PMID- 20831512
OWN - NLM
STAT- MEDLINE
DCOM- 20110207
LR  - 20191210
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 49
IP  - 7
DP  - 2010 Oct
TI  - Investigation of respiration induced intra- and inter-fractional tumour motion 
      using a standard Cone Beam CT.
PG  - 1192-8
LID - 10.3109/0284186X.2010.498834 [doi]
AB  - BACKGROUND: To investigate whether a standard Cone beam CT (CBCT) scan can be 
      used to determined the intra- and inter-fractional tumour motion for lung tumours 
      that have infiltrated the mediastinum. MATERIAL AND METHODS: This study includes 
      23 patients with non small cell lung cancer (NSCLC). The intra-fractional tumour 
      motion was analysed for each patient on a 4D-CT scan as well as on three 4D-CBCT 
      (fraction 3, 10 and 20). The 4D-CBCT was reconstructed from a standard 3D-CBCT 
      using in-house developed software. The tumour (GTV) was delineated in the first 
      phase of the 4D-CT. Registration of phase one from the 4D-CT and 4D-CBCT was used 
      to copy the GTV to the CBCT scans. Hereafter the motion of the outlined GTV was 
      tracked in the planning 4D-CT and the three 4D-CBCT using Pinnacle((R)) version 
      8.1w (research version). Additionally, the inter-fractional tumour movement, 
      relative to the bony structure, was obtained from the difference in tumour 
      position between the 3D-CT and the standard 3D-CBCT. RESULTS: It is possible to 
      track a lung tumour with mediastinal infiltration in the 4D-CBCT scan based on a 
      standard 3D-CBCT. The respiration motion in the 4D-CBCT is not significantly 
      different from the result found from the initial 4D-CT. Likewise, no differences 
      in respiration motion was found between fractions 3, 10 and 20. CONCLUSION: This 
      study shows that it is possible to track tumour motion for NSCLC patients with 
      mediastinal infiltration using a standard 3D-CBCT. No change in the 
      intra-fractional tumour motion of clinically relevance was observed during the 
      fractionated treatment course. The inter-fractional tumour motion found 
      underlines the importance of using daily IGRT with online match on soft tissue in 
      order to be able to reduce treatment margins.
FAU - Gottlieb, Karina Lindberg
AU  - Gottlieb KL
AD  - Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark. 
      karina.lindberg@ouh.regionsyddanmark.dk
FAU - Hansen, Christian R
AU  - Hansen CR
FAU - Hansen, Olfred
AU  - Hansen O
FAU - Westberg, Jonas
AU  - Westberg J
FAU - Brink, Carsten
AU  - Brink C
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
SB  - IM
MH  - Carcinoma, Non-Small-Cell Lung/*diagnostic 
      imaging/pathology/physiopathology/radiotherapy
MH  - Cone-Beam Computed Tomography/*methods
MH  - Dose Fractionation, Radiation
MH  - Four-Dimensional Computed Tomography/methods
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - Lung Neoplasms/*diagnostic imaging/pathology/physiopathology/radiotherapy
MH  - Movement/*physiology
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Intensity-Modulated/methods
MH  - *Respiration
MH  - Respiratory Mechanics/physiology
MH  - Retrospective Studies
MH  - Tumor Burden/physiology
EDAT- 2010/09/14 06:00
MHDA- 2011/02/08 06:00
CRDT- 2010/09/14 06:00
PHST- 2010/09/14 06:00 [entrez]
PHST- 2010/09/14 06:00 [pubmed]
PHST- 2011/02/08 06:00 [medline]
AID - 10.3109/0284186X.2010.498834 [doi]
PST - ppublish
SO  - Acta Oncol. 2010 Oct;49(7):1192-8. doi: 10.3109/0284186X.2010.498834.