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Kidney motion in each direction and influencing factors derived from four dimensional computed tomography under free-breathing condition
Ma Mingwei1, Gao Xianshu1, Li Hongzhen1, Zhao Bo2,3, Zhang Min1, Liu Siwei1, Qin Shangbin1, Qi Xin1, Bai Yun1
1Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China; 2Department of Engineering Physics, Tsinghua University, Beijing 100084, China; 3Key Laboratory of Particle & Radiation Imaging, Ministry of Education, Tsinghua University, Beijing 100084, China
AbstractObjective To explore the amplitude of normal kidney motion in the 3D direction and its influencing factors under free-breathing condition. Methods Clinical data of 28 patients with a KPS score≥80 who received 4D CT scan from March 2018 to March 2019 were collected. All patients were diagnosed with liver, pancreatic or lung tumors. The kidney was outlined and the geometric center and 3D coordinate values were recorded. The motion of bilateral kidneys in each direction and the 3D direction was calculated. The volume of kidney and surrounding organs, age, sex, height and body mass index (BMI) were recorded. Clinical data were statistically compared by t-test or nonparametric test. Results The motion of the left and right kidneys in the the sup-inf (SI) direction were the largest up to (8.39±3.18) mm and (7.71±3.55) mm. The motion amplitudes of bilateral kidneys in male patients were significantly larger than those of the female counterparts in the left-right (LR), SI and 3D directions (all P<0.05). The motion amplitudes of bilateral kidneys in patients taller than 165cm were significantly larger than those of their counterparts with a height of ≤165cm (all P<0.05). Patients with a BMI≥25kg/m2had significantly larger motion amplitudes of the left kidney in the LR and ant-post (AP) directions compared with those of normal weight counterparts (all P<0.05). The motion amplitude of the left kidney in the AP direction in patients with the left kidney volume of >180cm3 was significantly larger than that of patients with smaller left kidney volume (P=0.014). Age was not significantly associated with kidney motion in each direction (P>0.05). Conclusions Kidney motion mainly occurs in the SI direction. The kidney motion amplitudes in male and taller patients are larger. Special attention should be paid to the use of breath motion control device to decrease the normal tissue damage.
Ma Mingwei,Gao Xianshu,Li Hongzhen et al. Kidney motion in each direction and influencing factors derived from four dimensional computed tomography under free-breathing condition[J]. Chinese Journal of Radiation Oncology, 2021, 30(5): 481-485.
Ma Mingwei,Gao Xianshu,Li Hongzhen et al. Kidney motion in each direction and influencing factors derived from four dimensional computed tomography under free-breathing condition[J]. Chinese Journal of Radiation Oncology, 2021, 30(5): 481-485.
[1] 吴先想,牛振洋,费振乐,等. 呼吸运动状态对动态调强放疗剂量分布影响的研究[J]. 中华放射医学与防护杂志, 2019, 39(3):197-201. DOI:10.3760/cma.j.issn.0254-5098.2019.03.007. Wu Xx, Niu ZY, Fei ZL, et al. The effect of respiratory motion states on dynamic IMRT dose distribution[J]. Chin J Radiol Med Prot, 2019, 39(3):197-201. DOI:10.3760/cma.j.issn.0254-5098.2019.03.007. [2] Sun X, Li Y, Li J, et al. Impact of the time proportion of respiratory phases on dosimetry in SBRT of lung tumor near the chest wall or diaphragm[J]. Technol Cancer Res Treat, 2019, 18:1533033819879897. DOI:10.1177/1533033819879897. [3] El-Sherif O, Yu E, Xhaferllari I, et al. Assessment of intrafraction breathing motion on left anterior descending artery dose during left-sided breast radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2016, 95(3):1075-1082. DOI:10.1016/j.ijrobp.2016.02.026. [4] GabryšD, Kulik R, Trela K, et al. Dosimetric comparison of liver tumour radiotherapy in all respiratory phases and in one phase using 4DCT[J]. Radiother Oncol, 2011, 100(3):360-364. DOI:10.1016/j.radonc.2011.09.006. [5] Ozgür A, Yalm Iker N. Extracorporeal shock wave lithotripsy of renal pelvis stones with PCK stonelith lithotripter[J]. Int Urol Nephrol, 2005, 37(1):9-11. DOI:10.1007/s11255-004-6085-2. [6] Song H, Ruan D, Liu W, et al. Respiratory motion prediction and prospective correction for free-breathing arterial spin-labeled perfusion MRI of the kidneys[J]. Med Phys,2017, 44(3):962-973. DOI:10.1002/mp.12099. [7] Stam MK, van Vulpen M, Barendrecht MM, et al. Kidney motion during free breathing and breath hold for MR-guided radiotherapy[J]. Phys Med Biol, 2013, 58(7):2235-2245. DOI:10.1088/0031-9155/58/7/2235. [8] Song R, Tipirneni A, Johnson P, et al. Evaluation of respiratory liver and kidney movements for MRI navigator gating[J]. J Magn Reson Imaging, 2011, 33(1):143-148. DOI:10.1002/jmri.22418. [9] Testa A, Soldati G, Giannuzzi R, et al. Ultrasound M-mode assessment of diaphragmatic kinetics by anterior transverse scanning in healthy subjects[J]. Ultrasound Med Biol, 2011, 37(1):44-52. DOI:10.1016/j.ultrasmedbio.2010.10.004. [10] 范文骏, 龙淼淼, 沈文,等. Cine-MRI测量健康成年人肾脏运动幅度[J]. 