Intrafractional gastric motion and interfractional stomach deformity during radiation therapy

Miho Watanabe, Koichi Isobe, Haduki Takisima, Takashi Uno, Naoyuki Ueno, Hiroyuki Kawakami, Naoyuki Shigematsu, Miki Yamashita, Hisao Ito

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background and purpose: To evaluate intrafractional gastric motion and interfractional variability of the stomach shape during radiation therapy (RT) for gastric lymphoma. Materials and methods: For 11 patients with gastric lymphomas, we undertook fluoroscopic examinations at the time of the simulation, and once a week during RT to evaluate inter- and intrafractional gastric variations. We recorded anteroposterior and left to right X-ray images at inhale and exhale in each examination. We gave coordinates based on the bony landmarks in each patient, and identified the most superior, inferior, lateral, ventral, and dorsal points of the stomach on each film. The interfractional motion was assessed as the distance between a point at inhale and the corresponding point at exhale. We also analyzed interfractional variation based on each point measured. Results: The intrafractional gastric motion was 11.7 ± 8.3, 11.0 ± 7.1, 6.5 ± 6.5, 3.4 ± 2.3, 7.1 ± 8.2, 6.6 ± 5.8 mm (mean ± SD) for the superior, inferior, right, left, ventral and dorsal points, respectively, which was significantly different between each point. The interfractional variability of stomach filling was -2.9 ± 14.4, -6.0 ± 13.4, 9.3 ± 22.0 mm for the superior-inferior (SI), lateral (LAT), and ventro-dorsal (VD) directions, respectively, and the differences of variabilities were also statistically significant. Thus, the appropriate treatment margins calculated from both systematic and random errors are 30.3, 41.0, and 50.8 mm for the SI, LAT, and ventro-dorsal directions, respectively. Conclusions: Both intrafractional gastric motion and interfractional variability of the stomach shape were considerable during RT. We recommend regular verification of gastric movement and shape before and during RT to individualize treatment volume.

Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalRadiotherapy and Oncology
Volume87
Issue number3
DOIs
Publication statusPublished - 2008 Jun

Fingerprint

Stomach
Radiotherapy
X-Rays
Therapeutics

Keywords

  • Gastric lymphoma
  • Interfractional shape
  • Intrafractional motion
  • Stomach

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Urology

Cite this

Watanabe, M., Isobe, K., Takisima, H., Uno, T., Ueno, N., Kawakami, H., ... Ito, H. (2008). Intrafractional gastric motion and interfractional stomach deformity during radiation therapy. Radiotherapy and Oncology, 87(3), 425-431. https://doi.org/10.1016/j.radonc.2007.12.018

Intrafractional gastric motion and interfractional stomach deformity during radiation therapy. / Watanabe, Miho; Isobe, Koichi; Takisima, Haduki; Uno, Takashi; Ueno, Naoyuki; Kawakami, Hiroyuki; Shigematsu, Naoyuki; Yamashita, Miki; Ito, Hisao.

In: Radiotherapy and Oncology, Vol. 87, No. 3, 06.2008, p. 425-431.

Research output: Contribution to journalArticle

Watanabe, M, Isobe, K, Takisima, H, Uno, T, Ueno, N, Kawakami, H, Shigematsu, N, Yamashita, M & Ito, H 2008, 'Intrafractional gastric motion and interfractional stomach deformity during radiation therapy', Radiotherapy and Oncology, vol. 87, no. 3, pp. 425-431. https://doi.org/10.1016/j.radonc.2007.12.018
Watanabe, Miho ; Isobe, Koichi ; Takisima, Haduki ; Uno, Takashi ; Ueno, Naoyuki ; Kawakami, Hiroyuki ; Shigematsu, Naoyuki ; Yamashita, Miki ; Ito, Hisao. / Intrafractional gastric motion and interfractional stomach deformity during radiation therapy. In: Radiotherapy and Oncology. 2008 ; Vol. 87, No. 3. pp. 425-431.
@article{5ff3eb95dbe64e5bb59b240cb1920e7d,
title = "Intrafractional gastric motion and interfractional stomach deformity during radiation therapy",
abstract = "Background and purpose: To evaluate intrafractional gastric motion and interfractional variability of the stomach shape during radiation therapy (RT) for gastric lymphoma. Materials and methods: For 11 patients with gastric lymphomas, we undertook fluoroscopic examinations at the time of the simulation, and once a week during RT to evaluate inter- and intrafractional gastric variations. We recorded anteroposterior and left to right X-ray images at inhale and exhale in each examination. We gave coordinates based on the bony landmarks in each patient, and identified the most superior, inferior, lateral, ventral, and dorsal points of the stomach on each film. The interfractional motion was assessed as the distance between a point at inhale and the corresponding point at exhale. We also analyzed interfractional variation based on each point measured. Results: The intrafractional gastric motion was 11.7 ± 8.3, 11.0 ± 7.1, 6.5 ± 6.5, 3.4 ± 2.3, 7.1 ± 8.2, 6.6 ± 5.8 mm (mean ± SD) for the superior, inferior, right, left, ventral and dorsal points, respectively, which was significantly different between each point. The interfractional variability of stomach filling was -2.9 ± 14.4, -6.0 ± 13.4, 9.3 ± 22.0 mm for the superior-inferior (SI), lateral (LAT), and ventro-dorsal (VD) directions, respectively, and the differences of variabilities were also statistically significant. Thus, the appropriate treatment margins calculated from both systematic and random errors are 30.3, 41.0, and 50.8 mm for the SI, LAT, and ventro-dorsal directions, respectively. Conclusions: Both intrafractional gastric motion and interfractional variability of the stomach shape were considerable during RT. We recommend regular verification of gastric movement and shape before and during RT to individualize treatment volume.",
keywords = "Gastric lymphoma, Interfractional shape, Intrafractional motion, Stomach",
author = "Miho Watanabe and Koichi Isobe and Haduki Takisima and Takashi Uno and Naoyuki Ueno and Hiroyuki Kawakami and Naoyuki Shigematsu and Miki Yamashita and Hisao Ito",
year = "2008",
month = "6",
doi = "10.1016/j.radonc.2007.12.018",
language = "English",
volume = "87",
pages = "425--431",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

