Abstract
PURPOSE: To quantify pancreas tumor motion on both a planning 4D-CT and during a single fraction treatment using the CyberKnife linear accelerator and Synchrony respiratory tracking software, and to investigate whether a single 4D-CT study is reliable for determining radiation treatment margins for patients with locally advanced pancreas cancer. METHODS AND MATERIALS: Twenty patients underwent fiducial placement, biphasic pancreatic protocol CT scan and 4D-CT scan in the treatment position while free-breathing. Patients were then treated with a single 25 Gy fraction of stereotactic body radiotherapy. Predicted pancreas motion in the superior-inferior (SI), left-right (LR), and anterior-posterior (AP) directions was calculated from the maximum inspiration and maximum expiration 4D-CT scan. For CyberKnife treatments, mean respiratory cycle motion and maximum respiratory cycle motion was determined in the SI, LR, and AP directions. RESULTS: The range of centroid movement based on 4D-CT in the SI, LR, and AP directions were 0.9 to 28.8 mm, 0.1 to 13.7 mm, and 0.2 to 7.6 mm, respectively. During CyberKnife treatment, in the SI direction, the mean motion of the centroid ranged from 0.5 to 12.7 mm. In the LR direction, the mean motion range was 0.4 to 9.4 mm. In the AP direction, the mean motion range was 0.6 to 5.5 mm. The maximum range of movement (mean) during CyberKnife treatment in the SI, LR, and AP directions were 4.5 to 48.8 mm (mean 20.8 mm), 1.5 to 41.3 mm (mean 11.3 mm), and 1.6 to 68.1 mm (mean 13.4 mm), respectively. Neither the maximum or mean motion correlated with the 4D-CT movement. CONCLUSIONS: There is substantial respiratory associated motion of pancreatic tumors. The 4D-CT planning scans cannot accurately predict the movement of pancreatic tumors during actual treatment on CyberKnife.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 364-368 |
| Number of pages | 5 |
| Journal | American Journal of Clinical Oncology: Cancer Clinical Trials |
| Volume | 32 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 2009 |
| Externally published | Yes |
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Keywords
- Cyberknife
- IGRT
- Pancreas cancer
- Radiation therapy
- SBRT
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Pancreatic tumor motion on a single planning 4D-CT does not correlate with intrafraction tumor motion during treatment. / Minn, A. Yuriko; Schellenberg, Devin; Maxim, Peter; Suh, Yelin; McKenna, Stephen; Cox, Brett; Dieterich, Sonja; Xing, Lei; Graves, Edward; Goodman, Karyn A.; Chang, Daniel; Koong, Albert C.
In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 32, No. 4, 08.2009, p. 364-368.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Pancreatic tumor motion on a single planning 4D-CT does not correlate with intrafraction tumor motion during treatment
AU - Minn, A. Yuriko
AU - Schellenberg, Devin
AU - Maxim, Peter
AU - Suh, Yelin
AU - McKenna, Stephen
AU - Cox, Brett
AU - Dieterich, Sonja
AU - Xing, Lei
AU - Graves, Edward
AU - Goodman, Karyn A.
AU - Chang, Daniel
AU - Koong, Albert C.
PY - 2009/8
Y1 - 2009/8
N2 - PURPOSE: To quantify pancreas tumor motion on both a planning 4D-CT and during a single fraction treatment using the CyberKnife linear accelerator and Synchrony respiratory tracking software, and to investigate whether a single 4D-CT study is reliable for determining radiation treatment margins for patients with locally advanced pancreas cancer. METHODS AND MATERIALS: Twenty patients underwent fiducial placement, biphasic pancreatic protocol CT scan and 4D-CT scan in the treatment position while free-breathing. Patients were then treated with a single 25 Gy fraction of stereotactic body radiotherapy. Predicted pancreas motion in the superior-inferior (SI), left-right (LR), and anterior-posterior (AP) directions was calculated from the maximum inspiration and maximum expiration 4D-CT scan. For CyberKnife treatments, mean respiratory cycle motion and maximum respiratory cycle motion was determined in the SI, LR, and AP directions. RESULTS: The range of centroid movement based on 4D-CT in the SI, LR, and AP directions were 0.9 to 28.8 mm, 0.1 to 13.7 mm, and 0.2 to 7.6 mm, respectively. During CyberKnife treatment, in the SI direction, the mean motion of the centroid ranged from 0.5 to 12.7 mm. In the LR direction, the mean motion range was 0.4 to 9.4 mm. In the AP direction, the mean motion range was 0.6 to 5.5 mm. The maximum range of movement (mean) during CyberKnife treatment in the SI, LR, and AP directions were 4.5 to 48.8 mm (mean 20.8 mm), 1.5 to 41.3 mm (mean 11.3 mm), and 1.6 to 68.1 mm (mean 13.4 mm), respectively. Neither the maximum or mean motion correlated with the 4D-CT movement. CONCLUSIONS: There is substantial respiratory associated motion of pancreatic tumors. The 4D-CT planning scans cannot accurately predict the movement of pancreatic tumors during actual treatment on CyberKnife.
AB - PURPOSE: To quantify pancreas tumor motion on both a planning 4D-CT and during a single fraction treatment using the CyberKnife linear accelerator and Synchrony respiratory tracking software, and to investigate whether a single 4D-CT study is reliable for determining radiation treatment margins for patients with locally advanced pancreas cancer. METHODS AND MATERIALS: Twenty patients underwent fiducial placement, biphasic pancreatic protocol CT scan and 4D-CT scan in the treatment position while free-breathing. Patients were then treated with a single 25 Gy fraction of stereotactic body radiotherapy. Predicted pancreas motion in the superior-inferior (SI), left-right (LR), and anterior-posterior (AP) directions was calculated from the maximum inspiration and maximum expiration 4D-CT scan. For CyberKnife treatments, mean respiratory cycle motion and maximum respiratory cycle motion was determined in the SI, LR, and AP directions. RESULTS: The range of centroid movement based on 4D-CT in the SI, LR, and AP directions were 0.9 to 28.8 mm, 0.1 to 13.7 mm, and 0.2 to 7.6 mm, respectively. During CyberKnife treatment, in the SI direction, the mean motion of the centroid ranged from 0.5 to 12.7 mm. In the LR direction, the mean motion range was 0.4 to 9.4 mm. In the AP direction, the mean motion range was 0.6 to 5.5 mm. The maximum range of movement (mean) during CyberKnife treatment in the SI, LR, and AP directions were 4.5 to 48.8 mm (mean 20.8 mm), 1.5 to 41.3 mm (mean 11.3 mm), and 1.6 to 68.1 mm (mean 13.4 mm), respectively. Neither the maximum or mean motion correlated with the 4D-CT movement. CONCLUSIONS: There is substantial respiratory associated motion of pancreatic tumors. The 4D-CT planning scans cannot accurately predict the movement of pancreatic tumors during actual treatment on CyberKnife.
KW - Cyberknife
KW - IGRT
KW - Pancreas cancer
KW - Radiation therapy
KW - SBRT
UR - http://www.scopus.com/inward/record.url?scp=69349095126&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=69349095126&partnerID=8YFLogxK
U2 - 10.1097/COC.0b013e31818da9e0
DO - 10.1097/COC.0b013e31818da9e0
M3 - Article
C2 - 19398901
AN - SCOPUS:69349095126
VL - 32
SP - 364
EP - 368
JO - American Journal of Clinical Oncology
JF - American Journal of Clinical Oncology
SN - 0277-3732
IS - 4
ER -