MRI quantification of pancreas motion as a function of patient setup for particle therapy -a preliminary study.
Particle therapy (PT) has shown positive therapeutic results in local control of locally advanced pancreatic lesions. PT effectiveness is highly influenced by target localization accuracy both in space, since the pancreas is located in proximity to radiosensitive vital organs, and in time as it is subject to substantial breathing-related motion. The purpose of this preliminary study was to quantify pancreas range of motion under typical PT treatment conditions. Three common immobilization devices (vacuum cushion, thermoplastic mask, and compressor belt) were evaluated on five male patients in prone and supine positions. Retrospective four-dimensional magnetic resonance imaging data were reconstructed for each condition and the pancreas was manually segmented on each of six breathing phases. A k-means algorithm was then applied on the manually segmented map in order to obtain clusters representative of the three pancreas segments: head, body, and tail. Centers of mass (COM) for the pancreas and its segments were computed, as well as their displacements with respect to a reference breathing phase (beginning exhalation). The median three-dimensional COM displacements were in the range of 3 mm. Latero-lateral and superior-inferior directions had a higher range of motion than the anterior-posterior direction. Motion analysis of the pancreas segments showed slightly lower COM displacements for the head cluster compared to the tail cluster, especially in prone position. Statistically significant differences were found within patients among the investigated setups. Hence a patient-specific approach, rather than a general strategy, is suggested to define the optimal treatment setup in the frame of a millimeter positioning accuracy.
Centro Nazionale di Adroterapia Oncologica. Giulia.Fontana@Cnao.it.
Giulia
G
Fontana
Marco
M
Riboldi
Chiara
C
Gianoli
Cezarina I
CI
Chirvase
Gaetano
G
Villa
Chiara
C
Paganelli
Paul E
PE
Summers
Barbara
B
Tagaste
Andrea
A
Pella
Piero
P
Fossati
Mario
M
Ciocca
Guido
G
Baroni
Francesca
F
Valvo
Roberto
R
Orecchia
D000465:Algorithms; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007103:Immobilization / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010190:Pancreatic Neoplasms / Q000532:radiotherapy*; D056888:Patient Positioning; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D061106:Radiotherapy Setup Errors / Q000517:prevention & control*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012119:Respiration; D012189:Retrospective Studies
J Surg Res. 2012 May 15;174(2):319-25
21937061
Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):884-91
19395190
Med Dosim. 2014 Summer;39(2):139-45
24661778
Phys Med Biol. 2011 Aug 21;56(16):R113-44
21775795
Technol Cancer Res Treat. 2014 Dec;13(6):485-95
24354749
Radiat Oncol. 2014 Aug 30;9:192
25175267
Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):274-83
16618582
Radiother Oncol. 2003 Jul;68(1):69-74
12885454
J Cancer Res Ther. 2014 Oct-Dec;10(4):932-6
25579531
Technol Cancer Res Treat. 2014 Jun;13(3):259-67
24206202
Nat Rev Clin Oncol. 2010 Jan;7(1):37-43
19949433
World J Gastroenterol. 2014 Mar 7;20(9):2358-64
24605033
Int J Radiat Oncol Biol Phys. 2013 Aug 1;86(5):914-21
23845843
CMAJ. 2013 Oct 1;185(14):1219-26
23610017
Lancet Oncol. 2006 Aug;7(8):676-85
16887485
Radiat Oncol. 2006 Sep 04;1:33
16952315
Radiother Oncol. 2014 May;111(2):252-7
24746577
Phys Med. 1998 Jul;14 Suppl 1:1-19
11542635
CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29
25559415
Radiother Oncol. 2007 Dec;85(3):424-8
18036688
Curr Oncol Rep. 2014 Jun;16(6):388
24740136
Radiother Oncol. 2009 Aug;92 (2):231-7
19211167
Med Phys. 2015 Aug;42(8):4814-21
26233208
Radiother Oncol. 2009 Aug;92(2):238-43
19454367
J Gastrointest Surg. 2010 Oct;14(10):1547-59
20839073
Radiat Oncol. 2014 Jan 09;9:11
24401365
World J Gastroenterol. 2014 Aug 28;20(32):11142-59
25170201
J Gastrointest Surg. 2012 Apr;16(4):771-83
22127781
Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):435-41
22197238
Int J Radiat Oncol Biol Phys. 2011 Feb 1;79(2):602-8
20675063
Int J Radiat Oncol Biol Phys. 2013 Aug 1;86(5):908-13
23688811
PLoS One. 2013;8(2):e55991
23418491