中国医学影像学杂志, 2013, 21(5):380-382. DOI:10.3969/j.issn.1005-5185.2013.05.019. Fan WJ, Long MM, Shen W, et al. Measurement of healthy adult kidney′s range of motion by cine-MRI[J]. Chin J Med Imag, 2013, 21(5):380-382. DOI:10.3969/j.issn.1005-5185.2013.05.019. [11] Karava K, Ehrbar S, Riesterer O, et al. Potential dosimetric benefits of adaptive tumor tracking over the internal target volume concept for stereotactic body radiation therapy of pancreatic cancer[J]. Radiat Oncol, 2017, 12(1):175. DOI:10.1186/s13014-017-0906-9. [12] Heinzerling JH, Anderson JF, Papiez L, et al. Four-dimensional computed tomography scan analysis of tumor and organ motion at varying levels of abdominal compression during stereotactic treatment of lung and liver[J]. Int J Radiat Oncol Biol Phys, 2008, 70(5):1571-1578. DOI:10.1016/j.ijrobp.2007.12.023. [13] Haji K, Royse A, Green C, et al. Interpreting diaphragmatic movement with bedside imaging, review article[J]. J Crit Care, 2016, 34(1):56-65. DOI:10.1016/j.jcrc.2016.03.006. [14] Wade OL. Movements of the thoracic cage and diaphragm in respiration[J]. J Physiol, 1954, 124(2):193-212. DOI:10.1113/jphysiol.1954.sp005099. [15] Kim WY, Suh HJ, Hong SB, et al. Diaphragm dysfunction assessed by ultrasonography:influence on weaning from mechanical ventilation[J]. Crit Care Med, 2011, 39(12):2627-2630. DOI:10.1097/CCM.0b013e3182266408. [16] Hu Y, Zhou YK, Chen YX, et al. Magnitude and influencing factors of respiration-induced liver motion during abdominal compression in patients with intrahepatic tumors[J]. Radiat Oncol, 2017, 12(1):9. DOI:10.1186/s13014-016-0762-z. [17] Lin LL, Hertan L, Rengan R, et al. Effect of body mass index on magnitude of setup errors in patients treated with adjuvant radiotherapy for endometrial cancer with daily image guidance[J]. Int J Radiat Oncol Biol Phys, 2012, 83(2):670-675. DOI:10.1016/j.ijrobp.2011.07.026. [18] Wong JR, Gao Z, Merrick S, et al. Potential for higher treatment failure in obese patients:correlation of elevated body mass index and increased daily prostate deviations from the radiation beam isocenters in an analysis of 1,465 computed tomographic images[J]. Int J Radiat Oncol Biol Phys, 2009, 75(1):49-55. DOI:10.1016/j.ijrobp.2008.07.049. [19] Choi M, Fuller CD, Wang SJ, et al. Effect of body mass index on shifts in ultrasound-based image-guided intensity-modulated radiation therapy for abdominal malignancies[J]. Radiother Oncol, 2009, 91(1):114-119. DOI:10.1016/j.radonc.2008.08.002. [20] Toledo NSG, Kodaira SK, Massarollo PCB, et al. Left hemidiaphragmatic mobility:assessment with ultrasonographic measurement of the craniocaudal displacement of the splenic hilum and the inferior pole of the spleen[J]. J Ultrasound Med, 2006, 25(1):41-49. DOI:10.7863/jum.2006.25.1.41. [21] Toledo NS, Kodaira SK, Massarollo PC, et al. Right hemidiaphragmatic mobility:assessment with US measurement of craniocaudal displacement of left branches of portal vein[J]. Radiology, 2003, 228(2):389-394. DOI:10.1148/radiol.2282011554. [22] Remouchamps VM, Letts N, Yan D, et al. Three-dimensional evaluation of intra-and interfraction immobilization of lung and chest wall using active breathing control:a reproducibility study with breast cancer patients[J]. Int J Radiat Oncol Biol Phys, 2003, 57(4):968-978. DOI:10.1016/s0360-3016(03)00710-7. [23] Gagel B, Demirel C, Kientopf A, et al. Active breathing control (ABC):determination and reduction of breathing-induced organ motion in the chest[J]. Int J Radiat Oncol Biol Phys, 2007, 67(3):742-749. DOI:10.1016/j.ijrobp.2006.09.052. [24] Hu Y, Zhou YK, Chen YX, et al. Clinical benefits of new immobilization system for hypofractionated radiotherapy of intrahepatic hepatocellular carcinoma by helical tomotherapy[J]. Med Dosim, 2017, 42(1):37-41. DOI:10.1016/j.meddos.2016.10.005.