TY - JOUR
T1 - MRI-based Assessment of 3D Intrafractional Motion of Head and Neck Cancer for Radiation Therapy
AU - Gurney-Champion, Oliver J.
AU - McQuaid, Dualta
AU - Dunlop, Alex
AU - Wong, Kee H.
AU - Welsh, Liam C.
AU - Riddell, Angela M.
AU - Koh, Dow-Mu
AU - Oelfke, Uwe
AU - Leach, Martin O.
AU - Nutting, Christopher M.
AU - Bhide, Shreerang A.
AU - Harrington, Kevin J.
AU - Panek, Rafal
AU - Newbold, Kate L.
PY - 2018
Y1 - 2018
N2 - Purpose: To determine the 3-dimensional (3D) intrafractional motion of head and neck squamous cell carcinoma (HNSCC). Methods and Materials: Dynamic contrast-enhanced magnetic resonance images from 56 patients with HNSCC in the treatment position were analyzed. Dynamic contrast-enhanced magnetic resonance imaging consisted of 3D images acquired every 2.9 seconds for 4 minutes 50 seconds. Intrafractional tumor motion was studied in the 3 minutes 43 seconds of images obtained after initial contrast enhancement. To assess tumor motion, rigid registration (translations only) was performed using a region of interest (ROI) mask around the tumor. The results were compared with bulk body motion from registration to all voxels. Motion was split into systematic motion and random motion. Correlations between the tumor site and random motion were tested. The within-subject coefficient of variation was determined from 8 patients with repeated baseline measures. Random motion was also assessed at the end of the first week (38 patients) and second week (25 patients) of radiation therapy to investigate trends of motion. Results: Tumors showed irregular occasional rapid motion (eg, swallowing or coughing), periodic intermediate motion (respiration), and slower systematic drifts throughout treatment. For 95% of the patients, displacements due to systematic and random motion were <1.4 mm and <2.1 mm, respectively, 95% of the time. The motion without an ROI mask was significantly (P<.0001, Wilcoxon signed rank test) less than the motion with an ROI mask, indicating that tumors can move independently from the bony anatomy. Tumor motion was significantly (P=.005, Mann-Whitney U test) larger in the hypopharynx and larynx than in the oropharynx. The within-subject coefficient of variation for random motion was 0.33. The average random tumor motion did not increase notably during the first 2 weeks of treatment. Conclusions: The 3D intrafractional tumor motion of HNSCC is small, with systematic motion <1.4 mm and random motion <2.1 mm 95% of the time.
AB - Purpose: To determine the 3-dimensional (3D) intrafractional motion of head and neck squamous cell carcinoma (HNSCC). Methods and Materials: Dynamic contrast-enhanced magnetic resonance images from 56 patients with HNSCC in the treatment position were analyzed. Dynamic contrast-enhanced magnetic resonance imaging consisted of 3D images acquired every 2.9 seconds for 4 minutes 50 seconds. Intrafractional tumor motion was studied in the 3 minutes 43 seconds of images obtained after initial contrast enhancement. To assess tumor motion, rigid registration (translations only) was performed using a region of interest (ROI) mask around the tumor. The results were compared with bulk body motion from registration to all voxels. Motion was split into systematic motion and random motion. Correlations between the tumor site and random motion were tested. The within-subject coefficient of variation was determined from 8 patients with repeated baseline measures. Random motion was also assessed at the end of the first week (38 patients) and second week (25 patients) of radiation therapy to investigate trends of motion. Results: Tumors showed irregular occasional rapid motion (eg, swallowing or coughing), periodic intermediate motion (respiration), and slower systematic drifts throughout treatment. For 95% of the patients, displacements due to systematic and random motion were <1.4 mm and <2.1 mm, respectively, 95% of the time. The motion without an ROI mask was significantly (P<.0001, Wilcoxon signed rank test) less than the motion with an ROI mask, indicating that tumors can move independently from the bony anatomy. Tumor motion was significantly (P=.005, Mann-Whitney U test) larger in the hypopharynx and larynx than in the oropharynx. The within-subject coefficient of variation for random motion was 0.33. The average random tumor motion did not increase notably during the first 2 weeks of treatment. Conclusions: The 3D intrafractional tumor motion of HNSCC is small, with systematic motion <1.4 mm and random motion <2.1 mm 95% of the time.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041368080&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29229323
U2 - https://doi.org/10.1016/j.ijrobp.2017.10.016
DO - https://doi.org/10.1016/j.ijrobp.2017.10.016
M3 - Article
C2 - 29229323
SN - 0360-3016
VL - 100
SP - 306
EP - 316
JO - International journal of radiation oncology, biology, physics
JF - International journal of radiation oncology, biology, physics
IS - 2
ER -