Dataset Information

Abdominal organ position variation in children during image-guided radiotherapy.

ABSTRACT:

Background

Interfractional organ position variation might differ for abdominal organs and this could have consequences for defining safety margins. Therefore, the purpose of this study is to quantify interfractional position variations of abdominal organs in children in order to investigate possible correlations between abdominal organs and determine whether position variation is location-dependent.

Methods

For 20 children (2.2-17.8 years), we retrospectively analyzed 113 CBCTs acquired during the treatment course, which were registered to the reference CT to assess interfractional position variation of the liver, spleen, kidneys, and both diaphragm domes. Organ position variation was assessed in three orthogonal directions and relative to the bony anatomy. Diaphragm dome position variation was assessed in the cranial-caudal (CC) direction only. We investigated possible correlations between position variations of the organs (Spearman's correlation test, ?), and tested if organ position variations in the CC direction are related to the diaphragm dome position variations (linear regression analysis, R²) (both tests: significance level p ResultsIn all directions, correlations between liver and spleen position variations, and between right and left kidney position variations were weak (????0.43). In the CC direction, the position variations of the right and left diaphragm domes were significantly, and stronger, correlated with position variations of the liver (R² =?0.55) and spleen (R² =?0.63), respectively, compared to the right (R² =?0.00) and left kidney (R² =?0.25). Differences in ? and ? between all organs were small and insignificant.

Conclusions

No (strong) correlations between interfractional position variations of abdominal organs in children were observed. From present results, we concluded that diaphragm dome position variations could be more representative for superiorly located abdominal (liver, spleen) organ position variations than for inferiorly located (kidneys) organ position variations. Differences of systematic and random errors between abdominal organs were small, suggesting that for margin definitions, there was insufficient evidence of a dependence of organ position variation on anatomical location.

SUBMITTER: Huijskens SC

PROVIDER: S-EPMC6136223 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Abdominal organ position variation in children during image-guided radiotherapy.

Huijskens Sophie C SC van Dijk Irma W E M IWEM Visser Jorrit J Balgobind Brian V BV Te Lindert D D Rasch Coen R N CRN Alderliesten Tanja T Bel Arjan A

Radiation oncology (London, England) 20180912 1

<h4>Background</h4>Interfractional organ position variation might differ for abdominal organs and this could have consequences for defining safety margins. Therefore, the purpose of this study is to quantify interfractional position variations of abdominal organs in children in order to investigate possible correlations between abdominal organs and determine whether position variation is location-dependent.<h4>Methods</h4>For 20 children (2.2-17.8 years), we retrospectively analyzed 113 CBCTs ac ...[more]

PMID: 30208936

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Project description:AIMS:Magnetic resonance image-guided radiotherapy (MRIgRT) has been clinically implemented since 2014. This technology offers improved soft-tissue visualisation, daily imaging, and intra-fraction real-time imaging without added radiation exposure, and the opportunity for adaptive radiotherapy (ART) to adjust for anatomical changes. Here we share the longest single-institution experience with MRIgRT, focusing on trends and changes in use over the past 4.5 years. MATERIALS AND METHODS:We analysed clinical information, including patient demographics, treatment dates, disease sites, dose/fractionation, and clinical trial enrolment for all patients treated at our institution using MRIgRT on a commercially available, integrated 0.35 T MRI, tri-cobalt-60 device from 2014 to 2018. For each patient, factors including disease site, clinical rationale for MRIgRT use, use of ART, and proportion of fractions adapted were summated and compared between individual years of use (2014-2018) to identify shifts in institutional practice patterns. RESULTS:Six hundred and forty-two patients were treated with 666 unique treatment courses using MRIgRT at our institution between 2014 and 2018. Breast cancer was the most common disease, with use of cine MRI gating being a particularly important indication, followed by abdominal sites, where the need for cine gating and use of ART drove MRIgRT use. One hundred and ninety patients were treated using ART in 1550 fractions, 67.6% (1050) of which were adapted. ART was primarily used in cancers of the abdomen. Over time, breast and gastrointestinal cancers became increasingly dominant for MRIgRT use, hypofractionated treatment courses became more popular, and gastrointestinal cancers became the principal focus of ART. DISCUSSION:MRIgRT is widely applicable within the field of radiation oncology and new clinical uses continue to emerge. At our institution to date, applications such as ART for gastrointestinal cancers and accelerated partial breast irradiation (APBI) for breast cancer have become dominant indications, although this is likely to continue to evolve.

Dataset Information

Abdominal organ position variation in children during image-guided radiotherapy.

Background

Methods

Conclusions

Publications

Abdominal organ position variation in children during image-guided radiotherapy.

Similar Datasets

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