着相关性。对日常X线片的分析表明，使用横膈膜作为对线标志预测线圈位置的误差在上下方向上为1.8 mm（sigma），在左右方向上为2.2 min，与对线中固有的不确定性大小相似。这项研究表明，肝脏内不同位置的运动范围是由横膈膜位置预测的，匹配或超过现有的系统，以进行解释性跟踪。这表明，对于大多数患者，横膈膜是一个可接受的解剖标志，用于在前后投影中进行肝脏运动的放射学评估。(C)2001 Elsevier Science Inc.
Purpose: To determine the accuracy of estimation of liver movement inferred by observing diaphragm excursion on radiographic images.Methods and Materials: Eight patients with focal liver cancer had platinum embolization microcoils implanted in their livers during catheterization of the hepatic artery for delivery of regional chemotherapy. These patients underwent fluoroscopy, during which normal breathing movement was recorded on videotape. Movies of breathing movement were digitized, and the relative projected positions of the diaphragm and coils were recorded. For 6 patients, daily radiographs were also acquired during treatment. Retrospective measurements of coil position were taken after the diaphragm was aligned with the superior portion of the liver on digitally reconstructed radiographs.Results: Coil movement of 4.9 to 30.4 mm was observed during normal breathing. Diaphragm position tracked inferior-superior coil displacement accurately (population sigma 1.04 mm) throughout the breathing cycle. The range of coil movement was predicted by the range of diaphragm movement with an accuracy of 2.09 mm (sigma). The maximum error observed measuring coil movement using diaphragm position was 3.8 mm for a coil 9.8 cm inferior to the diaphragm. However, the distance of the coil from the top of the diaphragm did not correlate significantly with the error in predicting liver excursion. Analysis of daily radiographs showed that the error in predicting coil position using the diaphragm as an alignment landmark was 1.8 mm (sigma) in the inferior-superior direction and 2.2 min in the left-right direction, similar in magnitude to the inherent uncertainty in alignment.Conclusions: This study demonstrated that the range of ventilatory movement of different locations within the liver is predicted by diaphragm position to an accuracy that matches or exceeds existing systems for ventilatory tracking. This suggests that the diaphragm is an acceptable anatomic landmark for radiographic estimation of liver movement in anterior-posterior projections for most patients. (C) 2001 Elsevier Science Inc.