Four-Dimensional Measurement of the Displacement of Internal Fiducial Markers During 320-Multislice Computed Tomography Scanning of Thoracic Esophageal Cancer

• Published in: International journal of radiation oncology, biology, physics Vol. 79; no. 2; pp. 588 - 595
• Main Authors: Yamashita, Hideomi, M.D., Ph.D, Kida, Satoshi, M.Sc, Sakumi, Akira, Ph.D, Haga, Akihiro, Ph.D, Ito, Saori, Ph.D, Onoe, Tsuyoshi, M.D, Okuma, Kae, M.D, Ino, Kenji, R.T.T, Akahane, Masaaki, M.D., Ph.D, Ohtomo, Kuni, M.D., Ph.D, Nakagawa, Keiichi, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-2011; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; BODY; BOSONS; Carcinoma, Squamous Cell - diagnostic imaging; CLEARANCE; Computed tomography; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; ELEMENTARY PARTICLES; Esophageal cancer; Esophageal Neoplasms - diagnostic imaging; ESOPHAGUS; EXCRETION; EXHALATION; Female; Fiducial Markers; FOUR-DIMENSIONAL CALCULATIONS; Four-Dimensional Computed Tomography - methods; Gastroenterology. Liver. Pancreas. Abdomen; Hematology, Oncology and Palliative Medicine; Humans; INHALATION; INTAKE; Internal margin; Intrafraction motion; Male; MASSLESS PARTICLES; Medical sciences; MEDICINE; Middle Aged; MOTION; Movement; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; PHOTONS; Radiography, Thoracic; RADIOLOGY; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; RESPIRATION; THERAPY; TOMOGRAPHY; Tumors; Internal margin; Computed tomography; Esophageal cancer; Intrafraction motion; Motion; Radiodiagnosis; Esophageal disease; Thorax; Malignant tumor; Esophagus cancer; Fiducial marker; Medical imagery; Digestive diseases; Multislice; Computerized axial tomography; Cancer
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2010.03.045

Purpose To investigate the three-dimensional movement of internal fiducial markers placed near esophageal cancers using 320-multislice CT. Methods and Materials This study examined 22 metal markers in the esophageal wall near the primary tumors of 12 patients treated with external-beam photon radiotherapy. Motion assessment was analyzed in 41 respiratory phases during 20 s of cine CT in the radiotherapy position. Results Motion in the cranial–caudal (CC) direction showed a strong correlation ( R2 > 0.4) with the respiratory curve in most markers (73%). The average absolute amplitude of the marker movement was 1.5 ± 1.6 mm, 1.6 ± 1.7 mm, and 3.3 ± 3.3 mm in the left–right (LR), anterior–posterior (AP), and CC directions, respectively. The average marker displacements in the CC direction between peak exhalation and inhalation for the 22 clips were 1.1 mm (maximum, 5.5 mm), 3.0 mm (14.5 mm), and 5.1 mm (16.3 mm) for the upper, middle, and lower thoracic esophagus, respectively. Conclusions Motion in primary esophagus tumor was evaluated with 320-multislice CT. According to this study, 4.3 mm CC, 1.5 mm AP, and 2.0 mm LR in the upper, 7.4 mm CC, 3.0 mm AP, and 2.4 mm LR in the middle, and 13.8 mm CC, 6.6 mm AP, and 6.8 mm LR in the lower thoracic esophagus provided coverage of tumor motion in 95% of the cases in our study population.