Xin Wang1, Amol J Ghia2, Zhongxiang Zhao1, Jinzhong Yang1, Dershan Luo1, Tina M Briere1, Ramiro Pino3, Jing Li2, Mary F McAleer2, David C Weksberg4, Eric L Chang5, Paul D Brown2, James N Yang1. 1. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, USA. 4. Department of Radiation Oncology, PinnacleHealth Cancer Institute, Harrisburg, PA, USA. 5. Department of Radiation Oncology, University of Southern California Keck School of Medicine, Norris Cancer Hospital, Los Angeles, CA, USA.
Abstract
PURPOSE: To assess the dosimetric effects of respiratory motion on the target and spinal cord in spinal stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS: Thirty patients with 33 lesions were enrolled on a prospective clinical protocol and simulated with both free-breathing and four-dimensional (4-D) computed tomography (CT). We studied the target motion using 4-D data (10 phases) by registering a secondary image dataset (phase 1 to 9) to a primary image dataset (phase 0) and analyzing the displacement in both translational and rotational directions. The study of dosimetric impacts from respiration includes both the effect of potential target and spinal cord motion and anatomic changes in the beam path. A clinical step-and-shoot IMRT plan generated on the free-breathing CT was copied to the 4-D datasets to evaluate the difference in the dose-volume histogram of target and normal tissues in each phase of a breathing cycle. RESULTS: Twenty three lesions had no motion in a breathing cycle; four lesions had anterior-posterior motion ≤ 0.2 mm; two lesions had lateral motion ≤ 0.2 mm; and eight lesions had superior-inferior motion, most ≤ 0.2 mm with the worst at 0.6 mm. The difference of maximum dose to 0.01 cm3 of spinal cord in different phases of a breathing cycle was within 20 cGy in worst case. Target volumes that received the prescription dose (V100) varied little, with deviations of V100 of each phase from the average CT < 1% in most cases. Only when lesions were close to the diaphragm (e.g., at T11) did the V100 deviate by about 7% in the worst case scenario. However, this was caused by a small dose difference of 20 cGy to part of the target volume. CONCLUSIONS: Breathing induced target and spinal cord motion is negligible compared with other setup uncertainties. Dose calculation using averaged or free-breathing CT is reliable when posterior beams are used.
PURPOSE: To assess the dosimetric effects of respiratory motion on the target and spinal cord in spinal stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS: Thirty patients with 33 lesions were enrolled on a prospective clinical protocol and simulated with both free-breathing and four-dimensional (4-D) computed tomography (CT). We studied the target motion using 4-D data (10 phases) by registering a secondary image dataset (phase 1 to 9) to a primary image dataset (phase 0) and analyzing the displacement in both translational and rotational directions. The study of dosimetric impacts from respiration includes both the effect of potential target and spinal cord motion and anatomic changes in the beam path. A clinical step-and-shoot IMRT plan generated on the free-breathing CT was copied to the 4-D datasets to evaluate the difference in the dose-volume histogram of target and normal tissues in each phase of a breathing cycle. RESULTS: Twenty three lesions had no motion in a breathing cycle; four lesions had anterior-posterior motion ≤ 0.2 mm; two lesions had lateral motion ≤ 0.2 mm; and eight lesions had superior-inferior motion, most ≤ 0.2 mm with the worst at 0.6 mm. The difference of maximum dose to 0.01 cm3 of spinal cord in different phases of a breathing cycle was within 20 cGy in worst case. Target volumes that received the prescription dose (V100) varied little, with deviations of V100 of each phase from the average CT < 1% in most cases. Only when lesions were close to the diaphragm (e.g., at T11) did the V100 deviate by about 7% in the worst case scenario. However, this was caused by a small dose difference of 20 cGy to part of the target volume. CONCLUSIONS: Breathing induced target and spinal cord motion is negligible compared with other setup uncertainties. Dose calculation using averaged or free-breathing CT is reliable when posterior beams are used.
Authors: Martin J Murphy; Steven D Chang; Iris C Gibbs; Quynh-Thu Le; Jenny Hai; Daniel Kim; David P Martin; John R Adler Journal: Int J Radiat Oncol Biol Phys Date: 2003-04-01 Impact factor: 7.038
Authors: David C Weksberg; Matthew B Palmer; Khoi N Vu; Neal C Rebueno; Hadley J Sharp; Dershan Luo; James N Yang; Almon S Shiu; Laurence D Rhines; Mary Frances McAleer; Paul D Brown; Eric L Chang Journal: Int J Radiat Oncol Biol Phys Date: 2012-03-22 Impact factor: 7.038
Authors: Amit K Garg; Almon S Shiu; James Yang; Xin-Shelley Wang; Pamela Allen; Barry W Brown; Patricia Grossman; Erik K Frija; Mary Frances McAleer; Syed Azeem; Paul D Brown; Laurence D Rhines; Eric L Chang Journal: Cancer Date: 2012-04-17 Impact factor: 6.860
Authors: Mischa S Hoogeman; Joost J Nuyttens; Peter C Levendag; Ben J M Heijmen Journal: Int J Radiat Oncol Biol Phys Date: 2007-11-08 Impact factor: 7.038
Authors: Fang-Fang Yin; Samuel Ryu; Munther Ajlouni; Jingeng Zhu; Hui Yan; Harrison Guan; Kathleen Faber; Jack Rock; Muwaffak Abdalhak; Lisa Rogers; Mark Rosenblum; Jae Ho Kim Journal: Med Phys Date: 2002-12 Impact factor: 4.071
Authors: John W Nelson; David S Yoo; John H Sampson; Robert E Isaacs; Nicole A Larrier; Lawrence B Marks; Fang-Fang Yin; Q Jackie Wu; Zhiheng Wang; John P Kirkpatrick Journal: Int J Radiat Oncol Biol Phys Date: 2008-11-10 Impact factor: 7.038
Authors: Kosj Yamoah; Nicholas G Zaorsky; Joshua Siglin; Wenyin Shi; Maria Werner-Wasik; David W Andrews; Adam P Dicker; Voichita Bar-Ad; Haisong Liu Journal: Int J Med Phys Clin Eng Radiat Oncol Date: 2014-02
Authors: Murat Alp Oztek; Nina A Mayr; Mahmud Mossa-Basha; Matthew Nyflot; Patricia A Sponseller; Wei Wu; Christoph P Hofstetter; Rajiv Saigal; Stephen R Bowen; Daniel S Hippe; William T C Yuh; Robert D Stewart; Simon S Lo Journal: Neurosurgery Date: 2020-11-16 Impact factor: 4.654
Authors: Jihye Koo; Louis Nardella; Michael Degnan; Jacqueline Andreozzi; Hsiang-Hsuan M Yu; Jose Penagaricano; Peter A S Johnstone; Daniel Oliver; Kamran Ahmed; Stephen A Rosenberg; Evan Wuthrick; Roberto Diaz; Vladimir Feygelman; Kujtim Latifi; Eduardo G Moros; Gage Redler Journal: Technol Cancer Res Treat Date: 2021 Jan-Dec