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Matsumoto S, Mukumoto N, Ono T, Iramina H, Hirashima H, Adachi T, Miyabe Y, Kishi N, Mizowaki T, Nakamura M. Margins to compensate for respiratory-induced mismatches between lung tumor and fiducial marker positions using four-dimensional computed tomography. Phys Imaging Radiat Oncol 2025; 33:100728. [PMID: 40026906 PMCID: PMC11871501 DOI: 10.1016/j.phro.2025.100728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 01/31/2025] [Accepted: 02/05/2025] [Indexed: 03/05/2025] Open
Abstract
Background and purpose Tumors and fiducial markers do not always exhibit synchronous motion across different respiratory phases, in a phenomenon called the target localization error (TLE). We determined the margin to compensate for the TLE using four-dimensional computed tomography (4D-CT). Materials and methods We analyzed data from 21 lung tumor patients with fiducial markers; 11 for TLE determination and 10 for validation. Shifted CT images were generated by aligning the centroids of the fiducial markers in the reference phase of 4D-CT with those in each respiratory phase, and the union of gross tumor volumes (GTVs) was determined (G T V u n i o n s h i f t ). Conversely, variations in GTV centroids across the respiratory phases were calculated, and the 95th percentile of the root mean square error was defined as the TLE. Using this TLE, a GTV with an added TLE (G T V T L E r e f ) was generated in the reference phase. Subsequently, a treatment plan assuming dynamic tumor tracking (DTT) was created for the planning target volume, derived by adding an isotropic 5 mm margin toG T V T L E r e f , and the dose coverage forG T V u n i o n s h i f t was evaluated. Results The TLEs (standard deviations of the root mean square error) were 2.0 (0.8) mm, 2.1(0.7) mm, and 3.2 (1.1) mm in the left - right, anterior - posterior, and superior - inferior directions, respectively. A dosimetric evaluation revealed thatG T V u n i o n s h i f t did not receive 100 % of the prescribed dose in four of 10 cases owing to artifacts. Conclusion The TLE can be compensated by adding an anisotropic margin to the GTV in the reference phase, a critical consideration in DTT.
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Affiliation(s)
- Seiya Matsumoto
- Department of Advanced Medical Physics, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Nobutaka Mukumoto
- Department of Radiation Oncology, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahi-machi, Abeno-ku, Osaka 545-0051 Japan
| | - Tomohiro Ono
- Department of Radiation Oncology, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, Shiga 524-0022, Japan
| | - Hiraku Iramina
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hideaki Hirashima
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takanori Adachi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yuki Miyabe
- Department of Radiation Oncology, Kitano Hospital, 2-4-20 Ogi-machi, Kita-ku, Osaka 530-8480, Japan
| | - Noriko Kishi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Mitsuhiro Nakamura
- Department of Advanced Medical Physics, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
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Zhao Y, Ge Y, He Q. Preoperative Staging Diagnosis of Colorectal Cancer Based on Multi-Row Spiral CT. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Colorectal cancer is a common malignant tumor of digestive tract, and its incidence has increased significantly in recent years. The 5-year survival rate of patients with early local colorectal cancer is more than 90%, with local invasion of about 68%, and distant metastasis of less
than 10%. Therefore, early diagnosis and early treatment is an effective means for the prevention and treatment of colorectal cancer. At present, X-ray air-barium double contrast radiography and fiberoptic endoscope are most commonly used in the examination of colorectal tumors in the world.
These two methods have the advantages of simple operation, intuition and low cost. However, it is limited to judge the depth of tumor invasion, whether to break through the serosa, lymphatic metastasis, and distant metastasis. In this work, it can be confirmed that the measurement of preoperative
tumor vascular volume reconstruction density is feasible in the preoperative evaluation of colorectal cancer, it will provide clinicians with more valuable information about preoperative tumor staging. Besides, multi-slice spiral CT has the advantages of less trauma, high speed, and clear
image. It can not only judge the location of the tumor, the depth, and extent of tumor invasion, and show distant organ metastasis, but also has good application value in tumor staging. In this paper, the clinical data and MSCT imaging data of patients with colorectal cancer were analyzed
retrospectively, and the value of MSCT in the diagnosis of colorectal cancer was discussed.
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Affiliation(s)
- Yuwen Zhao
- Department of Anorectal Medicine, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou Zhejiang 311400, China
| | - Yujie Ge
- Department of Radiology, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou Zhejiang 311400, China
| | - Qunfeng He
- Department of Anorectal Medicine, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou Zhejiang 311400, China
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