Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control
Abstract Background Respiratory motion management with breath hold for patients with hepatobiliary cancers remain a challenge in the precise positioning for radiotherapy. We compared different image-guided alignment markers for estimating positional errors, and investigated the factors associated wi...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-020-07082-y |
| _version_ | 1819049017664864256 |
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| author | Tzu-Jie Huang Yun Tien Jian-Kuen Wu Wen-Tao Huang Jason Chia-Hsien Cheng |
| author_facet | Tzu-Jie Huang Yun Tien Jian-Kuen Wu Wen-Tao Huang Jason Chia-Hsien Cheng |
| author_sort | Tzu-Jie Huang |
| collection | DOAJ |
| description | Abstract Background Respiratory motion management with breath hold for patients with hepatobiliary cancers remain a challenge in the precise positioning for radiotherapy. We compared different image-guided alignment markers for estimating positional errors, and investigated the factors associated with positional errors under breath-hold control. Methods Spirometric motion management system (SDX) for breath holds was used in 44 patients with hepatobiliary tumor. Among them, 28 patients had a stent or embolized materials (lipiodol) as alignment markers. Cone-beam computed tomography (CBCT) and kV-orthogonal images were compared for accuracy between different alignment references. Breath-hold level (BHL) was practiced, and BHL variation (ΔBHL) was defined as the standard deviation in differences between actual BHLs and baseline BHL. Mean BHL, ΔBHL, and body-related factors were analyzed for the association with positional errors. Results Using the reference CBCT, the correlations of positional errors were significantly higher in those with stent/lipiodol than when the vertebral bone was used for alignment in three dimensions. Patients with mean BHL > 1.4 L were significantly taller (167.6 cm vs. 161.6 cm, p = 0.03) and heavier (67.1 kg vs. 57.4 kg, p = 0.02), and had different positional error in the craniocaudal direction (− 0.26 cm [caudally] vs. + 0.09 cm [cranially], p = 0.01) than those with mean BHL < 1.4 L. Positional errors were similar for patients with ΔBHL< 0.03 L and > 0.03 L. Conclusion Under rigorous breath-hold respiratory control, BHL correlated with body weight and height. With more accurate alignment reference by stent/lipiodol, actual BHL but not breath-hold variation was associated with craniocaudal positional errors. |
| first_indexed | 2024-12-21T11:25:28Z |
| format | Article |
| id | doaj.art-bf217b7496c24696add282ccabad3196 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-21T11:25:28Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-bf217b7496c24696add282ccabad31962022-12-21T19:05:40ZengBMCBMC Cancer1471-24072020-07-012011910.1186/s12885-020-07082-yImpact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory controlTzu-Jie Huang0Yun Tien1Jian-Kuen Wu2Wen-Tao Huang3Jason Chia-Hsien Cheng4Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of MedicineTaoyuan Psychiatric Center, Ministry of Health and WelfareDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of MedicineDepartment of Medical Imaging and Radiological Technology, Yuanpei University of Medical TechnologyDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of MedicineAbstract Background Respiratory motion management with breath hold for patients with hepatobiliary cancers remain a challenge in the precise positioning for radiotherapy. We compared different image-guided alignment markers for estimating positional errors, and investigated the factors associated with positional errors under breath-hold control. Methods Spirometric motion management system (SDX) for breath holds was used in 44 patients with hepatobiliary tumor. Among them, 28 patients had a stent or embolized materials (lipiodol) as alignment markers. Cone-beam computed tomography (CBCT) and kV-orthogonal images were compared for accuracy between different alignment references. Breath-hold level (BHL) was practiced, and BHL variation (ΔBHL) was defined as the standard deviation in differences between actual BHLs and baseline BHL. Mean BHL, ΔBHL, and body-related factors were analyzed for the association with positional errors. Results Using the reference CBCT, the correlations of positional errors were significantly higher in those with stent/lipiodol than when the vertebral bone was used for alignment in three dimensions. Patients with mean BHL > 1.4 L were significantly taller (167.6 cm vs. 161.6 cm, p = 0.03) and heavier (67.1 kg vs. 57.4 kg, p = 0.02), and had different positional error in the craniocaudal direction (− 0.26 cm [caudally] vs. + 0.09 cm [cranially], p = 0.01) than those with mean BHL < 1.4 L. Positional errors were similar for patients with ΔBHL< 0.03 L and > 0.03 L. Conclusion Under rigorous breath-hold respiratory control, BHL correlated with body weight and height. With more accurate alignment reference by stent/lipiodol, actual BHL but not breath-hold variation was associated with craniocaudal positional errors.http://link.springer.com/article/10.1186/s12885-020-07082-yRadiotherapyBreath holdingHepatocellular carcinomaPatient positioningRadiotherapy planningComputer-assisted/methods |
| spellingShingle | Tzu-Jie Huang Yun Tien Jian-Kuen Wu Wen-Tao Huang Jason Chia-Hsien Cheng Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control BMC Cancer Radiotherapy Breath holding Hepatocellular carcinoma Patient positioning Radiotherapy planning Computer-assisted/methods |
| title | Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control |
| title_full | Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control |
| title_fullStr | Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control |
| title_full_unstemmed | Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control |
| title_short | Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control |
| title_sort | impact of breath hold level on positional error aligned by stent lipiodol in hepatobiliary radiotherapy with breath hold respiratory control |
| topic | Radiotherapy Breath holding Hepatocellular carcinoma Patient positioning Radiotherapy planning Computer-assisted/methods |
| url | http://link.springer.com/article/10.1186/s12885-020-07082-y |
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