TY - JOUR

T1 - Intrafractional gastric motion and interfractional stomach deformity during radiation therapy

AU - Watanabe, Miho

AU - Isobe, Koichi

AU - Takisima, Haduki

AU - Uno, Takashi

AU - Ueno, Naoyuki

AU - Kawakami, Hiroyuki

AU - Shigematsu, Naoyuki

AU - Yamashita, Miki

AU - Ito, Hisao

PY - 2008/6

Y1 - 2008/6

N2 - Background and purpose: To evaluate intrafractional gastric motion and interfractional variability of the stomach shape during radiation therapy (RT) for gastric lymphoma. Materials and methods: For 11 patients with gastric lymphomas, we undertook fluoroscopic examinations at the time of the simulation, and once a week during RT to evaluate inter- and intrafractional gastric variations. We recorded anteroposterior and left to right X-ray images at inhale and exhale in each examination. We gave coordinates based on the bony landmarks in each patient, and identified the most superior, inferior, lateral, ventral, and dorsal points of the stomach on each film. The interfractional motion was assessed as the distance between a point at inhale and the corresponding point at exhale. We also analyzed interfractional variation based on each point measured. Results: The intrafractional gastric motion was 11.7 ± 8.3, 11.0 ± 7.1, 6.5 ± 6.5, 3.4 ± 2.3, 7.1 ± 8.2, 6.6 ± 5.8 mm (mean ± SD) for the superior, inferior, right, left, ventral and dorsal points, respectively, which was significantly different between each point. The interfractional variability of stomach filling was -2.9 ± 14.4, -6.0 ± 13.4, 9.3 ± 22.0 mm for the superior-inferior (SI), lateral (LAT), and ventro-dorsal (VD) directions, respectively, and the differences of variabilities were also statistically significant. Thus, the appropriate treatment margins calculated from both systematic and random errors are 30.3, 41.0, and 50.8 mm for the SI, LAT, and ventro-dorsal directions, respectively. Conclusions: Both intrafractional gastric motion and interfractional variability of the stomach shape were considerable during RT. We recommend regular verification of gastric movement and shape before and during RT to individualize treatment volume.

AB - Background and purpose: To evaluate intrafractional gastric motion and interfractional variability of the stomach shape during radiation therapy (RT) for gastric lymphoma. Materials and methods: For 11 patients with gastric lymphomas, we undertook fluoroscopic examinations at the time of the simulation, and once a week during RT to evaluate inter- and intrafractional gastric variations. We recorded anteroposterior and left to right X-ray images at inhale and exhale in each examination. We gave coordinates based on the bony landmarks in each patient, and identified the most superior, inferior, lateral, ventral, and dorsal points of the stomach on each film. The interfractional motion was assessed as the distance between a point at inhale and the corresponding point at exhale. We also analyzed interfractional variation based on each point measured. Results: The intrafractional gastric motion was 11.7 ± 8.3, 11.0 ± 7.1, 6.5 ± 6.5, 3.4 ± 2.3, 7.1 ± 8.2, 6.6 ± 5.8 mm (mean ± SD) for the superior, inferior, right, left, ventral and dorsal points, respectively, which was significantly different between each point. The interfractional variability of stomach filling was -2.9 ± 14.4, -6.0 ± 13.4, 9.3 ± 22.0 mm for the superior-inferior (SI), lateral (LAT), and ventro-dorsal (VD) directions, respectively, and the differences of variabilities were also statistically significant. Thus, the appropriate treatment margins calculated from both systematic and random errors are 30.3, 41.0, and 50.8 mm for the SI, LAT, and ventro-dorsal directions, respectively. Conclusions: Both intrafractional gastric motion and interfractional variability of the stomach shape were considerable during RT. We recommend regular verification of gastric movement and shape before and during RT to individualize treatment volume.

KW - Gastric lymphoma

KW - Interfractional shape

KW - Intrafractional motion

KW - Stomach

UR - http://www.scopus.com/inward/record.url?scp=46549090056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46549090056&partnerID=8YFLogxK

U2 - 10.1016/j.radonc.2007.12.018

DO - 10.1016/j.radonc.2007.12.018

M3 - Article

C2 - 18207268

AN - SCOPUS:46549090056

VL - 87

SP - 425

EP - 431

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 3

ER -